Intoeing and Pigeon Toes

Causes and Treatment of Intoeing, a.k.a. Pigeon Toes

What Is Intoeing?

When a child’s feet point inward instead of straight, it is known as intoeing. Also known as being pigeon toed, the condition is fairly common and nearly always corrects itself during early childhood. Your child may start out walking this way or the condition may develop at a later date. Intoeing is painless. However, pain may be associated with the issue that caused the condition.

What Causes Intoeing?

Intoeing is often genetic and may be caused one of three conditions:
  • The foot turns inward, known as metatarsus adductus
  • The shinbone turns inward, known as tibial torsion
  • The thighbone turns inward, known as femoral anteversion
Intoeing Illustration
Intoeing Photo credit: achesandjoints.org

Metatarsus adductus

In a child with metatarsus adductus, the foot bends inward from the midpoint to the toes. The condition may be mild, meaning the foot is still flexible, or rigid.

Typically, the condition corrects itself by the time the child reaches 6 months. In the case of severe rigidity, casting and special shoes typically resolve the problem. Surgery is rarely needed.

Although severe cases of metatarsus adductus may resemble clubfoot, the conditions are not the same. Clubfoot nearly always requires treatment very soon after the child is born.

Tibial torsion

If the lower leg twists inward, this is known as tibial torsion. The condition typically improves gradually, with normal alignment occurring by the time the child starts school.

Tibial torsion does not respond to conservative treatment, e.g. splints, physical therapy, or special footwear. If the child reaches their eighth birthday without improvement and experiences significant walking problems, your podiatrist may recommend surgery. This involves rotating the shin bone to its proper position.

Femoral anteversion

The inward turning of the thighbone, known as femoral anteversion, does not usually become obvious until the child reaches school age. The condition nearly always corrects itself by the age of 9 or 10.

This is another instance where conservative treatment does not correct the issue. If your child has femoral anteversion coupled with severe deformity or gait issues, surgery may be considered after age 10. It requires cutting the femur (thigh bone) to rotate it to the correct position.

Children's Feet Problems Treatment

When to Call Dr. Jarman

As stated above, intoeing is very common, particularly when children first begin walking. The condition nearly always corrects itself as your child grows.

Of course, if you’re worried about your child’s gait, it never hurts to schedule a consultation with Dr. Jarman. And if your child experiences pain when walking, talk to your pediatric podiatrist right away.

Your child’s feet are designed for life

Make an appointment today if your child has Pigeon In-Toeing.