Pigeon Toes (In-toeing)
What are Pigeon Toes (In-toeing)?
Pigeon toes, also known as in-toeing, is a condition caused by misalignment of the bones or joints. This causes the toes to point inward, facing each other instead of forward. Pigeon toes are common among young children and generally resolve on their own without any pain.
Causes of Pigeon Toes
Pigeon toes occur when the bones in the shin, foot, or thigh are misaligned. Three common causes of pigeon toes include:
1. Bones in the foot
When there is a malformation of the bones that connect the toes to the ankle, it causes the toes to point towards the centre. This is known as metatarsus adductus, a congenital malformation, and it gives the foot a “C” shape. The malformation is common among babies younger than 12 months.
2. Shin bone
When the shin bone is inwardly rotated towards the middle of the body, it causes the legs to appear bow-legged. This is a common cause of pigeon toes that develop among children aged between 1 and 3 years old. However, this condition generally resolves on its own by the time the child is 5 years old.
3. Thigh bone
The inward rotation of the thigh bone in relation to the hip is another cause of pigeon toes. This condition is called femoral anteversion, and it is hereditary. However, femoral anteversion can also result from the fetus’s position in the uterus and is usually diagnosed between the ages of 3 and 6 years. Poor sitting habits during the toddler stage can also be a contributory factor.
Symptoms of Pigeon Toes
An easy tell-tale sign of pigeon toes is when your child’s feet are point towards each other while:
- Standing
- At rest
- Walking
- Running
However, it is common for children or infants to have their toes turned inwards when walking or running. If you notice that your child tends to trip or fall more than their peers when moving quickly, it is essential to seek medical advice for a proper diagnosis, as there is a higher risk of stress fractures when the child reaches adulthood.
When Should I Seek Help?
Pigeon toes generally are painless. However, if you notice any swelling, pain, or a limp associated with your child’s pigeon toes, it is crucial to seek medical help for a proper evaluation.
Treatment Options
In general, pigeon toes will get better over time. Physical therapy and exercises can help to correct pigeon toes. However, depending on the severity of the condition, your healthcare provider may recommend the following treatment options:
1. Serial casting or orthotics
If the metatarsus adducts is severe or shows no signs of improvement, a series of casts to stretch and lengthen the child’s muscles may be recommended. Orthotics may also be prescribed.
2. Osteotomy
Another treatment option is osteotomy, especially if the cause of pigeon toes is tibia-related that affects your child’s functional mobility. This procedure may be considered for children above the age of 11 years old with severe symptoms.