Understanding Intoeing in Children: Should You Be Concerned?

Intoeing, or “pigeon-toeing” is a common paediatric presentation where the feet turn inward rather than pointing straight ahead. This can be noticed when standing, walking or running and can sometimes cause tripping and clumsiness. As parents, it’s natural to worry when you notice your child’s feet don’t look the way you expect them to, but in most cases, intoeing is completely normal and often resolves without intervention as a child ages. 

 

What Causes Intoeing?

When a baby is in the womb, they are all bundled up which influences the torsion (twist) in the bones. As babies grow, the bones begin to unwind. This is the reason why feet turning in is more common in babies, shins turning in is more common in toddlers and hips/thigh bones turning in is more common in preschoolers or primary school children. 

 

There are three main reasons a child may have intoeing:

Metatarsus Adductus: This occurs when the front part of the foot curves inward, typically occurring due to the positioning of the baby in the uterus during pregnancy. This requires early treatment from your paediatric physiotherapist. 
Tibial Torsion: The shin bone (tibia) may be slightly twisted, causing the feet to turn inward while the kneecaps face forward. This typically improves by about 8 years of age.
Femoral Anteversion: This involves an inward twist of the thigh bone (femur) where the kneecaps point inwards. You may also notice that your child prefers W sitting. This reduces as your child ages, usually improving by about 10 years of age.

 

Is Intoeing a Problem?

In most cases, intoeing does not cause pain or limit a child’s activity. Children with intoeing can still walk, run, and play without discomfort. It’s also rare for intoeing to lead to long-term issues such as arthritis or movement limitations.

Understanding Intoeing in Children | Hub & Spoke Health

When to Seek Help from your Paediatric Physiotherapist 

  • If intoeing is only occurring on one side of the body
  • If it is worsening or isn’t improving with time 
  • If it is causing pain or excessive tripping
  • If your child is finding it difficult to participate in physical activities 
  • If the feet are stiff and not improving with time 

In these cases, a “wait and see” approach is NOT recommended, and they should seek assessment from a physiotherapist. 

 

What Can Physiotherapy Do?

Physiotherapy focuses on promoting proper movement patterns and can be helpful in cases where intoeing is severe or persistent. In rare cases, orthotics or even surgery may be recommended, but these are typically reserved for older children or those with significant discomfort.

 

If you have any concerns about your child’s gait, feel free to reach out to us at Hub and Spoke Health for an assessment.

Paediatric Physiotherapist for Intoeing in Children | Hub & Spoke Health



source https://hubandspoke.health/intoeing-in-children/

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