My foot turns inward in heels

by Kimberly
(Oklahoma City)

The only injury/birth defect that I can think of is when I was born, I was pigeon-toed so I had to wear this bar with shoes to hold my feet straight and it worked but that was years ago. For the past three years, I sometimes have a sharp pain in the anterior part of my ankles that actually causes me to almost fall and the worst part is, when I wear heels (3-4") my left foot turns inward and becomes weak with a dull ache from the outer left side of my foot up to my upper ankle area...sometimes it even "pops"...I have done flex exercises and nothing is working. What could this be?

RESPONSE

Hi Kimberly,

It would seem to me that you have a structural deformity in your foot that is aggravated by an incline in the height of your shoe heel. Deformity may too strong a word, but said simpler, your foot structure is such that when the heel is inclined, it changes the dynamics of the way the foot functions and in your case the heel turns inward.
Because you had bars on your shoes as a child I will assume you suffered from what is known as internal tibial torsion which is an inward twisting of the lower legs causing you to in toe (pigeon toed) and that you wore what is known as a Denis-Browne bar on your shoes.
Sometimes, however, the in toeing condition is caused by a condition known as metatarsus adductus. In this condition the deformity is within the foot and this is an inward angulation of the the metatarsal bones which are the long bones just behind the toes.
In cases like this the patient, you, may develop what is known as a cavus foot or high arched foot. In your case, when you put on high heels it further exacerbates the problem thus causing your foot to turn inward at the level of the heel.
So, with the foot turned inward, it tends to stretch the anatomy on the outside of your foot, in particular the tendons that run down the outside of the ankle into the foot. You may also be over stretching the ligaments that attach on the outside of the foot and ankle.
I am not so sure that stretching exercises are going to do much for you. A better bet would be to address the structural deformity itself. This is generally done through the use of an orthotic device.
Without having the luxury of actually examining you, I would think an orthotic with a valgus wedge (an arch support with a build up on the outside of the heel) would force your heel to stop turning inward. This coupled with perhaps wearing a slightly lower heel might do the trick.
The proper way to deal with this situation would be to see a foot specialist in your area who can examine the dynamics of your foot and the way you walk, to determine the best course of treatment.

Marc Mitnick DPM
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