Question
My active 7 yr old (loves soccer especially) appears to have a tibia which protrudes medially at the ankle.  I realized this the other day when I noticed that his right shoe seemed to be collapsing inward.  I thought with the last pair of shoes it was because of the quality of shoe and that he was not lacing them up properly, but now i am concerned that he may have a developing condition.  Let me know what this could be.  Thank you!

Answer
Hi Matt,

This sounds like a severe flatfoot.  When the ankle turns in and the arch collapses, the tibia will rotate and stick out.  When this deformity is present, the shoes will wear out more quickly on the inside.  Many kids will develop pain and fatigue as well. This may happen at any time.  They are also more prone to injury.

Please see this information on my web site for more details:
http://www.thetampapodiatrist.com/document_disorders.cfm?id=160

The most important treatment to start will be custom orthotic devices/arch supports to help support the foot and ankle.  Also, stretching and strengthening exercises help.  In more severe cases, a metal implant may be inserted into the inside of the foot so it does not collapse.

What I would do now is see a Podiatrist for an exam and treatment.  I would check to make sure that the Podiatrist often treats children with flatfoot.

Hope that helps.  

Sincerely,

Marc Katz, DPM
Tampa, FL
Advanced Podiatry
www.thetampapodiatrist.com
www.tampacryosurgery.com
www.fix-my-foot.com