Foot pain isn't resolving?
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Medically Reviewed | Dr. Tom Biernacki, DPM | Board-Certified Podiatric Surgeon | Balance Foot & Ankle, Michigan
Quick Answer:
Quick Answer: Cavus foot, or high arch, creates concentrated pressure on the heel and ball of the foot, causing pain and instability. Dr. Biernacki evaluates your arch structure and biomechanics to prescribe custom orthotics, bracing, or surgical correction if needed to restore normal weight distribution and eliminate pain.
Cavus foot, commonly called high arch, is a structural deformity where the arch of the foot is excessively elevated. This creates an unstable base of support and concentrates weight on the heel and the ball of the foot, leading to chronic pain, calluses, and increased risk of ankle sprains. At Balance Foot & Ankle, Dr. Tom Biernacki specializes in both conservative and surgical management of cavus foot to restore normal function and eliminate pain.
Understanding Cavus Foot
Cavus foot can be congenital (present from birth) or develop secondary to neurological conditions like Charcot-Marie-Tooth disease, cerebral palsy, or spinal cord injury. The high arch creates abnormal pressure distribution, leading to heel pain, metatarsalgia (ball of foot pain), toe deformities like hammertoes and clawing, and chronic ankle instability. Without proper treatment, cavus foot worsens over time and can lead to joint arthritis.
Conservative Treatment Options
Initial management focuses on reducing pressure and stabilizing the foot. Dr. Biernacki prescribes custom orthotics with arch support, lateral heel wedging, and forefoot cushioning to redistribute weight evenly. Proper footwear with firm arch support and wider toe box is essential. Strengthening and stretching exercises improve foot stability and reduce compensatory pain in the ankle and knee.
Surgical Correction
When conservative care fails, Dr. Biernacki may recommend surgical correction. Procedures include dorsal wedge osteotomy to lower the arch, plantar fascia release to improve flexibility, or combined procedures depending on the severity and associated deformities. Surgery is minimally invasive and restores normal arch height and foot mechanics.
Long-Term Management
After treatment, ongoing management with proper orthotics, footwear, and foot care prevents recurrence and complications. Dr. Biernacki coordinates with physical therapy to ensure optimal strength and flexibility, allowing patients to return to normal activities pain-free.
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✅ Pros / Benefits
- Custom orthotics dramatically reduce pain
- Surgical correction restores normal arch mechanics
- Minimally invasive surgical techniques
- Prevents long-term complications like arthritis
❌ Cons / Risks
- Requires proper footwear compliance
- Surgery involves recovery period
- Cavus foot is often lifelong condition requiring ongoing management
Dr. Tom Biernacki’s Recommendation
High arch feet are mechanically vulnerable. The pressure concentration on the heel and ball of the foot creates predictable problems down the line. By prescribing the right orthotics early and addressing any toe deformities surgically, I help my high-arch patients avoid chronic pain and keep their ankles stable for life.
— Dr. Tom Biernacki, DPM | Board-Certified Podiatric Surgeon | Balance Foot & Ankle
Frequently Asked Questions
Is cavus foot hereditary?
Cavus foot can be congenital or acquired. Congenital high arch often runs in families. Acquired cavus foot develops secondary to neurological conditions or injury. A thorough evaluation helps determine the cause.
Can custom orthotics fix my high arch?
Custom orthotics won’t change your arch structure, but they redistribute pressure, provide arch support, and reduce pain significantly. For most patients, proper orthotics eliminate symptoms without surgery.
When is surgery recommended for cavus foot?
Surgery is considered when conservative care fails after 8-12 weeks, when deformities worsen, or when secondary problems like hammertoes develop. Dr. Biernacki will discuss whether surgery is appropriate for your case.
What footwear should I wear with cavus foot?
Look for shoes with firm arch support, cushioning in the forefoot, a wider toe box, and a heel cup that prevents heel motion. Avoid flat shoes and sandals that provide no support.
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Dr. Tom Biernacki, DPM is a double board-certified podiatrist and foot & ankle surgeon at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has reached over one million views.
- Plantar Fasciitis: Diagnosis and Conservative Management (PubMed)
- Plantar Fasciitis (APMA)
- Diagnosis and Treatment of Plantar Fasciitis (PubMed / AAFP)
- Heel Pain (APMA)