Causes, prevention and treatment for Intoeing or ‘Pigeon Toed’.

IntoeingIntoeing, also known, as “pigeon toed”, is a condition that causes the toes to point inward when walking. It is most common in infants and children under two years of age and generally corrects itself as the child grows.

Treatment modalities for intoeing are generally temporary to improve function.

Causes of Intoeing:

  • Tibial torsion – where the shinbone is twisted inwards.
  • Intrauterine positioning while the bones were still soft can cause the twist. The bone will slowly untwist as the child grows and will usually be resolved by the time the child is ready for school.
  • Femoral anteversion – where the thighbone is twisted inwards. This bone will also untwist and correct itself at a slower rate than the tibia and resolved by age nine or ten. In some children this doesn’t correct completely and this intoeing gait remains into adulthood.
  • Metartasus adductus – where the feet are curved inwards in a “C-shaped” fashion. Most of these children also get better without treatment, but for those few children who have very curved feet, bracing stretching or special shoes may help temporarily.
  • “W” sitting and abnormal sleeping positions that cause increased internal rotation at the hip and knee joints.

Symptoms of Intoeing:

  • Clumsy and difficulties with sporting activities.
  • Tripping and falling over feet.
  • Minimal to no pain is reported in children.

Treatment for Intoeing:

  • Observe and monitor for intervention.
  • Change sitting and sleeping positions.
  • Exercises that encourage external rotation of the legs (e.g. frog jumps, bike riding, penguin walks, ballet).
  • Stretching both passive and active.
  • Gait plates in shoes to physically prevent the feet turning in and appropriate footwear.
  • Serial casting if severe and or bracing.
  • Surgery in very extreme cases that are not responding to conservative treatment.

If your child is experiencing any of these symptoms Well Heeled Podiatry can provide your child with a conservative treatment regime of stretching, exercises, insoles/gaitplates and footwear advice to assist with their frustrations and dysfunctions.

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