Hollow Foot (Pes Cavus) Orthotics

by Mark Paigen 8 minute read

This blog explains Pes Cavus (hollow foot) and how to manage it with effective orthotics and exercises for long-term relief.

The Basics: TL;DR ---

Understanding Pes Cavus. A high, rigid arch that doesn’t flatten under pressure, leading to pain, instability, and mobility challenges.
Causes and Symptoms. Includes congenital issues, neurological disorders, trauma, or muscle imbalances. Symptoms like foot pain, claw toes, and instability are common.
Non-Surgical Treatment Options. Use orthotic insoles, supportive shoes, targeted exercises, and physical therapy to relieve pain and improve alignment.
Tread Labs Advantage. Tread Labs offers extra high arch support insoles with adjustable features that provide a customizable, durable, and cost-effective solution.

Need To Know ---

Pes cavus (high arch feet) can cause discomfort and foot problems without proper support. Tread Labs orthotics offer the highest over-the-counter arch support, modular design, and customizable options to provide targeted pain relief and stability for those with high arches, making them an excellent alternative to custom orthotics.

Shop Insoles for Pes Cavus

    1.   Understanding Pes Cavus: What is a Hollow Foot?
    2.   Pes Cavus Causes and Symptoms
    3.   Non-Surgical Pes Cavus Treatment Options
    4.   Why Tread Labs Orthotics Are Ideal for Pes Cavus
    5.   The Best Orthotics for Pes Cavus Relief

Understanding Pes Cavus: What is a Hollow Foot?

Pes cavus, also known as hollow foot or high arch feet, is a foot condition characterized by an unusually high arch that remains rigid, even under pressure. Unlike a normal foot structure, where the arch flattens slightly to help absorb shock, the arch on a pes cavus foot stays elevated causing uneven weight distribution.

Differences Between Pes Cavus and Normal Foot Structures

In a typical foot, the arch supports body weight by flexing and flattening with each step, which helps distribute pressure evenly across the foot. However, in a pes cavus deformity, the arch remains inflexible, resulting in most of the pressure being concentrated on the forefoot and heel. This lack of shock absorption can lead to increased stress on the muscles, tendons, and ligaments, often causing pain, instability, and other complications. Proper management of high arch feet typically involves using pes cavus orthotics to provide the necessary support and balance that the foot structure lacks.

Pes Cavus Causes and Symptoms

Pes cavus, or hollow foot, can develop because of various underlying conditions. The causes can range from genetic factors to neurological disorders, and understanding these can help in determining the appropriate pes cavus treatment.

Pes Cavus Causes

Congenital Pes Cavus. Many cases of pes cavus deformity are hereditary, meaning individuals are born with a naturally high arch. This type of pes cavus foot tends to remain consistent throughout life and will likely not change much without intervention.

Neurological Disorders. Conditions such as Charcot-Marie-Tooth disease, cerebral palsy, and spina bifida can lead to high arch feet. These disorders cause muscle imbalances and nerve damage, which result in abnormal foot positioning and pes cavus.

Trauma or Injury. Severe trauma to the foot or ankle can cause structural changes, leading to high arch pes cavus. In some cases, injuries affecting the nerves or muscles can result in a high arch deformity.

Muscle Imbalances. Imbalances between muscle groups in the lower leg and foot can cause the foot to adopt a high-arched position. Over time, this can develop into a rigid pes cavus foot.

Pes Cavus Symptoms

Foot Pain. The most common symptom of pes cavus is foot pain, particularly in the ball of the foot (metatarsalgia) and the heel. This is caused by the uneven distribution of weight across the foot.

Instability. Individuals with high arch feet often experience instability when walking or standing, making them prone to ankle sprains. This occurs because the foot’s natural shock absorption is compromised.

Calluses and Corns. The abnormal pressure points created by a pes cavus deformity can lead to calluses and corns on the ball and heel of the foot, as these areas endure most of the stress during movement.

