Metatarsus Adductus – If Your Child’s Toes Point Inward

by | Jun 26, 2019

If you are a parent, then you likely planned the birth of your child to a T. You carefully chose their name, decorated their room with the coziest items you could find, and shopped for the most up-to-date baby gear out there.

One thing you may not have planned for (or even expected) is that your baby would be born with a foot deformity! But the Southern California Foot & Ankle Specialists are here to ease your mind, because most congenital foot conditions are easily treatable when addressed immediately after birth.

The most common foot and ankle deformity seen in babies is known as metatarsus adductus (MTA). The name may seem a little complicated, but the symptoms of this condition are more straight forward than you might think – in-toeing.

Sound familiar?

You may also have noticed a gap between the largest and second largest toes, and while the front of the foot turns inward, the rest of the foot stays in its proper position, including the heel. This is what makes MTA essentially different from clubfoot, a condition in which the entire foot is curved or angled.

Though the exact cause of MTA is unknown, many believe that it has to do with the way the baby is turned while in the mother’s womb. In some cases, the condition has been present in other family members, too.

Metatarsus Adductus

So Does Your Child Have MTA?

If you suspect your child’s feet are in any way abnormal, you should come visit our office right away for an accurate diagnosis. We can easily determine if your child has developed metatarsus adductus with a physical examination. During the examination, we will also ask for a complete birth history of the child and ask if any other family members were known to have metatarsus adductus.

Some symptoms we may look for when evaluating your child’s feet include:

  • High arches
  • Separation of big toe from second toe
  • Toes point inward

Now, if the heel and forefoot can be aligned with each other with gentle pressure on the forefoot while holding the heel steady, then your child likely has developed what is called a flexible metatarsus adductus. This diagnostic technique is known as passive manipulation.

On the other hand, if the forefoot is more difficult to align with the heel, it is considered a nonflexible, or stiff foot.

Can MTA Be Treated?


The overall goal of treating MTA is placing the foot back in its appropriate position. If your child’s foot is flexible, we may recommend a “wait and see” approach. Often the situation will resolve itself as the child grows and develops. However, a simple home exercise plan that involves stretching may also be helpful.

You should also pay close attention to your child’s sleeping position – all babies should sleep on their backs to reduce the risk of SIDS (unless advised differently by a physician). Doing so will also aid the correction of MTA since the feet are often turned in when a baby sleeps on the stomach.

For cases where the foot is not flexible (or stiff), casting may be attempted prior to any invasive treatments such as surgery. Long casts are used to manipulate the front of the foot. This process can be intense since the casts must be changed frequently (every 1-2 weeks). A special shoe may also be used in straightening process.

If the foot does not respond to this method, the involved joints may have to be addressed surgically, and casting will still be required after the procedure. However, these instances are very rare and we will exhaust all treatment methods available before considering the surgical route.

Specific treatment for MTA will be determined based on:

  • Your child’s age
  • Your child’s overall health
  • Your child’s medical history
  • The severity of the condition
  • Your child’s tolerance for specific medications, procedures, or therapies
  • Expectations for the course of the condition
  • Your opinion or preference

The good news is that MTA often resolves itself given time (without any need for treatment) in the majority of affected children. Though this doesn’t mean that you should just ignore signs of the condition in your child’s feet. Proper diagnosis is still essential to ensure your child’s lower limbs grow and develop the way they are supposed to.

Find Expert Pediatric Care at Southern California Foot & Ankle Specialists

Here at Southern California Foot & Ankle Specialists, we know that the diagnosis of a foot deformity at your child’s birth can be overwhelming. But you’re not alone! Our team of foot and ankle experts will walk with you every step of the way to make sure that your child’s future is not riddled with foot and ankle problems.

All you have to do is schedule a visit at our office today to learn more about available treatment options for common pediatric conditions. You can call our Ladera Ranch, CA office at (949) 364-9255, or simply take advantage of our request form online to have one of our trained staff members reach out to you instead.