Medically reviewed by Dr. Tom Biernacki, DPM
Board-certified podiatric surgeon | Balance Foot & Ankle, Howell & Bloomfield Hills, MI
Last reviewed: May 2026
High arches near Hartland create predictable damage at five anatomical sites — but a high-arched foot can also be the first visible sign of a neurological condition that hasn’t yet caused other symptoms. One clinical test performed in-office distinguishes structural cavus from neurological cavus in under 2 minutes. Call (810) 206-1402 for a high arch evaluation.
Medically Reviewed by: Dr. Tom Biernacki DPM · Board-Certified Podiatrist · Balance Foot & Ankle PLLC · Updated 2026
High Arch Foot Treatment Near Hartland, MI
High arch foot (cavus) evaluation and treatment near Hartland, MI is available at Balance Foot & Ankle in Howell. Dr. Biernacki DPM performs the Coleman block test to distinguish flexible from rigid hindfoot varus, conducts neurological evaluation for Charcot-Marie-Tooth disease in progressive cases, and manages lateral ankle instability, peroneal tendon issues, and stress fractures caused by the cavus foot’s rigid high-load mechanics. Call (810) 206-1402.
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The High-Arch Foot: Why Rigid High Arches Cause Injury
While flat feet are associated with overpronation and medial column overload, the high-arch (cavus) foot creates the opposite problem — rigid supination with lateral column overload, poor shock absorption, and concentrated pressure under the metatarsal heads and heel. The cavus foot is defined by an elevated longitudinal arch (increased calcaneal pitch on lateral weight-bearing X-ray, usually >30°) with hindfoot varus alignment. It is significantly less common than flat feet but causes a specific cluster of problems that disproportionately affects athletes: recurrent lateral ankle sprains (varus hindfoot predisposes to inversion), peroneal tendon pathology (lateral loading stress), metatarsal stress fractures (rigid, non-compliant forefoot unable to distribute impact), plantar fasciitis (tight plantar fascia and intrinsic muscles), and lateral column pain (sinus tarsi and calcaneocuboid joint impingement). The most important evaluation for new cavus foot patients: neurological workup. Approximately 60-70% of cavus feet in adults have an underlying neurological cause — the most common being Charcot-Marie-Tooth disease (hereditary motor and sensory neuropathy), which produces progressive bilateral symmetric cavovarus deformity. Any adult with a new or progressive high arch should have neurological evaluation including EMG/NCV and family history. Coleman block test: A forefoot-driven cavus (plantarflexed 1st ray causing hindfoot to compensate into varus) — when the lateral forefoot is off-loaded on a block, the hindfoot varus corrects → flexible, treat the forefoot. Fixed hindfoot varus that does not correct = rigid deformity requiring hindfoot correction.
Key Takeaway: New or progressive high arch in an adult = neurological workup (Charcot-Marie-Tooth). Coleman block test distinguishes forefoot-driven (flexible hindfoot, treat forefoot) from fixed rigid hindfoot (treat hindfoot). Custom orthotics with lateral forefoot posting + lateral flange for ankle support. Surgical: 1st metatarsal dorsiflexion osteotomy for forefoot-driven; calcaneal osteotomy for rigid hindfoot varus. Recurrent ankle sprains = cavus foot until proven otherwise.
Treatment: Supporting Lateral Stability
Conservative treatment: Custom orthotics with lateral forefoot wedge/posting to reduce the plantarflexed 1st ray driving hindfoot varus. Lateral ankle brace (lace-up or semi-rigid) to compensate for ligamentous laxity from recurrent sprains. Wide toe box shoes with cushioned midsoles (avoid motion-control shoes designed for flat feet — they worsen cavus alignment). Stretching of plantar fascia and intrinsic foot muscles. Achilles/gastrocnemius stretching for equinus component. Surgical correction: Depends on Coleman block test result. Forefoot-driven (flexible hindfoot): 1st metatarsal dorsiflexion osteotomy (elevates the plantarflexed 1st ray, allowing hindfoot to correct to neutral). Rigid hindfoot varus: calcaneal osteotomy (lateral displacement or Dwyer closing wedge). Plantar fascia release for rigid intrinsic equinus. Peroneus longus to brevis tenodesis to augment eversion strength. Combined procedures often required for severe deformity.
⚠️ See a Podiatrist If:
- Recurrent lateral ankle sprains — cavus/varus alignment driving repeated inversion injuries
- High arch that is progressively getting higher — neurological evaluation urgent
- Family history of high arches with foot drop or leg weakness — Charcot-Marie-Tooth evaluation
- Lateral forefoot calluses or metatarsal stress fractures — rigid cavus foot overload
- Foot drop or difficulty clearing the floor while walking — neurological cause
OrthoInfo – AAOS: Cavus Foot (High-Arched Foot)
Getting to Our Office From Hartland
Our Howell office at 4330 E Grand River Ave, Howell, MI 48843 is about 10 minutes from Hartland via US-23 or M-59. We accept most major insurance. Call (810) 206-1402 or book online.
High Arch Causing Ankle Problems? Get a Cavus Foot Evaluation
Balance Foot & Ankle · Serving Hartland & Michigan
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📋 Dr. Tom Biernacki, DPM, FACFAS answers:
High arched feet (cavus foot) near Hartland are treated with custom orthotics that fill the arch space and redistribute pressure across the entire plantar surface, cushioning shoes with extra depth, and physical therapy stretching the plantar fascia and calf muscles. Ankle bracing may be needed for associated instability. In progressive cases surgical correction and tendon transfers restore balanced foot mechanics. Our podiatry clinic serving Hartland offers comprehensive cavus foot evaluation and custom orthotic casting.
Dr. Tom Biernacki, DPM is a board-certified foot & ankle surgeon (ABFAS & ABPM) 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 made him one of the most-followed foot & ankle educators on YouTube.