Don't Let Your Child's Pigeon Toes Be a Worry

Pigeon toes are also known as intoeing (the toes point inward), and the medical term is metatarsus adductus. The good news: Intoeing is usually something your child will outgrow; almost 90% of cases are resolved by the age of six. it doesn’t cause more falls (clumsiness) or arthritis. The biggest problem is fitting shoes. If you are considering special shoes or braces, please save yourself the money and visit a podiatrist first. Braces, special shoes or shoe inserts usually don’t help.

What can I do about my child’s pigeon toes? There are three reasons for intoeing in a healthy child. They are:

1. A curve in the foot itself ; again, the medical term is metatarsus adductus . You may notice a curve in the foot when your child is still a baby. The curve in the foot is caused before the baby is born, when the baby’s feet are pressed inside the uterus. The feet get straightened as a result of normal growth after birth, over ninety percent of the time. If the foot shape is very curved, ask your doctor how you can gently stretch your baby's foot. In more pronounced cases of curved feet, casting the feet may be done to straighten the feet before your baby starts walking. And even if the feet remain somewhat curved after casting, the only problem may be with fitting shoes. Don’t worry, curved feet are not a painful condition, nor will curved feet prevent activities.

2. A twist in the tibia bone , which is the bone between the ankle and knee (it’s called internal tibial torsion). There is normally some inward twisting in babies (they appear bow-legged). In some babies, the twist doesn’t get straight enough that their feet point straight ahead, so they look pigeon-toed. Luckily, by the age of six to eight years of age the bones usually grow correctly. Again, braces and special shoes are ineffective, and kids often don’t like to wear them (children often don’t want to be reminded about being ‘different’ at this age). Even if the torsion does not completely resolve, it doesn’t interfere with activities or cause pain. Surgery is rare and is usually done only when appearance is a problem. The bones can be surgically rotated into the proper position.

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3. An inward twist in the thigh bone , the bone between the knee and hip, is called excess femoral anteversion, and is first noted usually in toddlers between the ages of two and four; it can worsen over time. Again, all babies start with some inward twist of the thigh bone . Babies also have brand-new, taut muscles and ligaments. After walking for a year or two, these same ligaments and muscles loosen and allow the inward twist of the thigh bone to be more pronounced.

There is a higher incidence of congenital hip associated with this condition, so be sure your baby has a thorough exam to rule out this condition

More good news : This usually resolves itself, as with the internal tibial torsion, by age six to eight. No need for braces or special shoes. And again, surgery can be an option in a very few cases (turning the bone so the foot points straight). If you are still concerned, consult your baby’s doctor.