Claw Toes. The rigidity associated with pes cavus can cause the toes to curl downward, a condition known as claw toes. This occurs when the high arch pulls the toes into a contracted position.

Difficulty Fitting Shoes. People with high arches or hollow foot may struggle to find well-fitting shoes that offer adequate support. Without proper footwear, the symptoms of pes cavus can worsen over time.

Recognizing these causes and symptoms is essential for finding effective pes cavus treatment and managing pes cavus symptoms. Proper footwear, targeted exercises, and pes cavus orthotics can help alleviate pain and improve stability for those with this foot condition.

Non-Surgical Pes Cavus Treatment Options

Managing pes cavus involves a combination of non-surgical and surgical options, depending on the severity of the condition and the associated symptoms. Early intervention with the right pes cavus treatment methods can help reduce pain, improve stability, and prevent further complications. Here’s a look at some of the most effective non-surgical treatment strategies for pes cavus deformity.

1. Orthotic Insoles for Pes Cavus

Using insoles with very high arches are one of the most effective non-surgical treatments. High arch feet insoles are designed to provide the necessary support and cushioning to alleviate pressure points, reduce pain, and improve foot alignment. Custom or over-the-counter orthotics with high arch support can provide substantial relief for high arch pes cavus. We'll dive deeper into the benefits of insoles for pes cavus and orthotics for hollow foot in the next section.

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Best/only OTC arch support for extra high arches I have found
"Excellent company, easy to work with and fast shipping. I have extremely high arches- wet test reveals a complete break between heel and the pinky toe (pes cavus). These are the only insoles I have found that have a contour to support my foot. I wish I made enough money to justify buying multiples pairs but for now I switch them between shoes daily. If you are in between sizes like me (I wear a 9.5 or 10.5 depending on shoe, etc) they suggest buying the smaller size. I did this and have found that mine work great in all of my shoes."
— Jason M., Verified Buyer (Tread Labs Pace (formerly Stride) Insole Review)

2. Hollow Foot Shoes

Hollow foot shoes are designed to accommodate high arches by providing enhanced arch support, a deep heel cup for stability, wide toe box, and cushioned soles for shock absorption. They help reduce pressure on the heel and ball of the foot, promoting better foot alignment while helping to manage pes cavus symptoms. However, finding hollow foot shoes that fit well and match your style can be quite challenging.

3. Exercises and Physical Therapy

Specific pes cavus exercises and physical therapy can help strengthen the muscles around the foot and ankle, improve flexibility, and reduce pain. Exercises that target the muscles responsible for foot alignment can help in managing pes cavus deformity. Stretching exercises for the calf muscles and Achilles tendon are particularly beneficial.

Pes Cavus Exercises

Toe Tapping and Curling. Sit with feet flat. For toe tapping, lift your toes while keeping heels down; tap back down, repeating 15-20 times. For toe curling, use toes to grip and pull a small towel on the floor. Repeat 10-15 times per foot to strengthen the muscles in high arch feet.

Calf and Achilles Stretching. Stand facing a wall. Place one foot forward, bend the knee, and keep the back leg straight. Lean in to stretch the calf and Achilles tendon of the back leg. Hold for 15-30 seconds and switch. This helps improve flexibility and reduces tension in the pes cavus foot.

Ankle Circles and Resistance. Sit or stand with one leg lifted. Rotate the ankle in circles 10-15 times each way. Use a resistance band around the forefoot to push and pull against for added strength. These exercises enhance ankle stability, reducing the risk of sprains in pes cavus deformity.

Foot Rolling for Flexibility. Sit and roll a tennis ball or foot roller under the arch of your foot for 1-2 minutes. This helps massage the plantar fascia, enhancing flexibility and easing foot pain, common in pes cavus. Repeat for both feet.

These exercises can be guided by a physical therapist specializing in foot and ankle conditions to ensure proper form and technique.

