In-toeing in children
In-toeing is when the feet are turned inwards when walking – you may have heard this gait referred to as ‘Pidgeon toed’. In-toeing in children is common and normal when they are developing. It may be a concern of parents as you may notice tripping, clumsiness or generally awkward particularly when running. The three most common causes of in toeing arise from the feet, lower leg and upper leg:
The foot may be turned inwards: ‘Metatarsus Adductus’
It has been suggested that this curved alignment where the feet are curved inwards arises from the position of the baby in utero. This is okay as in most infants it is a flexible alignment – meaning that you can move the foot straight. This will generally correct without treatment by the age of two or three years. Treatment if required generally involves gentle exercises, footwear advice, or shoe inserts for a period of time.
The lower leg bone (tibia) may be turned inwards: ‘Internal tibial torsion’
This is when the bone in the lower leg (‘shin bone’/tibia) is rotated inwards between the knee and the ankle which makes children’s feet appear to be turned in. This is a very common and usually corrects without treatment by the age of 8 years old. No exercises, shoe inserts, special shoes or braces can help this.
The upper leg bone (femur) may be turned inwards: ‘Internal femoral torsion’
This is when the bone in the upper leg (femur) is rotated inwards between the hip and the knee which makes children’s feet appear to be turned in. This is normal in young children – they may find it easy and/or comfortable to sit in the ‘W’ position on the floor instead of the typical cross-legged position. It may be wise to avoid this position, although there is no evidence it is harmful. No exercises, shoe inserts, special shoes or braces can help internal femoral torsion and usually self corrects by 10 years of age.
SUMMARY: In-toeing is normal in children and usually corrects by the age of 10. Consult your GP or Podiatrist if you have any concerns with your child’s in-toeing gait or if:
- In toeing affects one leg
- In toeing is severe, and not improving with time
- Causing tripping in school age children that affects participation in activities
- The feet are stiff and not improving with time
THIS INFORMATION IS FOR EDUCATIONAL PURPOSES ONLY AND IS NOT INTENDED TO REPLACE PROFESSIONAL PODIATRIC ADVICE. TREATMENT WILL VARY BETWEEN INDIVIDUALS DEPENDING UPON YOUR DIAGNOSIS AND PRESENTING COMPLAINT. AN ACCURATE DIAGNOSIS CAN ONLY BE MADE FOLLOWING PERSONAL CONSULTATION WITH A PODIATRIST.