Intoeing in Children
Most kids get off to a shaky start when first learning to toddle—pulling themselves up, taking those first jerky, wobbly steps forward before falling, making a little more progress each day. A little early awkwardness is to be expected, but as baby begins walking more and gaining confidence, you may notice their feet pointed inward—a condition known as intoeing, or pigeon toes.
Parents, understandably, want their children to grow up healthy and strong, so pigeon-toed walking in early childhood is a frequent concern. Toes that point inward don’t always need treatment, but you’ll definitely want to watch baby closely to ensure proper development.
Types of Intoeing in Children
There are actually three main types of intoeing for little ones. They vary in terms of where the rotation primarily takes places, and may become obvious at different times during a child’s development.
Curved Foot—Metatarsus Adductus
Here, the bending occurs only at the front half of the foot. About 1 in 500 babies will be born with this condition, and about 9 out of 10 cases will resolve by themselves without treatment. However, we’ll keep a close eye on the situation, and if it hasn’t fixed itself by a certain age, we can provide treatments such as stretching or temporary casting to help gently straighten the foot. In extremely rare cases, the foot may be quite rigid and resistant to stretching; surgery may need to be employed to release the joints, but only as a last resort.
Twisted Shinbone—Tibial Torsion
Here, the primary location of rotation is in the shins, below the knees. This may be the result of the shins not being able to rotate outward due to cramped confinement in the womb. Most cases will correct on their own by age 4, but some can take more time. Conservative treatments like bracing or special shoes tend not to work in any case, but if your child has reached 8-10 years of age with limited improvement or continued walking difficulties, surgical correction may be considered.
Twisted Thigh Bone—Femoral Anteversion
If the twisting occurs in the thigh bone, it won’t be just the feet that point inward, but also the knees. As with tibial torsion, most cases are thought to be caused by uterine confinement and are usually self-correcting. However, it tends to stick with kids longer—the condition is generally most apparent around age 5. Again, conservative approaches have been shown to be largely unsuccessful; if the problem persists and is causing problems after age 9 or 10, surgery may be the right choice.
When Should My Child See a Podiatrist?
Although many cases and causes of pigeon toes will disappear on their own without any treatment, we strongly recommend you see a podiatrist as soon as you discover or observe an inward pointing in your child’s feet. An early evaluation can rule out any more serious causes of intoeing (such as a nerve condition), and allow us to set a “benchmark” to monitor whether the condition is improving.
Most of the time, intoeing will not cause any pain or discomfort for your little one. However, severe intoeing may disrupt or delay the development of healthy walking patterns, causing extra stumbling, tripping, or instability. If you notice any signs that your child is struggling to walk correctly, tires easily, or exhibits signs of pain or discomfort, please bring them into see us. Fill out a contact form online, or give one of our two offices a call to set up an appointment: (718) 434-0600 for our office on Avenue L in Midwood, Brooklyn, or (845) 352-7507 to see us in Spring Valley, NY.