Intoeing means that a child’s feet turn inward when walking or running, instead of pointing straight ahead. It is commonly referred to as being “pigeon-toed.” Intoeing often causes young children to trip over their own feet. In a vast majority of young children, intoeing will correct itself with out treatment. However, if it is still present after age ten, it is more likely that it will continue to persist. Nevertheless, it typically will not cause pain or lead to future problems such as arthritis.

If the intoeing is associated with pain, swelling, or a limp, an evaluation by a pediatric orthopaedic specialist is recommended.

The three common causes of intoeing are:

A curved foot (metatarsus adductus)

Metatarsus adductus usually improves by itself, but sometimes casts or special shoes are needed. Surgery is seldom required.

Twisted shin bone (tibial torsion)

Tibial torsion will almost always improve before school age without any treatment. Splints, braces, special shoes, and exercises do not help. Rarely, surgery is done if a significant twist persists and interferes with walking.

Twisted thighbone (femoral anteversion)

Similarly, femoral anteversion will almost always improve without treatment, but generally takes a little longer than tibial torsion (up to age nine or ten). Children with femoral anteversion have knees that point inward as well, and they often will like to sit in the “W” position rather than the cross-legged position. Like tibial torsion, splints, braces, special shoes, and exercises do not help—and surgery is only done in severe, persistent cases.