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Overview
Like flat feet, high arches may be present from birth, or caused by conditions such as stroke or Charcot-Marie-Tooth disease. Usually, high arches do not cause pain, although you may need custom orthotic cushions made for your shoes. Surgery may become necessary if your high arch foot becomes too painful or leads to arthritis or a stress fracture. Surgery may include reconstructing a ligament, fusing the hindfoot, shifting bones to better alignment, and transferring a tendon from one part of the foot to another.


Causes
The causes of high arched feet can vary greatly. They range from neurological disorders, club foot, injury, and often times there may be no known reason. The idea behind surgery to correct this often painful condition is to bring the arch down and thereby, allow the ground pressure of walking to be more evenly distributed across the entire bottom of the foot. Over time high arch feet can cause severe plantar calluses, ulcerations broken metatarsals and even chronically sprained ankles.

Symptoms
Pain and tenderness associated with plantar fascia strains are usually felt on the bottom of the foot and may manifest either as a specific or general area of tenderness. Plantar fascia pain may be increased or decreased by stretching of the arch. Generally, in mild cases of plantar fasciitis, the pain will decrease as the soft tissues of the foot "warm up"; however, pain may increase as use of the foot increases. In more severe cases of plantar fasciitis, pain may increase when the arch is stressed. A more specific pain (point tenderness) is an indicator that something is wrong in that specific area. Pain with movement of the affected area is also an indicator of the particular body part affected.

Diagnosis
Flat feet are easy to identify while standing or walking. When someone with flat feet stands, their inner foot or arch flattens and their foot may roll over to the inner side. This is known as overpronation. To see whether your foot overpronates, stand on tiptoes or push your big toe back as far as possible. If the arch of your foot doesn't appear, your foot is likely to overpronate when you walk or run. It can be difficult to tell whether a child has flat feet because their arches may not fully develop until they're 10 years of age.

Non Surgical Treatment
The adult acquired flatfoot is best treated early. There is no recommended home treatment other than the general avoidance of prolonged weightbearing in non-supportive footwear until the patient can be seen in the office of the foot and ankle specialist. In Stage I, the inflammation and tendon injury will respond to rest, protected ambulation in a cast, as well as anti-inflammatory therapy. Follow-up treatment with custom-molded foot orthoses and properly designed athletic or orthopedic footwear are critical to maintain stability of the foot and ankle after initial symptoms have been calmed. Once the tendon has been stretched, the foot will become deformed and visibly rolled into a pronated position at the ankle. Non-surgical treatment has a significantly lower chance of success. Total immobilization in a cast or Camwalker may calm down symptoms and arrest progression of the deformity in a smaller percentage of patients. Usually, long-term use of a brace known as an ankle foot orthosis is required to stop progression of the deformity without surgery.


Surgical Treatment
If pain or foot damage is severe, your doctor may recommend surgery. Procedures may include the following. Fusing foot or ankle bones together (arthrodesis). Removing bones or bony growths also called spurs (excision). Cutting or changing the shape of the bone (osteotomy). Cleaning the tendons' protective coverings (synovectomy). Adding tendon from other parts of your body to tendons in your foot to help balance the "pull" of the tendons and form an arch (tendon transfer). Grafting bone to your foot to make the arch rise more naturally (lateral column lengthening).


Prevention
Arch pain occurs when the plantar fascia becomes worn down due to constant strain or excessive exercising. This may be caused by increasing your running or hiking mileage too fast, wearing inadequate footwear, lack of stretching, running on steep hills, standing on your feet for too long and abnormal anatomy such as flat foot. Stretching is an important exercise that should not be overlooked because the tightness or lack of tightness of the joints in the foot can also cause pain in the arch.

Stretching Exercises
Calf Raises. Strengthens the tendons in your heels and calf muscles, which support your arch. Raise up on the balls of your feet as high as possible. Slowly lower down. Do three sets of 10 reps. Progress to doing the raises on stairs (with heels hanging off), and then to single-leg raises. Step Stretch. Improves flexibility in your Achilles tendon and calf-when these areas become tight, the arch gets painfully overloaded. Stand at the edge of a step, toes on step, heels hanging off. Lower your heels down, past the step, then raise back up to the start position. Do three sets of 10 reps. Doming. Works the arch muscles and the tibialis posterior (in the calf and foot) to control excess pronation. While standing, press your toes downward into the ground while keeping the heel planted, so that your foot forms an arch (or dome). Release, and do three sets of 10 reps on each foot. Toe Spread and Squeeze. Targets the interossei muscles of the foot, which support the arch. While sitting, loop a small resistance band around your toes. Spread toes; release. Then place a toe separator (used at nail salons) in between toes. Squeeze toes in; release. Do three sets of 10 reps of each exercise on both feet. Towel Curls. Works the toe-flexor muscles that run along your arch to increase overall foot strength. Lay a small hand towel on the floor, and place one foot on the towel. Using just your toes, scrunch the towel toward you, hold, then slowly push the towel away from you back to start position. Do three sets of 10 reps on each foot.