Ankle & foot Orthopaedic Rehabilitation
High Arch Foot (Pes Cavus)
- Pain under the ball of the foot or heel
- Frequent ankle sprains
- Clawing of the toes
- Callus under the ball of the foot
Quick answer
A high arched foot absorbs shock poorly and concentrates load on the heel and the ball of the foot. This causes pain in those areas and makes ankle sprains more likely. Cushioning, foot strengthening and balance work manage most cases over eight to twelve weeks.
Typical recovery
8–12 weeks where symptomatic
A typical range, not a promise — how long it takes depends on how long it has been going on, and on what you do between appointments.
A high arch is the opposite of a flat foot: the arch stays raised even under load. The consequence is a rigid foot that absorbs shock poorly and loads a small area — the heel and the ball of the foot — heavily.
What it causes
- Pain under the ball of the foot or the heel
- Thick callus where the load concentrates
- Frequent ankle sprains, because the foot sits in a slightly turned-in position and has a smaller base of support
- Clawed toes
- Sometimes stress injuries in the foot from repeated concentrated loading
An important caveat
A high arch that develops or worsens, especially with toe clawing and weakness, can be a sign of an underlying neurological condition. Where the picture suggests it, we refer for neurological assessment rather than treating the foot alone.
How physiotherapy helps
- Cushioning and footwear advice — this foot type needs shock absorption, not arch support
- Strengthening the muscles on the outside of the ankle to reduce sprain risk
- Balance and proprioception training, given the higher sprain risk
- Calf and plantar fascia flexibility work
- Load management for running and standing tolerance
How long it takes
Eight to twelve weeks of strengthening and footwear change usually settles symptoms. The arch shape does not change, and treatment is about tolerating it well.
Medically reviewed by Nasir Mughees, BPT, MPT, Orthopaedic Physiotherapy · Last reviewed September 2026