Cavus foot / High arched feet
First-off let me say that I am not a medical professional. I am a librarian who recently found out that my chronic foot pain problems come from the fact that I have cavus feet. I am sharing what I have learned with the internet in hopes of helping others find foot relief faster (and cheaper) than I did. All of the information I present is either sourced (click on images to see where I got them from) or my personal opinion based on my experience.
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| Taken from Foot Health 4 Kids |
High arched feet put excessive pressure on the heel and bones of the forefoot - the metatarsal bones. In regular arched feet the flex of the foot and the angle of the arch deflect pressure from these areas. In high arched feet, the pressure is not deflected, which creates an environment where inflammation and pain, often in the forms of plantar fasciitus (heel pain) and metatarsalgia (forefoot pain, usually under the ball of the big toe or all the way across the front of the foot) can easily develop.
Common treatment for cavus foot is to wear orthotics that may have some traditional arch support, but will also have a special raised padded section just behind the forefoot to cushion the metatarsal heads and to help change the angle of the bones to even out pressure in the forefoot when you step down. Sometimes people can simply use metatarsal pads adhered to the insole of their shoes to provide the support and cushioning they need. For example, Pedag makes a 3/4 length insole that has only the metatarsal pad support.
All of this is nice, if you like wearing closed-toe shoes, but if you prefer sandals like me, you are out of luck. I have yet to find a good metatarsal pad that will work with sandals (too high or not high enough). Plus the pads often have a surface that assumes you will be wearing a sock, so the pad itself may make your foot feel sweaty or a gel form can stick uncomfortably to your skin.
Below are a few recommendations I have for shoes that have worked for me. I suffered from chronic metatarsalgia for several years, starting off intermittent and rather mild, and then escalating to almost crippling when I moved to an apartment with tile floors and worked in a building with thin carpet over concrete floor. Increasing my step count to 15,000 steps a day to lose weight did not help the situation at all.
1. If you are in active pain from metatarsalgia, I recommend that you see a podiatrist and get custom orthotics made. It can be costly, and may take a few weeks to have the appointment and then have the orthotics made, but it is the fastest way to get rid of the pain. You will have to wear your orthotics with closed-toe shoes until you are pain free. For me, that took between 4 and 6 weeks. I felt immediate comfort when wearing the orthotics while walking, but the inflammation that causes the achy and tired feeling in my feet took time to go away.
2. Whether you choose to see a podiatrist or not, you can immediately change the kind of footwear you are wearing to help relieve the pain and ultimately get rid of the inflammation in your forefoot.
- High heels are out for daily wear - depending on your tolerance you may be able to wear them for special occasions or not. I have never been comfortable in high heels, and often thought women who said they were comfortable were crazy. Now I know that we just have different feet, and if they had my feet, they wouldn't wear high heels either.
- You want to find shoes that have a very soft, almost squishy texture under your forefoot/ball of your foot. Finding a good balance between softness and the necessary firmness for durability can be frustrating. The vast majority of shoes are too hard under the forefoot for cavus feet. Say goodbye to the super thin leather soles, or to hard platform shoes. Memory foam in the insole may provide enough cushion and shock absorption for your feet, or it may end up being too thin of a layer to provide the cushioning you need. If you are currently in pain, wear super cushy athletic shoes/running shoes - you will find some immediate relief from pain. Without custom orthotics addressing the pressure points in your forefoot it will take longer to get rid of the chronic inflammation. Depending on how severe your cavus foot is, you may not be able to get rid of the inflammation without shoe modifications like orthotics or metatarsal pads.
- Get some metatarsal pads and try them out. Look to online videos to help you with pad placement on your insoles. The pads need to be just behind the metatarsal heads, not directly under them, for best results. Pharmacies and specialty stores like running shoe stores or medical supply stores are most likely to have metatarsal pads in stock. If you can't find any locally, there are dozens of places online that come up when you search for metatarsal pads.
- Because of the shape of the foot bed, many people may find relief wearing Birkenstock shoes. Their footbeds have a metatarsal support built in, but I find the standard cork foot bed is too hard for my feet. However, I can wear their soft foot bed styles, which are a regular foot bed with a layer of memory foam for cushioning. I can wear them to work and walk 6,000 - 10,000 steps in a day without real discomfort, but I don't wear them two days in a row. While generally comfortable, they still don't have as much cushioning as my feet like. Mephisto makes similar kinds of shoes, and some of their styles also have the memory foam in the foot bed and I wear them to work without problems as long as I don't wear either pair back to back or for several days in a row.
- You may want to look at rocker bottom shoes as well. Rocker bottoms have a curved outer sole that creates a rocking motion when you walk, which can take pressure off of both your forefoot and your heel. The down side to these shoes is that they can be expensive, and the shoes have a definitely chunky look to them, since the sole is thicker to accommodate the rocker curve. However, there are closed-toe options, Mary-jane styles, sandals, and athletic shoes, so if you like how your feet feel in rocker-bottomed shoes, you have options for different activities. MBT is perhaps the best known brand for rocker bottom shoes as they have retail stores in some malls.
- For a more economical option, look into Sketchers shoes. They have many styles that have memory foam foot beds, and super cushiony soles. They also have a rocker bottom style. The ShapeUps line has been recommended online for people with metatarsalgia. I tried a pair of their GoWalk memory foam shoes and found them plenty cushiony, but while wearing them to work I found they were a bit too flexible for my foot. You may find them comfortable, and since there are many retail outlets, go check them out.
