Generally, people’s feet point forward and outward. However, in some people, the toes and the feet will curve inward. This is known as in-toeing or being “pigeon toed”. This condition is prevalent among children, but adult pigeon toe is possible. Often times, in children, in-toeing will eventually go away with the natural growth of the child. In some cases, however, a podiatrist must correct pigeon toe, possible via toe surgery. A podiatrist would only perform surgery for correcting pigeon toe in the most severe of cases.
Picture of Pigeon Toe
Is This Condition Serious?
In-toeing will generally not cause serious problems, even if the body never corrects it. This condition will not cause clumsiness or arthritis; however, these children may have a difficult time finding shoes that will fit their foot’s curve. This alone is usually enough to have the condition corrected. They do make braces and shoe inserts, and corrective shoes for pigeon toes, but these can be expensive and ineffective.
A small percentage of people with pigeon toe will exhibit a severe twist in the tibia or femur which may bother them for aesthetic reasons. This problem will usually require surgery to correct. Fortunately in-toeing does not cause any serious problem, contrary to popular belief it will not cause arthritis or clumsiness. One of the largest problems for children with in-toeing is that shoes do not properly fit and are uncomfortable to wear due to the curve of the foot. However, many braces and shoe inserts do little to solve the problem and are expensive. Most cases are not severe but a few children do suffer from a severe twist in the leg and thigh bone, this condition although mainly cosmetic, to fix this condition it does require surgery.
Types and Treatment Options for In-toeing
There are several different situations that cause in-toeing to affect children. These are metatarsus adductus, excessive femoral ante-version and internal tibial torsion. Metatarsus adductus is characterized by a curve in the foot, which can be seen by looking at the child’s foot. This condition is normally caused by an awkward positioning inside the uterus and the foot will generally straighten as the child develops further. Even though the foot can correct itself your doctor can show you exercises and stretching techniques that will help stretch the child’s foot and correct the curve. Many doctors vary in beliefs about when to put casts on the child, but most believe that if casting is the right method of treatment it should be done before the child reaches an age at which they start to walk.
Internal tibial torsion is characterized by a twist in the tibia, or calf area of the leg. This symptom is noticeable by the time the child starts to walk. A slight twist in the bone is normal, straightening out during the first year of the baby’s life. In-toeing only occurs in these children if the leg doesn’t fully straighten by the time the child starts to walk, however the leg normally continues to straighten until the child reaches the age of six to eight years old. Braces and special shoes are available but have not been proven to work. Surgery is normally a cosmetic decision in these cases but should still be discussed with a podiatrist to help decide the safest and best course of action. Even if a small twist is left after the child stops developing it has not been shown to affect the abilities of the child, running and jumping can still be preformed.
Excessive femoral ante-version is characterized by a twist in the thighbone known as the femur. This often is not noticeable until the child is two to four years of age but it can get worse during the early developmental stages of a child’s life. Just like internal tibial torsion, all children are born with some amount of twist in this bone and it normally straightens within the first five years of a newborn’s life. The untwisting of the bone during the development stages of a newborn’s life is due to the ligaments and tendons loosening as the muscles in the area are used. Excessive femoral ante-version usually gets better with the aging of the child, but in some cases the leg remains twisted in appearance. In very severe cases surgery is required to allow the child’s feet to point straight ahead and allow them to walk normally. It is best to talk to your podiatrist to see your options and to find out if the child’s bones will correct the problem or if it is more serious and requires surgery.
Let Us Help You
Dr. Mechanik is Board Certified in Foot Surgery and Board Certified in Reconstructive Rear Foot and Ankle surgery. He has the medical and surgical skills to treat your foot conditions. He and his family are natives of the Denver area and opened Colorado Foot Institute in 2006.
Dr. Mechanik received his Doctor of Podiatric Medicine (DPM) degree from the the Dr. William M. Scholl College of Podiatric Medicine which is part of the Rosalind Franklin University of Medicine and Science, a national leader in medical education.
Dr. Mechanik then went on to complete a twenty-four month post-graduate Residency training program in Foot and Ankle Surgery and a twenty-four month surgical Fellowship training program in Lower Extremity Musculoskeletal Surgery.
Dr. Mechanik is a Fellow of the American College of Foot and Ankle Surgeons and a Diplomate, American Board of Foot and Ankle Surgery. He is Board Certified in Foot Surgery and Reconstructive Rearfoot/Ankle Surgery.
With his expertise in foot care, Dr. Mechanik will correct this pediatric disfigurement,and will help put your child back on the path to an active and healthy life. You can schedule an appointment by calling our office at 303-333-3383.