Intoeing typically occurs in infants and children under the age of 10. The appearance of the condition is apparent with the toes pointing inwards instead of straight ahead, thus commonly referred as “pigeon-toed”. Some infants are born with it, caused by the position in the womb. Others gradually develop it or the intoeing becomes noticeable after they started walking.
Usually, children outgrow intoeing. Their feet would straighten out as their legs grow longer without the use of casts, braces and surgery. Intoeing does not cause any pain or trouble in learning to walk. Only in severe cases that patients would trip and stumble often as a result of the conflicting directions that the feet are pointing.
Intoeing should not be confused with Hammertoes, which is a more severe deformity of the second, third or forth toe. It got its name from the way the middle joint of the toe is bent downwards like a hammer. While intoeing does not affect the child’s daily functions and would naturally correct itself over time, hammertoes causes pain, growth of corns and calluses, discomfort in wearing regular shoes, muscle imbalance, and these symptoms would worsen if left untreated. Surgery may even be required if it is diagnosed late.
To know the cause of intoeing, patient has to be diagnosed with the specific type of intoeing.
This is a common birth defect in which the middle of the foot to the toes are turned inwards. Most of the time, it gets better after a few months. But if the condition persists, casts and special shoes would usually correct the alignment without the need for surgery.
Because of the position in the womb, tibial torsion may occur even before the infant is born. The tibia, or lower leg, is bent inwards, making the feet twist inwards as well. Special shoes and therapy would not help but it usually goes away after the tibia grows longer. But if it does not get better even up to 8 years old and it affects the walking drastically, surgery may be required.
This occurs when the thighbone is turned inwards and may not be noticeable until the child is about 5 years old. As with tibial torsion, special shoes and therapy would not help but the condition improves with age. If walking is affected and causing significant tripping, surgery may be considered with the prerequisite that the child is at least older than 9 years old.