When your child’s feet turn inward, this is known as pigeon toes or intoeing. It’s a normal condition linked to heredity and positioning in utero.
Often, kids outgrow the problem, especially if it isn’t painful. However, if it’s causing pain, scheduling a consultation is a good idea. A podiatrist can pinpoint biomechanical imbalances and find noninvasive treatments that will work.
Preventing pigeon toes
When your child is walking or standing, their feet should be pointing forwards or slightly outwards. However, if they are pointing their toes inward then this is a sign that they have Pigeon Toes. This postural issue can cause problems when walking, running or playing sports. This is because it causes the foot to rotate inward and this can place a lot of stress on certain parts of the foot and knee. It can also lead to the foot becoming arthritic or developing other issues.
Pigeon Toes are more common in infants and children and most will grow out of the condition on their own. In some cases, this can take a long time and this is why early intervention with physiotherapy is important.
To prevent pigeon toes, your child will need to do exercises that target the muscle groups involved. This will include strengthening and stretching exercises. A specialist physiotherapist will be able to recommend the best exercises for your child. These exercises will aim to strengthen the muscles in the ankle, foot and lower leg to help prevent the toes from turning inward.
Another option is to use a brace that can correct the intoeing. This can be a more convenient option than casting or surgery. For example, Surestep SMOs are custom-made orthotic solutions that can be used for a range of conditions, including metatarsus adductus and femoral anteversion. They can be worn under your child’s clothing and are designed to help them walk more upright.
Identifying a pigeon toed gait
If your child walks with their feet pointing inward, they may be walking pigeon toed. This is normal and happens to most infants and children when they first start walking. Most children will resolve this problem on their own as they grow older. If your child’s gait is not resolving naturally, or if they are tripping and falling frequently, it may be time to consult a podiatrist.
Intoeing (pigeon toes) can occur for many reasons, including genetics, footwear, and physical trauma. It is also linked to medical conditions like cerebral palsy and neuromuscular disorders, which can cause weakness or lack of coordination.
Your pediatric orthopaedic surgeon will look at your child’s feet, legs, and hips, and will check for flexibility and movement. They will probably not need to take X-rays, but may want to do some tests to determine what is causing the in-toeing. The three most common causes of in-toeing are femoral anteversion, internal/medial tibial torsion (twisted shin bone), and metatarsus adductus (curved foot).
The best way to correct the condition is with physical therapy. This can help strengthen the muscles of the feet, shins and thighs and encourage natural correction of the gait. In severe cases, your child may need surgery to reset and realign the bones of the shin and thigh. We offer physical therapy, toe stretches, balance exercises, and gentle strengthening routines for kids with pigeon toes.
Treatment options
Most children will naturally grow out of their pigeon toes as they develop and their bones straighten. If they don’t, or if they’re having pain, limping or problems walking, then it is worth seeing your podiatrist for advice.
The most common condition linked to intoeing is metatarsus adductus, or a curved foot. It’s most common in infants. Children with this problem often feel clumsy and trip easily, and they may get teased at school.
Another condition linked to intoeing is a twist in the upper thigh bone (femur). This causes the knees and feet to turn inward when they’re standing or walking, known as femoral anteversion. This can occur in one or both legs, and can affect children or adults of any age.
If you’re an adult with pigeon toes, a consultation with our team will identify the root cause of your symptoms. We can offer a range of treatments, including foot mobilisation and exercises to help you stand and walk with better alignment. We can also prescribe orthotic solutions, such as Surestep SMOs, which are custom-made ankle braces that increase stability and improve alignment, guiding your little toes back into a more normal position. Our expert podiatrists can also advise on more invasive options, such as casting or surgery in severe cases. These are rarely necessary, and the results of treatment are usually very good.
Managing pigeon toes
In most cases, pigeon toes go away on their own as your child grows older. In fact, the condition is so common that Babe Ruth intentionally ran his bases pigeon-toed, believing it helped him to run faster. Even Paris Hilton has perfected a pigeon-toed photo stance to hide her size 11 feet. The good news is that pigeon intoeing, which is medically known as in-toeing, is typically harmless and improves on its own as your child develops and gains coordination.
Intoeing is most often caused by one of three conditions: metatarsus adductus, tibial torsion, or femoral anteversion. Typically, these conditions cause the front of your child’s foot to curve inward, though they may also affect the knee or hip. These conditions can be inherited or acquired, and your child’s position in the womb may contribute to mild bone rotations that persist after birth.
Mild intoeing is usually not an issue and can be addressed by observation and regularly monitoring your child’s gait. However, if your child’s intoeing is noticeable and doesn’t improve over time, a professional assessment may be required.
A physical therapist can perform a thorough evaluation and determine the best treatment option to correct your child’s intoeing. Treatments may include toe stretches and balance exercises that encourage a natural correction over time. For more serious issues, your physical therapist may suggest corrective braces or surgery to fix your child’s pigeon toes.