Parents have been asking me to step to it and provide some information on intoeing in their infants and toddlers. Let me put my best foot forward and provide some information on the topic.
Intoeing is a condition in which the feet curve inward instead of pointing straight ahead. It can affect one or both feet. It may be due to a twist in one of the leg bones: the foot and the shin bone (or tibia) are common causes during late infancy and early toddlerhood. It could also affect the thighbones (or femur), which commonly causes intoeing during the pre-school and school age years. The problem of intoeing can run in families and only rarely is associated with other orthopedic problems like clubfoot.
If intoeing is due to a foot problem, it is often seen at birth due to the baby’s foot being cramped in the womb. This condition can improve with stretching exercises and will rarely need casting. If the intoeing is not visible until your child starts walking, then it probably represents a twisting of the shin or thighbone.
What do we do about intoeing? The good news is that intoeing of the shinbone gets better with time, often before your child is 2 years of age – and almost always by school age. (The same goes when the problem involves the thighbone.) Only rarely is surgical treatment or a cast warranted.
Be aware that stretching exercises, special shoes and night braces have not been found to help if the problem involves the shinbone or thighbone twisting inward.
The good news is that there is no evidence that persistent intoeing leads to any significant problems in your child’s ability to walk, run or play sports. There is also no evidence that intoeing can cause arthritis as your child gets older.
If you are concerned about your child’s intoeing because it doesn’t seem to improve by 3 or 4 years of age, is associated with pain or a limp, or seems to be getting worse, simply talk with your child’s doctor. The doctor will examine your child’s feet and legs and then can tell you which bone is the problem.
Based on their examination, your child’s doctor may then decide if and when a bone or orthopedic doctor needs to see your child to determine whether or not further casting or surgery is necessary. Again, this is a rare occurrence with intoeing.
Hopefully tips like this will prevent the “agony of de-feet” when learning a little bit more about your child’s intoeing.
Lewis First, MD, is chief of Pediatrics at The University of Vermont Children’s Hospital and chair of the Department of Pediatrics at the Larner College of Medicine at UVM. You can also catch “First with Kids” weekly on WOKO 98.9FM and WPTZ Channel 5, or visit the First with Kids video archives at www.UVMHealth.org/MedCenterFirstWithKids.