High arches, ‘cavus’ or ‘cavo-varus’ means the arch under your foot is too high. This can be associated with the heel tipping inwards, the ankle tipping outwards and the whole foot can even swing inwards.

There are lots of causes for high arches. Some people are born with it and it may be totally normal for some people. Having high arches often stiffens the foot and there is one school of thought that a mild high arch can actually improve the function of the foot and lots of sports players have high arches. If the foot works well and doesn’t hurt, the shape doesn’t matter, this may be the way your foot was designed and can be completely normal for you. In this instance, to surgically change the foot to a different shape would actually stop it working properly and could cause more damage.

Some people are born with one or two feet with abnormally high arches that prevent the foot working normally. There may be a cause that can be corrected with insoles or surgery and in these instances, the function of the foot can be improved by correcting the shape.

In other cases a person may develop high arches over time, it can be related to injuries to the nerves or brain such as nerve or spinal trauma or stroke. It can also be related to some conditions such as Charcot Marie-Tooth. The overriding cause should always be considered and investigated properly unless the cause is already known.

If the foot is becoming sore, not working properly or you are worried it is collapsing more then you should visit your doctor. Treatment depends on the underlying cause and also the exact foot shape. It may require physiotherapy, podiatric input, insoles, specific footwear, surgery, or a mixture of some or all of these.

Surgical treatment may involve simple minor procedures, but often requires a full reconstruction. If the joints still move well then the foot can be corrected by reconstructing, lengthening or transferring tendons, reconstructing ligaments, , realigning joints, cutting and moving some of the bones. If the foot shape has been abnormal for some time the joints may become stiff and arthritic and then joints may need to be “fused” together. The surgery required is very bespoke to the exact cause, the shape of the foot and condition of the joints. An experienced foot and ankle surgeon will be able to assess your foot and X-rays to decide exactly which operation would improve your foot shape.

After surgery you will be in a cast and will likely spend the night in hospital. You will need to spend two weeks with the foot elevated to minimise swelling. After two weeks you will need to have a review to check the wound has healed well and to remove the stitches. It is likely you will be ‘non weight bearing’ for several weeks (usually 6), often followed by a period in a protective boot (often another 6 weeks).

It is imperative you do not smoke or use an e-cigarette after surgery as this prevents healing and raises the risk of infection.