You may have heard the words “pigeon-toed” used to describe toes that point inward toward each other. In podiatry, we use the term "in-toeing" for our patients with this issue, which is very common in young children. It generally sorts itself out without any treatment, but some children can benefit from treatment if their feet do not straighten out on their own.
Three Causes of In-toeing
Most cases of in-toeing in otherwise healthy children are the result of one of three causes:
- Metatarsus adductus. This occurs when a baby’s feet have been pressed into a curved position in the uterus. In 90 percent of cases, this issue resolves itself as the child grows up.
- Excess femoral anteversion. This is caused by a twist in the femur. Some degree of inward twist in the thigh bone is observable in all babies, but for some, the twist causes in-toeing after a child starts walking.
- Internal tibial torsion. This is caused by a twist in the tibia—the bone between the knee and the ankle—and is the most common cause of in-toeing. In most cases, this twist straightens out early on, but if it doesn’t, the child may in-toe when they start walking. Generally, the leg bones will continue to straighten until a child is 6 to 8 years old.
Is Treatment Necessary?
In the vast majority of cases, in-toeing does not require treatment. As we have noted, the condition generally works itself out as a child gets older. Even when it doesn’t, in-toeing seldom causes pain, clumsiness, or the onset of other conditions. In some rare cases, the following treatments may be advisable:
- Metatarsus adductus. Your doctor may uses casts or braces on your baby’s feet to help stretch them into a straighter position.
- Excess femoral anteversion. If the inward twist of the femur is strong, surgery may be required to straighten the feet. But the surgical option is only appropriate in the most severe cases.
- Internal tibial torsion. In some cases, this condition may cause an appearance issue that can be resolved by cutting the bones and turning them in the direction that will allow the feet to point straight ahead. This is a significant surgery and would not be undertaken lightly by a doctor.
We Are Happy to Discuss Your Child’s In-toeing
When your child’s feet appear to be pointing in an unusual way, it is only natural to want some reassurance and advice from a medical professional. Don’t hesitate to contact us if you’d like to discuss options to address in-toeing.