Supination & High Arches

Your foot rolls outwards with supination.

Supination is the opposite of pronation; it is where the foot rolls outwards so that the lateral edge of the foot is mostly in contact with the ground, the foot may also have an extremely high arch. Those who excessively supinate may find their outer ankle and leg become painful as well as their arch; Shoes may wear out quite quickly towards the outer edge and morph into a “banana” like shape. A neutral shoe will help with this foot type. Formthotics™ could also be beneficial; however they will require modifying by a medical professional such as a podiatrist.

The pes cavus foot type is one in which the sole of the foot is markedly hollow when bearing weight, and the arch is rounded and high.

Pes cavus is often called; high instep, high arch, talipes cavus, cavoid foot, or supinated foot type.

A person with high arches (pes cavus) needs a biomechanical and functional assessment to determine whether they are at risk of long-term complications. As with any pain the most important starting place is obtaining a confirmed diagnosis from an experienced health professional. Any pain of sudden and severe onset must be investigated urgently by your podiatrist, doctor, or suitably qualified health professional.

Due to the high arch, an excessive amount of weight is placed on the ball and heel of the foot when walking or standing. A cavus foot can cause a variety of symptoms, including pain and instability. High arches can develop at any age, and can occur in one or both feet.

Symptoms of Pes Cavus

The arch of a cavus foot will appear high even when standing. In addition, one or more of the following symptoms may be present:

  • Hammertoes (bent toes) or claw toes (toes clenched like a fist)
  • Calluses (hard skin) on the ball, side, or heel of the foot
  • Pain in the ball of the foot, arches, heels and outside leg when standing or walking
  • Susceptibility to ankle sprains and ankle instability
  • Increased risk of trips and falls

The excess loading on the base of the big toe can predispose people to develop sesamoiditis; forces lead to repetitive stress on the tendons at the outside of the foot and leg, causing tendon and muscle overuse; forces are increased on the inside of the ankle causing pain.

The foot is also more susceptible to: ankle sprains; fractures on the outside of the foot (Jones fractures); and pain directly under the big toe (sesamoiditis).

An unstable foot due to the heel tilting inward can lead to ankle sprains

Some people with cavus foot may also experience foot drop, a weakness of the muscles in the foot and ankle that results in dragging the foot when taking a step. Foot drop is usually a sign of an underlying neurologic condition.

Management of Pes Cavus may include some of the following:  

Formthotics™ can help relieve symptoms of pes cavus.

Formthotics can provide the ideal base to cushion, support and unload pressure areas in people with high arches. The multiple density options allow your podiatrist to select Formthotics best for your feet, footwear and activity. Your Formthotics are then able to be customised by your clinician specifically for the needs of your feet.

As cushioning is essential in managing the high arched foot, Formthotics dual density products add a cushioning layer on top of a supportive base. The Formax™ dual density foam provides increased shock absorption and even pressure distribution while maintaining a good level of support to optimise foot function and general comfort. Soft single density Formthotics are also available and are often the base of choice for high arch feet.

Pes Cavus, high arched feet need to be well managed and we recommend you visit a podiatrist or medical professional.


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