Here are some shoes that I have found work well for my feet. I am plump, which adds to the stress my feet feel, and lightly active on a general basis, meaning I generally walk between 6 and 8,000 steps a day 5 days a week.
Fitflops
Any of the styles you find comfortable with the thick/standard foot bed. There are some higher priced and more fashionable styles by Fitflop that look great, but have thinner and firmer soles that I didn't like on my foot. I have worn the pair of Surfa textile Fitflops below while traveling and walked 12 - 14,000 steps a day without pain. At the end of the day my feet did feel tired, but they didn't actively hurt. I wear them every weekend, and when I return home from work due to my hard, tiled floors. While I have only seen one or two styles of FitFlops in stores, and always some form of thong, there are hundreds of styles online including closed-toe shoes. Some styles may be work appropriate for your place of employment, so check out their site.
SAS (San Antonio Shoes)
There are some excellent closed toe shoe options for people who wear orthotics, and some fabulous sandals. My favorite pair of shoes is the Sorrento style. It's absolutely the most comfortable pair of sandals I have ever owned. The Pampa style looks great, and the sole looks similar to the Sorrento, but is about 80% as comfortable. The forefoot is less cushioned feeling, which means I can wear the shoes to work, but like my Birks and Mephisto pairs I wouldn't wear them multiple days in a row. I want to explore some of the other sandal styles, but I am over the moon that the Sorrento are so comfortable for me.
There are some excellent closed toe shoe options for people who wear orthotics, and some fabulous sandals. My favorite pair of shoes is the Sorrento style. It's absolutely the most comfortable pair of sandals I have ever owned. The Pampa style looks great, and the sole looks similar to the Sorrento, but is about 80% as comfortable. The forefoot is less cushioned feeling, which means I can wear the shoes to work, but like my Birks and Mephisto pairs I wouldn't wear them multiple days in a row. I want to explore some of the other sandal styles, but I am over the moon that the Sorrento are so comfortable for me.
Birkenstock Soft Footbed
As I mentioned before, some people may find that Birkenstock shoes solve their metatarsalgia issues. Due to a need for shock absorption and cushioning, I recommend sticking to the soft food bed styles. I have a pair of Florida soft footbed Birkenstocks, and they work well for occasional wear. The following styles currently have the soft foodbed option - if it isn't available locally you may have to order them online: Arizona, Bali, Florida, Gizeh, Grenada, Milano and the Boston clog.
Mephisto
Mephisto has both sandals and lace up shoes, but I have only ever tried on their sandals. Not all styles have metatarsal support, but the Helen has been recommended online for people with metatarsalgia. I have the Hannel style, which has the same footbed as the Helen, but doesn't put anything between my toes. If you look at the footbed, you can see the metatarsal bump just behind the ball of the foot region on the insole.
If you have a great pair of shoes that have helped your high arched feet, leave me a comment below. After I was diagnosed with high arches, I found it frustrating to do shoe research online, so any new information I can get would be greatly appreciated.
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And now, a few words about "barefoot" shoes
Born to Run: A Hidden Tribe, Superathletes, and the Greatest Race the World Has Never Seen is an absolutely amazing book and even better in audiobook format. I, like countless others, have been inspired by the story of indigenous runners in Copper Canyon who run barefoot, and the proposed theory of running barefoot. In many ways this book helped spark a barefoot running/barefoot-style shoe renaissance in the United States. I even gave barefoot running a good year effort. The only effort I ever really made at running.
Part of the popular conception of barefoot running is the idea that it's better bio-mechanically for your feet. From that came the idea that if you must wear shoes, wear shoes that allow you foot to move as if you were walking barefoot. This means a shoe with a wide toe box and pretty much no internal structure or support. Barefoot shoes are very thin-soled and flexible.
Supposedly, barefoot walking/running and barefoot shoes are better for every kind of feet, even flat feet. I have run (ha ha) into the one major caveat to that statement - barefoot shoes are great for every kind of foot EXCEPT cavus feet / high arched feet. I am not speaking without experience. I was a devoted member of the barefoot shoes are best brigade for 7 years. Whenever my feet hurt, which happened with greater frequency once I gained 50 lbs, or when I did a lot of walking, I told myself that my feet just needed more time to strengthen up and be pain free. Eventually my chronic metatarsalgia became so bad it drove me to a podiatrist even knowing that I would likely be given orthotics.
Regular shoes are often called "foot coffins" by barefoot enthusiasts, and I bought into that orthodoxy completely. It's amazing how much pain it took for me to change my course of action and way of thinking. In general, yes, barefoot walking is excellent for you. Barefoot running may or may not be excellent, depending on which study you read this week. Barefoot shoes may be great, as long as your feet are happy. But if your feet hurt, and the pain does not resolve over time, but grows worse, then you should try something else.
I have friends who are still barefoot enthusiasts, and as soon as I mentioned that my feet hurt, they recommended that I get a pair of Vibram fivefinger shoes. I have had 3 pairs of the darn things - pain is a great teacher, and stubbornly continuing to do something that causes you pain is foolish. Beware of allowing your thinking to become so rigid that real world feedback like pain can't break through it.
