Understanding Intoeing in Children: A Guide for Parents

In-toeing, also known as "pigeon toes," is a common condition in young children where the feet turn inward when walking or running. As a podiatrist, I often see parents concerned about this condition. This blog aims to provide a comprehensive guide to help parents understand the causes of in-toeing, what is considered normal at different ages, and when to seek medical advice.

What is In-toeing?

In-toeing is a condition where the feet point inward instead of straight ahead. It can affect one or both feet and can vary in severity. In-toeing is often noticeable when a child starts to walk and can sometimes persist into adolescence if not addressed.

Causes of In-toeing in children

In-toeing can result from several factors, often related to the alignment of bones in the legs and feet:

• Metatarsus Adductus: This condition involves the front part of the foot curving inward. It is usually present at birth and is more noticeable in infants.
• Tibial Torsion: This occurs when the shinbone (tibia) twists inward. It commonly becomes apparent when children start walking and is often seen in toddlers and young children.
• Femoral Anteversion: This condition involves the thigh bone (femur) twisting inward, leading to the knees and feet pointing inward. It typically becomes noticeable in preschool and school-age children.

Normal Age for Different Stages

• Infants: Metatarsus adductus is common and typically resolves on its own as the child grows and begins to walk. Extreme cases of metatarsus adductus may partially resemble a clubfoot deformity.
• Toddlers (1-3 years): Tibial torsion is often noticed when children start walking. Most children outgrow this condition by the age of 4 to 5 years as their bones naturally grow and straighten.
• Preschool and School-Age Children (3-6 years): Femoral anteversion is more noticeable around this age. In most cases, intoeing will correct itself by the age of 8 to 10 years old.

When to Be Concerned

While in-toeing is often a normal part of development, there are situations where parents should seek medical advice:

• Persistent in-toeing: If in-toeing does not improve as they get older, or if it seems to be worsening.
• Pain or Discomfort: If the child complains of pain in their feet, legs, or hips, or if in-toeing causes difficulty in walking or running.
• Severe in-toeing: If the in-toeing is severe and interferes with the child’s ability to participate in normal activities or sports and results in tripping.
• Family History: If there is a family history of severe skeletal abnormalities or conditions that affect walking.

Diagnosis

A thorough evaluation by a podiatrist or pediatrician can help determine the cause of in-toeing. This may include:

• Physical Examination: Assessing the child’s range of motion, muscle strength, and gait.
• Medical History: Reviewing any relevant medical or developmental history.
• Imaging: In some cases, X-rays or other imaging studies may be necessary to assess bone structure and joint alignment.

Treatment and Management

In most cases, in-toeing does not require treatment and resolves on its own as the child grows. However, if intervention is needed, the following options may be considered:

• Observation: Regular monitoring by a healthcare provider to track the child’s development and ensure the condition is improving naturally.
• Physical Therapy: Exercises to strengthen and stretch the muscles of the legs and feet can be beneficial, especially for children with tight muscles or tendons.
• Orthotic Devices: In some cases, custom orthotic devices or braces may be recommended to support proper foot alignment. Gait plates may also be used to facilitate turing the feet out.
• Surgery: Rarely, surgical intervention may be necessary for serious cases that do not improve with other treatments.

Encouraging Healthy Development

Parents can encourage healthy foot development in their children through various practices:

• Encourage Barefoot Play: Allowing children to walk and play barefoot when safe can help strengthen the muscles of the feet and improve balance. When your child is learning to walk choosing a shoe that will facilitate a barefoot walking patters, such as the Attipas childrens range is beneficial.
• Provide Proper Footwear: Ensure children wear well-fitted shoes that provide adequate support without being too restrictive.
• Promote Physical Activity: Encourage activities that involve running, jumping, and climbing to help develop strong and flexible muscles.

In-toeing in children is often a normal part of development and usually resolves on its own without treatment. Understanding the causes and knowing when to seek medical advice can help parents manage their child’s condition effectively. If you have concerns about your child’s in-toeing of foot development, don’t hesitate to reach out to a podiatrist for professional advice and reassurance.

Give your pigeon-toed walker the support they need with Attipas' specially designed shoes. Shop now!

For more detailed information and personalised guidance on any of the above, feel free to contact our clinic or visit our Well Heeled Podiatry website.

 

FAQS

What is intoeing in children?

Intoeing, sometimes called being pigeon-toed, is when a child's feet turn inward while walking or running. It's pretty common in kids and usually corrects itself as they grow up.

What causes intoeing in children?

There are a few different causes of intoeing. The most common ones are metatarsus adductus, where the front part of the foot is turned in, and internal tibial torsion, which involves the lower leg. Sometimes, increased femoral anteversion, or inward turning of the thighbone, can also play a role.

At what age does intoeing usually correct itself?

Most kids will outgrow intoeing by the age of 9 or 10. It's often just a phase that their bodies go through as they develop.

When should I be concerned about my child's intoeing?

If your child is experiencing significant walking problems or if the intoeing seems severe, you should definitely consult an orthopaedic specialist. Extreme cases of metatarsus adductus, for instance, may require special treatment.

Can intoeing be treated?

Yes! For most cases of intoeing, no special treatment is necessary, and it will correct itself. However, in more severe cases, treatments like splints or special shoes may be recommended by a pediatric orthopaedic specialist.

What is metatarsus adductus?

Metatarsus adductus is a foot deformity where the front part of the foot is angled inward. This condition is often seen in babies and usually resolves on its own. In some cases, it can contribute to intoeing.

What role do shoes play in treating intoeing?

Typically, special shoes aren't necessary for treating intoeing unless there are other complications. Most kids just need to grow out of it naturally. However, if your child has severe cases or other foot deformities like clubfoot, then specific footwear might be advised by an orthopaedic doctor.

How can I help my child with intoeing?

Encourage your child to walk and run as much as possible. Activities that promote good foot positioning, like playing on flat surfaces and engaging in sports, can help. If you're worried, talking to a pediatrician or orthopaedic specialist is always a good idea.

Is intoeing only a problem in infancy?

Not at all! While it's often noticed in infancy, intoeing can persist into the school age years. If it continues past 6 years of age or causes issues, it's best to get a professional opinion.

Attipas: The trusted choice for parents of children with intoeing. Discover why our shoes are recommended by pediatric orthopaedic specialists.

 

Written by Monique Milne Podiatrist at Well Heeled Podiatry

Suite 1/ 362 Hampton St, Hampton, VIC 3188

Phone: (03) 9603 0334

contact@wellheeledpodiatry.com