The arch of the foot receives lifelong attention. Just the footsteps around the pool in childhood are evidence of this important structural element so critical for painless ambulation.

The basic structure of the foot is a tripod, with three major points of contact with the ground. These are the heel, the head of the first metatarsal, and the head of the fifth metatarsal. Whereas a flat foot has a large surface area of contact, a foot with high arches can have excessive pressure at these three points.

High Arches

Cavovarus Foot Causes

A foot develops high arches generally due to an imbalance of muscle strength. For this reason, a careful physical examination with attention to relative strength of the muscles is very important.

Common causes include hereditary sensorimotor neuropathy such as Charcot-Marie-Tooth disease, stroke, myelodysplasia, and sometimes the cause is completely unknown. Usually, a referral to a neurologist is prudent when cavus foot is symptomatic.


A set of high-quality weight-bearing (standing) x-rays are required for diagnosis, as well as a thorough physical examination. Sometimes, an MRI may be necessary if there is concern for a tear in the tendons or ligaments.

Related Injuries

Due to the abnormal stresses on the high-arched foot, there are some predictable patterns of chronic injury. Common injuries in high-arched feet include:

  • Painful calluses
  • Clawing of the toes
  • Recurrent ankle sprains
  • Peroneal tendinitis or tears
  • Sesamoiditis or fractures of the sesamoid
  • Painful bunionette
  • Lateral column overload (pain at the lateral border of the foot)
  • Arthritis
  • Stress fractures in the foot and ankle

Cavovarus Foot Treatment

Physical therapy to strengthen the muscles that are weak and improve balance.

Orthotics to normalize the foot’s contact with the ground and offload areas of pressure. Daily callus care will also decrease pain.

Occasionally surgery is necessary when the deformity is severe or recurrent, and all non-operative treatments fail. This reconstructive surgery must address the symptomatic problem as well as the shape of the foot.


★ ★ ★ ★ ★

I came to Dr. Dixon with a painful bunion, not really knowing what I could feasibly do about it. She asked me a lot of questions to understand not just what was happening with my foot, but what my concerns were. She took a lot of time to explain my options to me, both surgical and non-surgical, and made sure that I understood so that I could make the best decision for myself. She was amazing – I didn’t feel rushed, and felt really comfortable asking questions! I would trust her with any problems I had with my feet.

Katie Y.

★ ★ ★ ★ ★

What to say about Dr. Dixon other than she is a one woman wonder. My best friend took a12′ fall while helping a friend move a piece of furniture downstairs. He had a pilon fracture of his right leg and, because he is on SSI, I dispaired for his care. Was he going to be crippled for life? Would he get a surgeon that would be able to deal with the complexities of this accident? Would anyone care about him enough to ensure his rehab? Yes. He was! So fortunate to have had the great fortune to have Dr. Alexis Dixon as his surgeon and friend. She can be starchy, true, but that is because she cares to make sure that rehab, therapy, and directions are taken seriously. My friend is recovering from this accident and is now taking an SDI class. He has a way to go yet but its looking good. So grateful for Dr. Dixon.

Noël J.