In-toeing, also known as “pigeon-toes”, occurs when the feet point inwards when walking. Children with in-toeing may walk or run with one or both feet turned inwards. While it is not typically painful, in-toeing may result in children tripping and falling or struggling to achieve gross motor milestones. Children who use an in-toeing gait also may prefer to use W-sitting.
1. Metatarsus adductus
- Curvature in the feet, resulting in the toes turning inwards.
2. Tibial torsion
- A twist in the shin bones (tibias), resulting in the feet turning in. This is the most common cause of in-toeing for toddlers.
3. Femoral anteversion
A twist in the thigh bones (femurs), making the feet turn in. This is the most common cause of in-toeing in school-aged children.
How Physiotherapy Can Help
- Physical assessment to determine the cause of in-toeing
- Gross motor assessment to ensure motor milestones are being achieved
- Strengthening exercises in neutral alignment
- Positioning recommendations