Do You See an In-toeing or Out-toeing Tendency in Your Child?

When you watch your child walk, does it seem that the toes point inward? This used to be called being “pigeon-toed.” Or – the opposite – does the foot seem to turn to the outside?

Many children have what we call “in-toeing” or “out-toeing.” The good news is that most children outgrow these abnormalities, often by the age of 2, without any special treatment or therapy.

Although sometimes the signs of in-toeing or out-toeing can appear in older children, usually they are observed just as the child begins walking. A family history can influence whether a child’s feet show these indications as well as how the baby was positioned before birth and, later on, if the child sleeps or sits for long periods a certain way.

Most Children Grow Out of In-Toeing

Most cases of in-toeing correct themselves when the children reach age 8 or 9. There are 3 types:

In metatarsus adductus, the point where the foot begins bending inward is at the middle of the foot. Mild cases are fairly flexible but the feet can be quite rigid in severe cases. If severe, or if the in-toeing lasts to age 6 and above, the child must be fitted with special shoes or a cast to force the feet to straighten.

A twisted thighbone is also called femoral anteversion and you’ll notice that the knees and feet twist inward also. This abnormality usually appears by age 6. If a child with this problem walks abnormally or trips frequently by the age of 9, surgery may be required.

When the twist occurs lower in the leg than a twisted thighbone, it’s a twisted shin situation or tibia torsion. In most cases, a school-aged child’s tibia should have “un-twisted.” If the problem persists, the child may need surgery at around 8 or 10.

Out-Toeing Is Far Less Common than In-Toeing

Children who have flat feet are at risk for out-toeing because the foot’s arch is not formed correctly and so the foot will turn to the outside. An out-toeing problem, if not resolved as the child matures, may result in pain and some degree of disability for adults.

At Your Next Step, we have extensive experience with in-toeing and out-toeing and other foot and ankle problems in children and teens. If you are concerned about your child’s gait or the shape of the feet, please call us for an evaluation.

In critical cases where the child’s walking is affected, we will prescribe custom-fitted orthotics, night braces and/or corrective shoes to alleviate the problem.

Come See Us for any Foot or Ankle Pain

Dr. Eric Ricefield, Dr. Mark Yagodich and Dr. Aliza V. Eisen, board certified or qualified podiatrists can quickly and accurately diagnose all types of foot and ankle problems and get started on effective treatments. Please contact us using the information at the website for our Ardmore, Paoli and Downingtown offices. Parents – have questions? – call us!

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