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Intoeing, commonly referred to as being pigeon toed, happens when children walk with their feet turned in. It’s a common condition that can be present at birth or develop in young children.
Intoeing usually doesn’t cause pain or prevent a child from learning to walk or run and often corrects itself. Most children’s feet gradually straighten out as they grow older and their walking and running improves. If the condition continues and is left untreated, it can lead to complications including:
- An unbalanced gait (way of walking) that can cause strain
- Reduced athletic ability because of problems running and jumping
- Foot deformities including bunions, hammertoes and flat feet
There are different causes for intoeing depending on where the legs or feet are misaligned:
- Curved foot (metatarsus adductus), which is usually present at birth
- Twisted shin (tibia torsion), the most common cause of intoeing, which occurs around age 1 to 3
- Twisted thighbone (femoral anteversion), which occurs around age 3 to 8
The exact causes for these foot and leg problems are not certain, but medical experts suspect that it may be related to:
- Family history of intoeing
- Cramped position in the uterus
Most children outgrow intoeing between ages 8 and 10. But your pediatrician may recommend testing if these symptoms continue or worsen:
- Feet shaped like crescent moons, mainly in infants
- Shins or thighbones that turn inward
- Limping, pain or swelling
- Problems with gait (way of walking) such as tripping or unusual clumsiness
Your pediatrician may recommend further testing if he or she suspects that your child has intoeing, including:
- Physical examination of your child’s legs
- Diagnostic imaging, including CT scans, to evaluate the alignment of your child’s leg bones
- X-ray images or fluoroscopy (X-ray video) to observe your child’s leg bones in motion
Intoeing usually corrects itself without treatment in almost all children. However, your pediatrician may recommend treatment if your child develops severe problems. There are different options depending on the cause of the intoeing, including:
- Casts or corrective shoes for babies from 6 to 9 months old who have severely deformed or rigid feet
- Surgery to realign the shinbone or thigh bone in older children
Division Chief, Orthopaedic Surgery and Sports Medicine
For more than 25 years, the Skeletal Dysplasia Clinic has provided multidisciplinary care for infants, children, and young adults with various forms of skeletal disorders.
From sprains and strains to complex congenital conditions, Children’s National Hospital offers one of the most experienced pediatric orthopaedic practices in the nation with experience in treating all areas from head to toe.
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