New parents may be alarmed when they get a look at their new baby and notice the baby’s feet turning in. It seems strange, but intoeing or pigeon toe is actually very common. We spoke with Kim O’Brien, a physician assistant in the Division of Orthopaedics and Sports Medicine to find out more.
“Intoeing is a fairly common in children, infants, and toddlers,” O’Brien said. “But 95 percent of kids outgrow it, so there is a small population of intoers, but it doesn’t cause long-term problems.
O’Brien said the signs of intoeing are when one or both feet turn inward. There are three different reasons for the intoeing:
- Metatarsus adductus: the bones of the foot turn inward
- Internal tibial (shin) torsion: the shin bone has a twist in it
- Internal Femoral (thigh bone) torsion: the thigh bone, or femur, rotates inward
“None of these require treatment anymore,” O’Brien said. “We used to treat them and we found out that it didn’t necessarily resolve it. We do not treat any of them in any otherwise healthy children.”
O’Brien says kids with other medical conditions, like cerebral palsy, may require treatment.
Without treatment, most types of intoeing will resolve through regular growth and development. Each type will resolve at different times, and parents can use these guidelines to help determine where their child is in the process:
- Metatarsus Adductus: Parents tend to see improvement by 12 months of age, but it can take up to 3 years to correct. We recommend the family do a massaging stretch on the inside of the foot.
- Internal Tibial (shin) torsion: Typically seen in kids under age 2. You can see an improvement by 5 years old, 7 at the latest. Let them run around be normal, healthy kids.
- Internal Femoral (thigh bone) torsion: Typically see between ages 3-10 and can take up to age 10 to resolve. Typically parents will gradually see improvement year by year.
O’Brien and the PAs in Orthopaedics have been running an intoeing clinic for years. She does offer one piece of advice for parents, if they’re concerned about intoeing and want to see her or another PA about it.
“If a child will be evaluated by us, we advise parents not to have x-rays beforehand because we don’t want kids exposed to unnecessary radiation. If we need to order x-rays, if they’re necessary, we will,” she said.
It turns out, for the 5 percent of children who remain intoers, there is one great advantage according to O’Brien – pigeon toed children tend to be very fast sprinters!
Parents of intoers, how has your experience with intoeing been?