Your questions answered

What is intoeing?

Also known as being “pigeon-toed”, in-toeing is when a child’s feet turn inward when they walk or run. In most children, intoeing improves as they grow, but if it seems particularly severe, is symmetrical, causing your child pain, or hindering their development, then you should consider seeking medical advice.

What causes intoeing?

It’s not clear why some children develop intoeing, but it can arise from issues anywhere in the leg from the foot to the hip.

The three most common causes are:

Internal tibial torsion: This is an inward twist in the leg bone that joins the knee to the ankle (called the tibia). This is quite normal in babies, and usually self corrects. In fact, for the vast majority of children with internal tibial torsion, the condition improves without treatment.

If your child suffers from severe tibial torsion that doesn’t improve and is affecting their movement, then a surgical procedure called an osteotomy can be used to correct your child’s gait.

Excess femoral anteversion: Another twisted bone, this time the thigh bone (called the femur) can cause a child’s feet to point inwards. As with internal tibial torsion, this is quite normal and will, most often, self-correct.

Intoeing from this cause tends to present in children between 2 to 4 years old. Very occasionally, the twist may be too severe to self-correct and may require surgery. In these cases, a procedure called a femoral derotation osteotomy can be used to reposition the bone and correct the child’s gait.

Metatarsus adductus: With this condition, a curve in the foot causes the toes to point inward. Most commonly occurring in newborns and infants, the curve in the foot is probably the result of the position of the baby inside the uterus. In almost all cases, the feet straighten as the child grows.

The cause of intoeing will have an effect on any treatment that you may be offered. For example, shoe inserts are often recommended for intoeing, but could, in fact, be unhelpful if the cause of the problem is located in the upper leg or hip. 


If you have any questions about anything you’ve read here, or if you’d like to book a consultation, please don’t hesitate to get in touch. A member of our team will be happy to help in whatever way they can.

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