Due to the relative stiffness of high arched feet insoles and the appropriate footwear are absolutely crucial. High arched feet present with reduced area of weight bearing surface and lead to an overload of those. When conservative treatment does not achieve sufficient protection and pain relief, operations can be very helpful to reduce the overload and pain. A combination of bony and soft tissue procedures will be necessary and experienced surgeons are able to assess the amount of surgery needed to provide a better alignment, reduce the overload and improve the gait pattern.
Whereas flat feet commonly are flexible feet, high arched feet tend to be rather stiff feet which can lead to overload on the sole of the foot. When the ankle/hindfoot tilts outwards into a so-called varus position certain structures, especially tendons and joints on the outside of the foot are prone to be overstressed. As for other conditions, there is a multitude of reasons why a foot is high arched but neurological disorders, trauma and genetics are the more common reasons. Especially the neurological cavus feet might be at risk of progressing over the years, hence a thorough history, clinical assessment and the input of a neurologist will help to clarify the diagnosis and the treatment plan.