Bracing and Splinting

For individuals with pes cavus, bracing and splinting can offer additional support and stability during hollow foot treatment. These devices help in aligning the foot and ankle properly, preventing excessive rolling or sprains. Night splints, in particular, can stretch the plantar fascia and Achilles tendon, reducing morning pain and stiffness. Ankle-foot orthoses (AFOs) are another option, especially for those with more severe deformities or accompanying neurological conditions.

Pain Management

We recommend focusing on non-invasive methods like pes cavus orthotics, stretching, and exercises to relieve pain and improve foot alignment. These treatments address the root cause rather than masking symptoms. While pain medications like NSAIDs can help temporarily by reducing inflammation, they are not a healthy long-term solution because of the potential side effects. Icing the affected area and using anti-inflammatory creams may provide relief from pain and discomfort. Prioritize sustainable pain management through proper support and physical therapy.

Why Tread Labs Orthotics Are Ideal for Pes Cavus

Pes cavus, or high arch feet, require specialized support to alleviate pain and enhance comfort. Tread Labs orthotics provide an effective over-the-counter (OTC) solution for those dealing with the challenges of this condition. Here’s why:

Key Features of Tread Labs Orthotics for High Arches

1. Highest Over-the-Counter Arch Support

Tread Labs insoles provide the highest over-the-counter arch support available for pes cavus, helping to redistribute pressure across the foot. For high arch feet or pes cavus foot, the 'Extra High' arch height is recommended.

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Great for High Arches!
"I have high arches and metatarsalgia, and Pace (with a met pad) is the only insole I’ve found that relieves the pain. (I’ve been searching for YEARS and have a huge pile of insoles that are “better than nothing” but Pace is the first actual solution that works!)"
—Melissa U., Verified Buyer (Tread Labs Pace Extra High Insole Review)

2. Multiple Firmness Levels

Firm (Ramble Model). Firm support for general use and everyday comfort.
Extra Firm (Pace Model). Extra firm support for medical-grade alignment and stability, ideal for pes cavus deformity.
Ultra Firm (Dash Model). Maximum firmness with carbon fiber inserts, designed to enhance biomechanics and performance.

3. Modular Metatarsal Pads

Adjustable metatarsal pads ensure a personalized fit, providing targeted support exactly where it’s needed to alleviate metatarsalgia and other forefoot pain associated with hollow foot.

4. Fit Any Shoe with Multiple Top Cover Options

Regular Top Covers. For most types of footwear, providing standard thickness.
Thin Top Covers. Perfect for low-profile shoes.
Short Top Covers. Ideal for dress shoes or limited-toe room styles.

5. Durable, High Quality Materials

Constructed from robust materials like molded plastic and open-cell polyurethane foam, Tread Labs orthotics are engineered for long-lasting support and stability. Their arch supports are guaranteed for life, ensuring reliable performance over time.

6. A Cost-Effective Alternative to Custom Orthotics

While custom pes cavus orthotics are often recommended, they can be expensive and require frequent adjustments. Tread Labs orthotics provide a customizable solution that is more affordable and durable. They ideal for those seeking a practical pes cavus treatment without the high cost. For a deeper comparison between Tread Labs insoles and custom orthotics, explore our blog: 'Tread Labs Insoles vs. Custom Orthotics'.

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Loved the first pair...
"Loved the first pair so much I bought a second pair! I rarely ever do that. I have very high arches, so almost all other arch supports aren't high enough to support my arches. So I always have sore feet and little support. This is the very first time I've had off-the-shelf supports that work! Otherwise, I have to spend about $1k for a pair of custom orthotics at someplace like the 'Good Feet Store'."
— Timothy V., Verified Buyer (Tread Labs Pace Wide Extra High Insole Review)

The Best Orthotics for Pes Cavus Relief

Managing pes cavus requires effective arch support and tailored solutions that address the unique needs of high arches. Tread Labs orthotics provide the high arch support, customized fit, and durability needed to effectively address the challenges of hollow foot. We recommend Tread Labs Pace Insoles [Extra High] as the best solution.