What Is the Most Common Cause of Intoeing?

The diagnosis of intoeing may apply to a child’s feet and their lower or upper legs:

1. The feet:
   • The front of the foot curves inward, and the foot as a whole is completely flexible.
   • This may be noticeable at birth or in the first few months.
   • It can affect either one or both feet and is most likely caused by your baby's position in the uterus.
   • When a child's foot is turned inward, this is referred to as metatarsus adductus.
   • Compared with the hindfoot, the forefoot is adducted or curved inward.
   • This gives the foot a “banana” or curved shape and will most likely result in an intoeing gait when a child walks.
2. The lower legs:
   • Excessive inward twist of the shinbone (tibia) relative to the knee joint may cause intoeing. This becomes apparent when the child begins to walk.
   • The cause is most likely due to your baby's position in the uterus.
   • Internal tibial torsion is another name for this condition.
3. The upper legs:
   • The thighbone (femur) is twisted excessively, causing the entire lower leg to turn inward relative to the hip joint.
   • It is more common in children aged three to six years. Femoral anteversion is another name for this condition.

Intoeing, also known as pigeon toe, is a condition in which the feet point inward instead of straight ahead when walking.

• It is frequently noticed by parents when their child begins to walk, but children of all ages can exhibit intoeing for various reasons.
• It usually does not cause pain or arthritis, and it usually goes away on its own in very early childhood with no treatment or intervention.

Signs or symptoms may include:

• Frequent tripping/falling and clumsiness
• Difficulty with shoes
• Difficulty progressing from walking to running
• Half-moon-shaped feet

Although intoeing is usually asymptomatic, it can be a source of embarrassment for the child, leading to low self-esteem and affecting their participation in activities.

An orthopedic surgeon should evaluate children who have intoeing that is accompanied by pain and swelling.

Intoeing is a problem that frequently resolves itself without the need for correction. As children grow, their toes begin to turn in the right direction. Podiatrists are specialists in the treatment of foot problems, such as intoeing.

Treatment outcomes for pediatric intoeing are better when treated early, and sometimes, only parent assurance and education are required.

Podiatry treatment options for children with intoeing include:

• Addressing postural issues
• Children’s orthotics including gait plates
• Stretching and strengthening
• Casting
• Physical therapy

Although most cases of children's intoeing resolve spontaneously, other cases may persist or worsen if the underlying cause is not addressed, so an evaluation with a podiatrist is required.

If the condition does not improve as the child grows, surgery may be the only option for treatment. Surgery is generally performed only when your child is aged 8 to 10 years and has significant problems walking.