By Lisa Green, Podiatrist.
What is in-toeing in children?
In-toeing in a child is also known as being ‘pigeon-toed’. It’s a common condition that leads to the feet pointing inward instead of straight ahead. This may get worse when they walk or run and is often noticed when children first begin to walk. In many cases, as the child grows and develops, in-toeing will typically resolve on its own.
At Rushden Podiatry, we base our management on each individual case, although in-toeing is not usually a cause for any concern, and in most cases will resolve on its own. It is a good idea to have your child evaluated by a Podiatrist if you notice that the in-toeing has become severe, your child is tripping a lot, it is only affecting one leg, or your child is complaining of pain or other related symptoms.
What causes in-toeing?
Metatarsus Adductus. Metatarsus adductus will typically present at birth, it can depend on the position of a baby in the uterus, particularly if they adopt the breach position. It can also be an inherited condition whereby the forefoot is in a curved, inwards position. This condition may be flexible or rigid.
Femoral anteversion. Femoral anteversion is a condition whereby the femoral neck of the thigh bone leans forward slightly, causing internal rotation of the leg. This can be a common cause of in-toeing in a child, especially between the ages of 3 and 8. As a child continues to grow, this condition is most likely to correct itself and will rarely need intervention.
Tibial torsion. Similar to femoral anteversion, tibial torsion is the internal rotation of the leg bone (the tibia). The bone itself will twist inwards causing a child to become ‘pigeon-toed’. This condition will again resolve as the child grows and has usually reduced, correcting itself by age 6 with no intervention needed.
Children’s feet typically have a predictable pattern of growth. From birth to 12 months, children’s feet grow at a rapid rate, with a fat pad under the arch, making the feet look flat. At the age of 3 a child will be very flat footed and can appear to be ‘pigeon toed’. From 3 years old up to the age of 7 the foot will change, and the arch will become more visible. It is essential to provide your child with good fitting shoes throughout their growth stages.
When would you treat a child with in-toeing?
Although in-toeing in children is a common part of development, there are times, in certain situations when treatment may be needed. If the tripping is severe or sudden or if your child is experiencing pain, an assessment by a Podiatrist is recommended. This assessment can rule out any functional or underlying structural issues that may need further investigation.
Treatments
Your podiatrist may suggest an insole to influence the angle of the foot as your child walks. Exercises may also be recommended in conjunction with insoles for strengthening the surrounding muscles and tendons. A personal plan will be allocated depending on your child’s condition and severity of in-toeing.
In many children, in-toeing will resolve or improve with growth and without intervention. Only in very severe cases is surgery warranted. Your podiatrist may advise a follow up appointment to monitor your child’s natural growth pattern.
If you are worried about your child in-toeing please do not hesitate to contact us on 01933 594444, alternatively you can book online with one of our podiatrists here at Rushden podiatry.
