You may have noticed the inward turn while playing with your infant’s toes, or watching your toddler scurry around. You may have told your kindergartener to keep his or her knees straighter and worried that your child would stay “pigeon-toed” into adulthood. Though it may not look normal, intoeing is common in young children. Fortunately, with a little monitoring, it does not have to become a permanent problem or interference in your child’s life.
The Twisting Problem
Intoeing is a condition where a person’s toes turn inward when standing or walking instead of pointing straight ahead. It is a common problem for infants and young children. It may affect one or both feet, and though it looks uncomfortable, only sometimes does it cause a child to trip or have trouble walking.
There are three main sources of intoeing: tibial torsion, femoral torsion, and metatarsus adductus. Tibial torsion exists when the shin bone, formally known as the tibia, twists inward. This can develop in the womb or as a young child. Femoral torsion is when the thigh bone, the femur, twists inward, pointing the knees toward each other. Metatarsus adductus exists when the bones from the mid-foot forward curve inward, making the foot a half-moon shape. The condition may resemble clubfoot in severe cases.
Intoeing is a common pediatric problem that frequently self-corrects by age ten, and rarely interferes with the child’s walking or activities. If you notice your child’s feet turning in, however, you should still have the condition evaluated by the team at Advanced Foot & Ankle Specialists to determine the cause and to monitor its development over time. That way, if complications do arise, it can be cared for immediately with a better chance of treatment success.
Each form of this condition tends to be most noticeable at different ages: metatarsus adductus develops primarily in babies; tibial torsion is most visible around age two; and femoral torsion manifests most clearly between ages five to six. These conditions seem to run in families, or even develop as the baby grows during pregnancy. By age ten, the intoeing should have corrected or at least significantly decreased. If you notice your child’s feet still turn in more than normal, or trip him or her up while walking, then surgery may become necessary.
For both tibial and femoral torsion, most conservative correction does not help the condition. Braces, special shoes, splints, and even exercises have not been shown to improve either problem. Usually the twisting self-corrects as the child’s body grows. In severe cases of metatarsus adductus in infants—when it has been present for several months with no improvement, the curve is extreme, or the foot is rigid and doesn’t straighten out when you move your baby’s foot, your child might need casting. Unlike the other intoeing conditions, this has been shown to help correct the direction of the foot and prevent it from getting in the way of the child’s walking. Surgery to reset any of the problematic bones usually only happens after age ten and only if the intoeing interferes with normal walking.
Keeping an eye on your child’s development and growth is important. Catching problems early is the key to preventing their bodies from becoming set in unnatural positions that will plague them as adults. Have your child’s foot health monitored by an expert from Advanced Foot & Ankle Specialists of Arizona. For an appointment or more information, visit the contact page online or call or fax one of our two convenient office locations: (480) 963-9000, (480) 963-0375 (fax) for our office in Chandler or (480) 981-1800, (480) 981-0229 (fax) for the office in Gilbert.