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Intoeing in children (pigeon toes)

Disclaimer: This fact sheet is for education purposes only. Please consult with your doctor or other health professional to make sure this information is right for your child.

What is intoeing?

Some children's feet turn in when they walk. This can be called pigeon-toed. There are many reasons why a child may walk with their feet pointing in, but most cases are corrected on their own as the child grows up. This is why there aren't many pigeon-toed adults.

What is the cause?

A cause is usually a twist in one of the leg bones. The shinbone (tibia) is the most common twisted bone. This is called tibial torsion. The twist can be caused by the way the baby lay in the womb, while the bones were still soft. The bone slowly untwists with new straight growth. Usually the twist is gone by school age.

The thigh bone (femur) can also be twisted in. This is called femoral anteversion. It usually corrects itself, more slowly, by age nine or ten. In a few children this doesn't correct fully and these are the people who walk pigeon-toed as adults. Some children have feet that are curved in. This is called metatarsus adductus. Most of these children also get better without treatment, but for those few children who have very curved feet, some bracing or special shoes may help in the first couple of years of life.

What treatment will be needed?

These bone twisting conditions cannot be fixed with braces, shoe inserts or special shoes. These were used in the past, but it has been discovered that the bones correct themselves. The braces or shoes were not needed. Occasionally your doctor may recommend a brace for a special reason.

What problems will occur?

Children who toe-in tend to trip a little more at first, but later on are fine. They are just as good at sport and no more likely to get arthritis or back problems than anyone else. The intoeing should not get worse and your child should still be able to do things that they used to do such as climbing stairs.

If you think your child's intoeing is getting worse, a doctor should see them again. Many parents worry that their child will always walk with their feet turned in, however this hardly ever happens. No treatment has been proven to improve a child's intoeing - it is best to just let it correct itself as the child grows.

• Most children with intoeing do not require treatment.
• Special shoes and braces aren't usually needed and are only recommended by doctors for rare cases. Orthotics have no role in the correction of intoeing.

The Children's Hospital at Westmead Tel: (02) 9845 3585 Fax: (02) 9845 3562 www.chw.edu.au	Sydney Children's Hospital, Randwick Tel: (02) 9382 1688 Fax: (02) 9382 1451 www.sch.edu.au	Kaleidoscope, Hunter Children's Health Network Tel: (02) 4921 3670 Fax: (02) 4921 3599 www.kaleidoscope.org.au