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January 29, 2024 Staff

Topics - Developmental

Nature, Causes and Treatment of Intoeing

Intoeing, often referred to as "pigeon-toed," is a condition seen in children where their feet turn inward when they walk or run. It's a common observation in pediatric orthopedics and generally falls into one of three main categories:

  1. Metatarsus Adductus: This condition is characterized by the inward curve of the front part of the foot. It's often noticeable from birth and usually improves on its own as the child grows.

  2. Internal Tibial Torsion: This is the most common cause of intoeing in toddlers and young children. It involves an inward twisting of the tibia (shinbone), causing the feet to turn inward.

  3. Femoral Anteversion: This condition involves the inward twisting of the femur (thighbone), more common in older children. It can cause intoeing and a "sitting in W" position when seated on the floor.


  • Genetics: A family history of intoeing can increase the likelihood of a child developing the condition.

  • In Utero Positioning: The position of the baby in the womb can affect the development of the feet and legs.

  • Growth Patterns: Children often grow in varying patterns, and intoeing can be a part of this process.


Diagnosis typically involves a physical examination by a pediatrician or pediatric orthopedist. They may assess the child's walking pattern, leg alignment, and hip rotation. In some cases, imaging tests like X-rays may be used for a more detailed evaluation.


Most cases of intoeing in children resolve naturally without any intervention as the child grows and matures. In rare cases where intoeing is severe or doesn’t improve with time, treatment options may include physical therapy, braces, or, very rarely, surgery.


The prognosis for children with intoeing is generally excellent. Most children outgrow the condition with no lasting effects. Regular monitoring and follow-ups with a healthcare professional are recommended to ensure proper development and to address any concerns that may arise.

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