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Dr. Gellner: A common concern parents have, is that their child's feet turn in. I'm Dr. Cindy Gellner, and today's topic on The Scope is Intoeing.

What is Intoeing?

Dr. Gellner: So what is intoeing? It's just like it sounds. Intoeing means the toes point inward. There are several different causes, but it's very, very common in babies, and young children. A lot of people will refer to it as pigeon toed.

So what does cause intoeing? Intoeing is observed in children less than 2 years old most often. It's caused by the shin bone, which is the tibia, the bigger of the two bones in the lower leg. That bone may be actually turned in a little bit. It's called tibial torsion, and it's caused because of how the baby is positioned when it's still inside the mother's womb before birth. For children over 2 years old, if this intoeing is still present, or it's new, it's most common cause is due to the thigh bone being turned in at the hip. That condition is also caused from birth. It causes the knees, feet, and toes to point inward. So it's not just the feet, like you would see in intoeing from the shin bone, but it actually is more the whole leg.

If your child has just the front part of the foot turned in, that's not intoeing. That's called . That's usually something you pick up at birth.

Diagnosing and Treating Intoeing

So how is it diagnosed? Usually as pediatricians, we just need to watch your child walk to see if they have intoeing, and what it's from. X-rays normally are not needed to diagnose intoeing. Once your child is diagnosed with intoeing, how do you treat it? Most children really don't need any treatment at all. The intoeing gets better on its own. When it's caused by the shin bone being turned in, it usually gets better once the child starts standing, and walking for a while, usually around age 5. If it's caused by the thigh bone being turned in, the main treatment is simply having the child not criss cross their legs while sitting down. The problem usually gets better when children start school, and they have to sit in chairs, and they're not sitting on the ground as much.

So how can you take care of your child, if they do have intoeing? The thing I recommend most, is just making sure they have supportive shoes, and being patient. Waiting for it to get better, or see if it gets worse. There's really not much you can do about intoeing, and there's really nothing you need to prevent your child from doing. Let them be active, let them play, and often this corrects on its own. I'm often asked, "What could I have done to prevent this from happening?" The bottom line is, nothing.

Children are born with intoeing. There's nothing you could do to prevent it. It's just because of how they are positioned, and curled up inside the womb before they're born. So, if your child is walking a little funny, they've got their feet turned in, chances are, it's going to be just fine. Just keep an eye on it. If your child continues to have the intoed feet, and it actually is causing a lot of problems with running, and walking, and daily activities as they get older into their later elementary school ages, at that time, then your doctor may refer you to a specialist.

updated: January 4, 2021
originally published: February 16, 2015