Intoeing in children (pigeon toes)

Disclaimer: This fact sheet is for education purposes only. Please consult with your doctor or other health professional to make sure this information is right for your child.

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What is intoeing?

Most people walk with their toes and feet pointing straight ahead. Some children's feet turn in when they walk. This can be called intoeing or being pigeon-toed. There are many reasons why a child may walk with their feet pointing in, but most cases are corrected on their own as the child grows up. This is why there aren't many pigeon-toed adults.

What is the cause?

There are three common causes of intoeing:

Tibial torsion –The shinbone (tibia) is the most common twisted bone. The twist can be caused by the way your baby lay in the womb while the bones were still soft. The bone slowly untwists as the child grows. Usually the twist is gone by school age.

Femoral anteversion - The thigh bone (femur) can also be twisted inwards. This usually corrects itself, more slowly, by age nine or ten. In some children this doesn't correct fully and these are the people who walk pigeon-toed as adults.

Metartasus adductus – The feet are curved inwards. Most of these children also get better without treatment, but for those few children who have very curved feet, some bracing or special shoes may help in the first few years of life.

What treatment will be needed?

The bone twisting conditions cannot be fixed with braces, shoe inserts or special shoes. These methods were used in the past and have been shown to have no effect.

It has been found that the bones correct themselves without any treatment. There is no need to try to modify your child’s walking or sitting. This will not alter their development and can lead to frustration for the child and parent for no reason. Very occasionally your doctor may recommend a brace for a special reason.

What problems will occur?

Children who have intoeing tend to trip a little more at first, but later on are fine. Children with intoeing are just as good at sport and are no more likely to get arthritis or back problems than anyone else. Intoeing should not get worse and your child should be able to take part in all types of physical activity.

If you are concerned about your child’s intoeing, you can take photographs or videos of your child walking every six months to keep a record of the changes. If you think your child's intoeing is getting worse, a doctor should see them again. Many parents worry that their child will always walk with their feet turned in, however this hardly ever happens. No treatment has been proven to improve a child's intoeing - it is best to just let it correct itself as your child grows.

Remember:

  • Most children with intoeing do not need treatment as they will self-correct over time.
  • Special shoes and braces aren’t usually needed and are only recommended by doctors for rare cases.
  • Orthotics are not useful for correcting intoeing.
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The Children's Hospital at Westmead
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Sydney Children's Hospital, Randwick
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Hunter New England Kids Health
www.hnekidshealth.nsw.gov.au

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