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High arches und cavus foot

High arches are characterised by a longitudinal arch that is too high. The foot appears short and deformed. There are callouses in the ball of the foot and the heel area.  It occurs typically during growth and tends to be hereditary. The cause is frequently a muscle imbalance in the foot musculature which gives rise to the defective position. The position can become fixed over the years such that passive correction of the foot is no longer possible.  It is often accompanied by toe deformities like claw toes or mallet toes.


High arch differences 

A distinction is made between the following forms of high arches:

  • Complete high arch/ Cavus foot: even steep positioning of the entire forefoot and lowering of the hind foot when weight is applied.
  • Medial cavus foot/ Pes cavovarus: in contrast to complete high arches there is an axial tilt of the hind foot when weight is applied
  • Heel cavus foot: special form which is characterised by restricted function of the calf musculature

A pronounced high arch restricts the movement process and causes pain when weight is applied. There is an increased risk of twisting the ankle with medial cavus foot/ cavovarus. Here is also the long-term risk of developing arthritis in the ankle.


The first thing to be documented in an examination is the range of movement. This is followed by a neurological examination to assess the muscles and nerves. A gait analysis gives good information about the position of the foot stance and swing phase during gait. This also allows good analysis of the adjunct joints during movement.

It is important to distinguish between complete high arches, medial cavus foot and heel cavus foot.  An X-ray examination is essential for this.


Treatment depends on the severity of the foot deformity. The muscles of the foot should be trained and stretched. Therefore, physiotherapy is important. Soft insoles support this procedure. If there is a pronounced loss of strength in the musculature, then lower-leg orthoses should be prescribed to compensate for the lacking muscle strength, so countering the advance of the deformity.

If the deformity is very pronounced, there is no other option than surgery. Correction of the toe deformities should also be considered in this. Post-operative provision with an orthosis is particularly important, at least temporarily.

An operation should certainly be performed by a foot specialist.

Dr. Klotz is one of the most experienced specialists in the field of correction of incorrect foot positions.

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Along with my work as Senior Consultant at the University Hospital in Linz, I run my “Wahlarzt” [elective doctor] surgeries in Linz and Vienna. I will be pleased to give you comprehensive advice there.

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Chefarzt Orthopädie & Unfallchirurgie
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