Intoeing & Out-Toeing
Intoeing – Learning to Walk with Turned Toes
First steps are an important milestone. They mark a new stage in children’s ability to move and interact with the world around them—and begin the development of mobility that will serve the child for the rest of his or her life. So it is understandable why parents might be concerned when they notice a gait abnormality like intoeing in their baby.
Why Toes Point Inward
Intoeing is a fairly common gait problem in small children. The toes turn inward when your child stands or walks, creating a “pigeon-toed” look. While this usually isn’t harmful, it can concern many families and does need to be monitored. Occasionally, intoeing does cause some issues—your little one can trip on his or her toes, or develop discomfort from pushing off of the wrong part of the foot when walking. Several underlying, congenital issues can cause the toes to turn inward: metatarsus adductus, tibial torsion, and femoral anteversion.
Metatarsus adductus is a curve in the middle of your baby’s foot. This can be a flexibility problem of a rigid deformity, depending on the severity of the issue. Tibial torsion is a natural twist in the lower leg bones, which rotates the foot so it appears to point inward. Usually it’s most noticeable once your child starts walking. Femoral anteversion is excessive rotation in the hip bones that twists the whole leg inward. It’s most apparent around school age.
Growing out of Gait Problems
Any child with intoeing should have their growth monitored by a children’s foot care specialist like Dr. Sanjay Patel. Our team will examine your little one’s feet to make sure that no developmental issues are related to the problem, and that your child isn’t struggling with pain. For most of these issues, the best treatment is waiting to see how they develop.
All of these problems can self-correct as your child grows older. For metatarsus adductus, however, you can take steps to straighten out the feet. Before your child begins walking, the feet are stretched and exercised to strengthen them. If the foot is rigid, the lower limbs may need to be braced or casted into the correct position so that the feet straighten as they grow.
For tibial torsion and femoral anteversion, braces and special shoes are not effective in correcting the twist of the bones. However, bones naturally rotate outward somewhat as they grow; typically this corrects the gait abnormality before the teen years. If the problem persists past ten years old, your child may need surgery to correct it.