f you connect the 3 points of support (the calcaneus and the base of the first and fifth toe) in between them you will find the 3 arches of the foot: the transverse in the front, the medial and the lateral.

3 pt foot


The medial arch is the longest and the highest. It’s the arch that doesn’t have contact with the ground, unless we are in front of a flat foot which is not a “normal’ foot. The medial arch is the most important of the three in both the statics and dynamics of the foot.


When you walk, you have micro movements of compression and the physiological mobility of the ankle/foot complex manages these loads correctly in a healthy foot. The angle of adaptation between the calcaneus (the heel) and the talus (the bone on top of the heel) is important to manage the tension/flexion between the 3 arches of the foot and the posterior part of the leg. When this harmony is missing, you run more likely into stress fractures and plantar fasciitis.


Many feet don’t meet the criteria of balance and harmony that are described here, however they are symptom-free. The human body is very capable to compensate when the misalignment is moderate but long term , the body, will most likely pay the price for these compensations.


When the medial arch is either too pronounced or too flat and long, we are in front respectively of the pathological high arch or flat foot.


High Arch (Pes cavus)

A common way to diagnose a pes cavus is through the footprint. Like kids playing in the sand or by using paint on your feet, you can easily analyze your foot shape.. The high arch presents a footprint that is really thin, where the medial part of the foot is completely missing.


One of the factors that helps the high arch to be more frequent and more pronounced is wearing shoes that are too short or high heeled shoes. In high heels the foot slides down because of the weight of the body and the heel moves closer to the toes increasing the curvature in the vault.

Flat Foot (Pes Planus)


The normal arch of the foot is maintained by ligaments and muscles. If this support system fails you are in the presence of the collapse of the plantar vault. The ligaments are able to maintain the arch by themselves, but only for a limited period of time. Without the muscles working properly, the arch will fall. We can say that this condition is mainly due to muscular insufficiency. When you look at this kind of foot, you will notice how the medial malleolus (the bone inside the ankle) is more pronounced and the footprint is much wider than a normal one. Sometimes it even becomes convex medially.


Which group does your foot belong? Take a picture of your footprint, tag @ilariacavagna and hashtag #HighHeelRescue on Instagram, and we’ll compare notes!