First published on Parent24.com:
My baby walks funny
Did you know that pigeon toes (or intoeing) occurs in 2 out of every 1000 children? But wait, there’s more.
Soon after my little girl was born, I noticed that she was very bowlegged and I couldn’t remember any of my other kids having legs like that. When she started walking at 10 months I noticed how her right foot was pointing inward as she walked. She was also more prone to falling than her brothers were. So I made an appointment with an orthopaedic surgeon.
The doctor confirmed that she was intoeing and explained the reasons why. During foetal development the lower limbs start rotating inward around the seventh week, this makes the toes point towards each other. Later the legs gradually rotate out again and this may carry on during childhood, but by the time of birth, the feet are approximately pointed straight forward.
A small amount of twist in infant legs is considered normal. With my little girl, the rotation was slightly more than normal resulting in feet pointing inwards when she walked.
Since this condition usually corrects by itself, no treatment is planned for now. However, if she still suffers from it at 12 years of age, we will look at it again.
There are three types of intoeing :
1. Metatarsus Adductus (curved foot)
Metatarsus adductus, is the most common congenital foot deformity.
In Metatarsus adductus, the front part of the foot curves inward. It is usually due to the way the baby was positioned inside the womb and is normally noticeable directly after birth. In most children this corrects itself by the age of 4 to 6 months. Should the curve be unusually severe or rigid, the doctor will probably do a cast or give stretching exercises. Although this condition isn’t painful at all, it could present a problem with finding shoes later in life.
2. Tibial Torsion (twisted shin)
The most common cause of intoeing is tibial torsion, which usually becomes apparent when infants begin to walk.
Tibial torsion is a twist to the main shin bone. When you look at the leg from the front and the knee is straight, the foot joint is obviously turned inward. This is usually noticed around the time that the baby starts to walk. Most babies have a slight twist to this bone that disappears by the age of one year. The cause is thought to be due to the way the baby was positioned inside the womb, but can also run in families. This used to be treated with boots connected to a bar, but research showed that children that went untreated showed the same recovery as children that were treated. Most children will grow out of this by the age of 8 years. Even if the problem persists, research has shown that it doesn’t cause arthritis or problems with jumping and running.
Tibial torsion:
- Affects boys and girls to an equal degree
- Two-thirds of the time both legs are affected, but in most cases legs are not affected equally, with one leg rotated more than the other.
- Occurs more frequently in the left leg than the right leg when in both legs
3. Femoral Anteversion (twisted thigh)
When intoeing starts in early childhood, it is most frequently due to medial femoral torsion.
Femoral anteversion is due to a twist in the femur close to the hip joint. It is less noticeable at a young age and usually comes to the parents attention around 4 to 6 years of age. The child will stand with knees and toes pointing inward. This too corrects on its own. Children with femoral anteversion tend to sit in the W position – with their knees bent and the feet to the side. Since this position reinforces the femoral anteversion it should be discouraged.
Femoral torsion :
- Is twice as common in girls than boys
- Almost always affects both legs equally
- Is believed to be inherited, to some degree
- Sometimes causes an abnormal gait and difficulty running
More about intoeing
Generally, children with intoeing are otherwise completely healthy and do not suffer from other abnormalities or diseases.
- It usually does not cause pain.
- It usually does not interfere with learning to walk.
- It has not been linked to arthritis in adulthood.
- It does not cause clumsiness.
- Occurs in about 2 out of every 1000 children.
- Is more common in infants and young children than in adolescents.
Useful websites
- FamilyDoctor.org
- American Academy of Orthopaedic Surgeons
- Columbia Orthopaedics
- University of Maryland Medical Centre
- American Orthopaedic Foot & Ankle Society
- Orthoseek.com