In-toeing refers to the appearance when a child walks or runs that their foot or toes point inwards towards each other. It is often referred to as being “pigeon-toed”.
In most people when you watch them walk their feet point slightly outwards. This is the result of development of the leg bones as you grow. In some people they have a tendency to turn their feet either straight forwards or inwards. In children, if their toes point inwards, it can often correct itself by the age of 8 or 9.
As you grow your bones change shape and also gradually change the direction in which your foot points. From the toes up to the hip joint, different bones can be aligned in different ways and can affect the way the foot points:
The most noticeable symptom of in-toeing is either the parents noticing the way the child is lying as an infant or walks or alternatively the child constantly trips over their feet when they run or do sports. Their legs can be turned inwards so their kneecaps are pointing towards one another.
Accurate clinical examination of the child assessing the alignment of all the lower limb joints from hip to feet can determine the source of the in-toeing. This examination assesses the “rotational profile” of the childs legs. X-Rays are seldom required to assess the feet. They can be taken to look for any other associated conditions for example developmental hip problems if needed.
It depends on the primary cause of the in-toeing:
The natural history of these conditions is that they tend to “grow out” as the child develops. If the child has a functional disability where the are in discomfort consistently or their in-toeing is causing problems when walking or running then it is worth seeking specialist Orthopaedic advice on surgery.