In-toeing gait

In-toe gait, also known as pigeon-toed walking, is a common observation in young children. It refers to a walking pattern where the feet turn inward while standing or walking. While typically harmless and resolving on its own, certain factors may warrant a healthcare professional’s evaluation.

 

Understanding In-Toe Gait:

  • Prevalence and Prognosis: Most children display some degree of in-toeing gait during their early walking years. Fortunately, this gait pattern usually improves naturally by age 6-8 years.

    • Potential Causes: Three main reasons can contribute to in-toe gait:

    • Metatarsus Adductus: In this condition, the forefoot (front part of the foot) curves inward. This positional deformity, often stemming from fetal positioning, usually corrects by age 3 without intervention.

    • Internal Tibial Torsion: Here, the shinbone (tibia) twists inward, causing the foot to appear pointed inward. This inward rotation typically improves by age 8.

    • Internal Femoral Torsion: This involves inward rotation of the thigh bone (femur). While appearing pigeon-toed, it’s a normal finding in young children and usually resolves by age 10. A common sitting position associated with this is the “W-sitting” where the child sits with their bottom resting between their heels.

When to Seek Medical Attention:

While in-toeing is often benign, consult a healthcare professional if you notice any of the following:

  • One-sided In-Toe Gait: If only one foot appears affected.

    • Severity and Lack of Improvement: If the in-toeing is severe and fails to improve with time.

    • Functional Impairment: If the in-toeing causes frequent tripping or hinders participation in activities.

    • Stiffness and Limited Movement: If the child’s feet appear stiff and lack normal range of motion.

Early Intervention:

Early diagnosis and intervention, if necessary, can help optimise your child’s development. A healthcare professional can conduct a physical examination and determine the underlying cause of the in-toeing gait. Treatment options, if needed, may include gentle stretching exercises or specialised footwear.

Remember: In-toeing itself is usually painless. However, pain might be present if an underlying condition caused the in-toeing gait.

 

 

Source: Fact sheet developed by The Royal Children’s Hospital – Orthopaedic fact sheet.