Have you noticed when your child walks or runs, their toes turn inward instead of pointing straight ahead? This is called intoeing, or more commonly known as being "pigeon-toed".
You may first notice this when your child begins to walk, but a child of any age may show signs of intoeing. Severe cases of intoeing will cause the child to stumble or trip as they catch their toes on the other heel. There is not usually pain associated with this foot deformity, nor does it lead to foot arthritis, as is popularly speculated.
For the majority of children under the age of 8, this condition will correct itself on its own, without the use of braces, casts, surgery, or other special treatment. Children who are suffering from pain from their intoeing, or there are signs of swelling or a limp should be seen by a podiatrist.
The cause of intoeing typically comes from an alignment issue from some area of the body. Three common conditions associated with intoeing are:
- Curved foot
- Twisted shin
- Twisted thighbone
These conditions often run in families, but can occur on their own or in conjunction with other orthopedic problems. Prevention is not an option since those conditions occur from developmental or congenital disorders.
Curved foot, or metatarsus adductus, is when a child's feet bend inward from the middle part of the foot to the toes. This is different than clubfoot, but severe cases may look like one. Some cases may be mild and flexible, but others may be severe and stiff. Curved foot typically improves on its own over the first 4 to 6 months of a child's life. Babies over 6 months who still have this condition, which may have progressed, may be treated with casts or special shoes. Surgery to correct the deformity is rarely used.
Twisted shin, or tibial torsion, is when the child's lower leg (tibia) twists inward. This can occur before birth, as the legs rotate to fit in the tight space of the womb. After birth, most infant's legs rotate to align properly. When the lower leg remains turned in, twisted shin occurs. As the child begins to walk, their feet turn inward because the tibia in the lower leg points the foot inward. The tibia can untwist as the bone grows taller. Tibial torsion almost always improves on its own, usually before the child goes to school. Splints, special shoes, and exercise programs do not work. If the child is 8 to 10 years old, with a severe walking problem or limp and still has this condition, surgery may be required to reset the bone.
Twisted thighbone, or femoral anteversion, is when the child's thighbone turns inward. It will appear most obvious when the child is 5 or 6 years old. The top part of the thighbone, near the hip, has an increased twist, which allows the hip to turn in more than it should. If you watch your child walk, both their toes and their knees will turn in. When sitting, children with this condition are often in a "W" position, with their knees bent and their feet flared out behind them. Most cases of twisted thighbone correct themselves, often spontaneously. Like tibial torsion, special shoes, braces, and exercises do not help. Surgery is not usually considered unless the child is 9 or 10 years old and the deformity causes tripping and an unsightly gait. Surgery involves cutting the femur and rotating it to the correct position.
If you believe have a foot problem and do not currently see a podiatrist, call one of our six locations to make an appointment.
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