Intoeing or pigeon toed walking is when the child’s feet turn inwards when walking. In a lot of cases, pigeon toed walking is stemming from the feet and should be outgrown by the age of 5-6 years old.
However, when a podiatrist sees children walking pigeon toed older than 5 years old, then I would say it can be a sign of a bigger problem.
What are the causes of in toeing in kids?
1) Metatarsus Adductus(curved feet) – which is usually due to not having enough room in the uterus. The Child should grow out of this by the age of 2 or 3 with some gentle exercises.
Metatarsus Adductus- When the feet turn inwards (this is specifically stemming from the Metatarsals or the balls of the feet.)
image from: http://www.nlm.nih.gov/medlineplus/ency/imagepages/9052.htm
2) Internal tibial torsion (twisted shin bone)
This is when the shin bone (the bone between the ankle and knee) turns inwards during walking. This is very common and kids will normally grow out of this by 8 years old without treatment.
3) Femoral Anterversion (Twisted thighbone) Femoral anteversion is evident at 5 or 6 years of age. The upper end of the thigh bone, near the hip, has an increased twist, which allows the hip to turn inward more than it turns outward. There can be associated weak hip musculature.
When is intoeing a sign of a bigger problem?
A child that walks pigeon toed usually requires a review a the 5-6 year old age group. The concerns raised by podiatrists and physiotherapists are usually to do with if your child falls a lot at school.
- Are they tripping over themselves?
- Are they having trouble keeping up with their peers?
Is the intoeing/pigeon toed appearance of their gait only affecting them on one leg?
If the hips are internally rotated/twisted thighbone, then the best option is to see a Paediatric physiotherapist to assist with some stretching and strengthening exercises. In the case of internal tibial rotation – Twisted shin bone, Some paediatric podiatrists are also able to assist with some stretching and strengthening exercises or an orthotic/insole in the shoe to change the internal position of the tibia bone.
It is important to note a lot of the time, a child will grow out of this condition, especially if it only affects the feet and shin bones.