High Arch Foot (Cavus Foot) Treatment in Michigan

Quick answer: High Arch Foot Cavus Michigan is a common foot/ankle topic that affects many patients. Effective treatment starts with a targeted diagnosis, conservative-first treatment, and escalation only when needed. We treat this regularly at our Howell and Bloomfield Hills practices. Call (810) 206-1402.

Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatric Surgeon — Balance Foot & Ankle, Howell & Bloomfield Hills, MI. Last updated April 2026.

While flat feet get the most attention in podiatric care, high arch feet (cavovarus or cavus feet) cause a distinctive and often underappreciated set of problems. The elevated arch concentrates ground forces under the heel and ball of the foot, reduces shock absorption, predisposes to lateral ankle instability and recurrent sprains, and increases the risk of lateral metatarsal and Jones fracture. At Balance Foot & Ankle in Southeast Michigan, Dr. Tom Biernacki evaluates cavus foot biomechanics comprehensively and provides targeted treatment for the full range of high-arch-related conditions.

What Causes High Arches?

Cavus foot most commonly has a neurological cause — Charcot-Marie-Tooth disease (CMT), the most common hereditary peripheral neuropathy, is the classic underlying condition and accounts for a significant proportion of cavovarus feet presenting to podiatry. Other neurological causes include spinal cord tethering, cerebral palsy, stroke, Friedreich’s ataxia, and peroneal nerve injury. Idiopathic cavus foot — without identifiable neurological cause — also occurs, often running in families. It is critical to identify neurological causes because they are progressive; the foot deformity is a window into systemic disease that may require neurology or neurosurgery co-management.

Clinical Features of Cavus Foot

The cavus foot has an elevated longitudinal arch, a plantarflexed first ray (the big toe side of the forefoot is lower than the fifth metatarsal side), a varus hindfoot (heel tilted inward), and clawing of the lesser toes from intrinsic muscle imbalance. On standing, the Coleman block test helps identify whether the hindfoot varus is driven by the plantarflexed first ray (flexible — corrects on the block) or is a fixed structural deformity of the calcaneus. This distinction determines whether soft tissue procedures alone can correct the deformity or whether bony procedures are needed.

Common complaints include: pain and callus under the 1st and 5th metatarsal heads (from high plantar pressure); recurrent ankle sprains and chronic ankle instability (from the supinated foot position that predisposes to inversion); stress fractures of the lateral metatarsals or fibula (from lateral column overload); claw toe pain from shoe pressure; and peroneal tendon pain or tears (from the overloaded peroneal tendons fighting the varus alignment).

Treatment

Conservative treatment centers on a lateral heel wedge orthotic that shifts weight medially, reducing the supination moment and lateral column overload. Custom orthotics for cavus feet are fabricated with deep heel cups to control hindfoot alignment and accommodative padding under the 1st and 5th metatarsal heads. Wide, roomy shoes with a stable heel counter are essential. Ankle bracing (lace-up brace or custom AFO) addresses recurrent instability. Physical therapy targeting peroneal strengthening and ankle proprioception helps compensate for the inherent instability of the high-arch foot.

Surgical treatment for symptomatic cavovarus foot includes: plantar fascia release (reduces the arch tension pulling the heel into varus); first metatarsal dorsiflexion osteotomy (elevates the plantarflexed first ray); peroneus longus-to-brevis transfer (reduces the plantarflexory pull on the first metatarsal and converts the longus to an active ankle evertor); calcaneal osteotomy (shifts the heel from varus to neutral alignment); and in fixed, arthritic deformity — triple arthrodesis. The surgical plan is customized based on the deformity components identified on examination and weight-bearing radiographs.

Frequently Asked Questions

High arches don’t have to mean chronic ankle sprains and foot pain. Contact Balance Foot & Ankle for a hands-on exam plus imaging when needed with Dr. Biernacki in Southeast Michigan.

Visit Balance Foot & Ankle — Same-Day Appointments Available

Our podiatry team serves patients throughout Michigan including Howell, Brighton, and Bloomfield Hills. If you’re dealing with heel pain, ingrown toenails, or a foot injury, we have same-day appointment availability.

Frequently Asked Questions

When should I see a podiatrist?

If symptoms persist past 2 weeks, affect your normal activity, or are accompanied by red-flag symptoms (warmth, redness, swelling, inability to bear weight).

What does treatment cost?

Most diagnostic visits and conservative treatments are covered by Medicare and major insurers. Out-of-pocket costs vary by your specific plan.

How quickly can I get an appointment?

Most non-urgent cases see us within 5 business days. Urgent cases (sudden pain, possible fracture) typically same or next business day.