Unique Characteristics of the High Arch

When it comes to abnormal foot mechanics, a pronated or flat foot is the most common condition, but there is a smaller minority or people that have a high arch or supinated foot which can equally cause problems in the lower extremity.  An elevated arch tends to transmit rather than absorb shock as it is very rigid and inflexible, this results in increased forces up the kinetic chain to the knee and hip, making it susceptible to stress fractures of the foot and leg.  A study reported in Clinical Biomechanics found that high arched subjects had increased leg stiffness and vertical loading rates compared to low arched runners. 

While athletes with excessive pronation or supination of the feet are susceptible to more knee injuries, they differ in the type of injury patterns.  High arched runners report more lateral knee injuries, as they tend to be more bow legged, as opposed to low arched runners who show more medial knee injuries as they are knocked kneed.  Stress fractures in the calcaneus and seasmoids bones of the feet are more common in high arches, whereas soft tissue injuries are more common in low arches.  High arched runners experience more lateral ankle sprains and iliotibial band problems, while low arched runners have more medial meniscus and patellar tendonitis problems. 

A high arched foot generally requires improved flexibility (mobilization/stretching) of the foot and stabilizing orthotics to help decrease the shock at the heel strike, absorbing some of the forces and minimizing transmission up the leg.  These components would help to reduce the injury potential of the rigid foot with associated knee injuries, particularly in the case of runners, as running multiplies the forces three times more on heel strike.   

The unique nature of a rigid, high arch was recently reinforced to me when I had a patient who had one high rigid foot, and requested fitting for orthotics.  Her history included being a runner in the past and suffering a calcaneal stress fracture and a long history of iliotibial band issues on the rigid foot side, both conditions associated with a high arch.  

Plantar fasciitis and heel spurs can occur with both a pronated or supinated foot, due to the abnormal structure and pulling on the fascia.  Treatment is similar with both of these conditions, which can include ice, cold laser, mobilization, stretching, and orthotics.  Just as with a low arch, a person with a high arch will have to take extra care of the feet and have good foot wear for life.