Why People with “High Arches” Can’t Find Orthotics That Work and How Finding the Right Orthotic Can Prevent Annoying, Chronic Foot & Ankle Pain
by Tamer Issa, PT, DPT
If you have “high arches”, you probably know it. You’ve compared your feet with others with “low arches” or “flat feet” and noticed the dramatic difference. You’ve probably been told over the years by a doctor, podiatrist, therapist, or shoe salesperson that you have high arches and you weren’t sure if that was a good thing or a bad thing.
Recently I had a patient with pain in the ball of the foot, heel, and Achilles tendon tell me that orthotics have never worked for her "high arches". I explain why below and in this video.
Whether having high arches is better or worse than having flat feet is irrelevant, because they both present with their own unique set of challenges. If you have high arches and you have had difficulty finding the right shoes or orthotics to support your feet, I’m not surprised and you should keep reading. I will simply explain why and I’ll also explain how your specific foot type leads to certain types of foot and ankle pain.
Most of the orthotics out on the market are geared towards and marketed to those with flat feet. We have all heard that finding shoes with arch support is better for us and that wearing flats or sandals without arch support is not good for us. It's been reported that approximately 10-20% of the population have high arches… maybe that’s why we don’t hear about orthotics or shoes that are geared towards those who have the opposite problem.
Let’s first breakdown the anatomy and biomechanics. This foot type is also known as a “supinated foot” or in medical terms, a “pes cavus” foot. This foot type is more complex and biomechanically more challenging. It leads to compensating with too much supination of the foot with walking. Below is an example of a foot that is supinated versus a pronated foot. The excessively supinated foot is more rigid and lacks mobility, which makes it less adaptable to uneven surfaces. It also transmits more shock to the ankle, knee, and hip.
Here are the classic characteristics of a high arch “supinated foot”:
- Very rigid foot
- A well-defined arch that sits higher off the ground
- The forefoot and big toe is pointed downward
- The rearfoot is pointed inward
- Excessive pressure on the ball of the foot and heel
A high arch foot type can lead to the following problems:
- Plantar Fasciitis (pain along the bottom of the foot near the base of the heel)
- Metatarsalgia (pain in the ball of the foot)
- Hammer Toes and Claw Toes (deformities of the toes)
- Achilles Tendonitis (overloading of the tendon that attaches to the back of the heel)
- Sesamoiditis and Sesamoid Fractures (bone pain at the base of the big toe)
- Ankle Instability (ankle sprains)
- Ankle Arthritis (arthritis due to overloading of the ankle joints)
Most of the problems related to a “supinated” foot type are due to excessive pressure on certain areas (big toe, metatarsals, heel), excessive plantar flexion overloading certain tissue (plantar fascia, Achilles tendon), and rigidity overloading other joints of the foot and ankle (arthritis, instability).
So, back to the original question. People with high arches have difficulty finding orthotics that work for them because most over-the-counter orthotics are not designed to support the shape of a high arched foot. They are designed to support the shape of a low arched foot. So they won’t be comfortable or they will cause compensations and pain elsewhere.
The only orthotic that I have found that is suitable for the high arched foot is the Vasyli Hoke supination orthotic. They are designed specifically for the biomechanical structure of the “supinated” high arched foot. We use the Vasyli medical custom orthotic product line because they have taken the time to design orthotics that support the biomechanical structure of various foot types and they meet the comfort needs of most people with various foot conditions.
If you have high arches, tell me about your experience. What problems have you noticed over time? What have you found that works and what doesn't work?