Does Your Child Need Treatment for Intoeing or Out-Toeing?

Intoeing and out-toeing are not necessarily “normal,” but they are also not particularly uncommon or a serious cause for concern. If you are a parent and have noticed that your child is walking in an intoed or out-toed fashion, you will be relieved to learn that the problem will likely disappear in time without treatment. As a matter of fact, treatment for intoeing or out-toeing are often not needed to improve the condition.

Starting with intoeing (also known as “pigeon-toed”), this fairly common condition appears as a result of in utero development. There are essentially three causes of intoeing: metatarsus adductus, tibia torsion, and femoral anteversion. These are related to how a fetus’ feet or legs are positioned.

Metatarsus adductus is a condition wherein the feet are bent inwards and form a half-moon shape from the toes to the midfoot. In tibia torsion, the tibia (larger of the two lower leg bones) is twisted inward. Femoral anteversion is similar to tibia torsion, except that the femur (thighbone) is twisted.

As children mature physically, they usually grow out of any intoeing issues, without the need for treatment.

In most instances, a case of intoeing isn’t anything to worry about. It does not result in pain and, even better, iwill often resolve itself in time as your child grows. There are various stages of your child’s development where you might notice this gait abnormality:

• Infancy. When babies are born with feet that are turned in, it typically is the result of positioning and crowding within the womb. In such a case, it is a good idea to check with us to see if any intoeing treatment—like early splinting or casting—might be necessary.
• Age 2. If a child is still intoeing during the second year, it is likely an inwards twisting of the tibia (shinbone), which is a condition known as internal tibial torsion. Internal tibial torsion tends to be passed along in families.
• Ages 3-10. Should the intoeing still be present during this age range, the issue is probably an inward twist at the femur (thighbone). This is referred to as medial femoral torsion and it can be genetic.

Typically, intoeing treatment hasn’t proven to be effective and most cases simply correct themselves after a while. At 9 or 10 years of age, however, it might be time to consider surgery as a way of correcting the condition. Of course, this is something we would discuss together and determine if it is best for your child.

If you are a parent worried about your child’s out-toeing, we are happy to report that this is usually the result of a minor condition, one that will also typically resolve by itself over time. Further, it is not often a sign of a functional deficiency.

It’s Always Best to Keep in Check

That said, it is possible that a case of intoeing or out-toeing will lead to either difficulty running or an abnormal gait for your child. We cannot tell you certainly without examining your son or daughter, but you can always bring him or her into our office for a proper evaluation. Doing so will enable us to provide you with peace of mind or initiate a treatment protocol, which will likely consist of conservative treatment methods.

For more information on child foot issues, or to request an appointment with our Ladera Ranch, CA office, give us a call at (949) 364-9255 (WALK).