The term in-toeing, or pigeon toed, is the term used to describe when a child walks or runs with their feet pointed inwards, instead of straight ahead.
You may notice that your child appears clumsy or often trips, especially when they are tired. In-toeing does not cause pain, and your child will be able to take part in normal activities and sport.
There are 3 common causes of in-toeing:
- Femoral anteversion (twisted thigh bone)
- Tibial torsion (twisted shin bone)
- Metatarsus adductus (curved foot)
Femoral anteversion occurs when the upper end of the thigh bone has an increased twist, causing the thighbone to turn inwards. This inward twist of the thigh, in turn, causes the knees and feet to point inwards when walking or running. Femoral anteversion, normally corrects with normal growth by the age of 12.
Tibial torsion occurs when the lower leg twists inwards. It can develop in the womb as the child’s legs rotate to adapt to the confined space. This should correct as the child grows (usually by around the age of 6).
Metatarsus adductus is when a child’s foot bends inwards towards the toes. You may notice this at birth or within the first few months. It can affect one, or both feet, and is most likely caused by the baby’s position within the womb. In some cases, where the problem is not flexible, and the problem does not seem to be improving, plaster casts or special boots may be used. However, in the majority of cases it corrects without treatment by walking age.
If you are concerned by your child’s in-toeing, your Physiotherapist or Podiatrist, will carry out a physical assessment to check for normal range of movement. This examination will help determine which part of the lower body in causing the in-toeing gait. If your child is complaining of pain, swelling or has a limp associated with in-toeing, you should always seek advice immediately.