Intoeing | Orthopaedics | Loyola Medicine


Overview and Facts about Intoeing

Intoeing is a disorder common in children where the feet turn inward while walking, instead of pointing straight ahead. This condition is also commonly known as being pigeon-toed. There are 3 main types of intoeing, and they are:

  • Femoral anteversion, which is when the thighbone rotates in
  • Tibial torsion, which is when the shinbone rotates in
  • Metatarsus adductus, which is when the foot rotates in

Generally, most children outgrow intoeing, but those who don’t will need treatment to correct the problem.

Signs and Symptoms of Intoeing

The symptoms of intoeing depend on which of the above orthopaedic conditions is causing the problem. However, common among all 3 is having problems with walking, such as stumbling or tripping.

In femoral anteversion, symptoms will first be noticed when your child turns 5 or 6. Their knees will point inward while they walk, and they will have a tendency to sit in a “W” shape, with their feet behind them and their knees bent under them.

In tibial torsion, you might notice right from birth that your baby’s leg turns inward. Usually, this condition corrects itself before age 4, but if it persists when your child is older, surgery may be required.

In metatarsus adductus, your child’s foot will rotate inward from the middle part of the foot down to the toes. It can sometimes look like clubfoot. Usually, the problem resolves itself by the time your child is 6 months old.

Causes and Risk Factors of Intoeing

Most problems with intoeing develop when the baby is growing in the womb. If space is tight in the uterus, the baby’s feet, hips or shin can get compacted, causing these body parts to grow inward.

Intoeing problems can also be genetic, meaning that if you or a relative had these problems, your child is more likely to have them as well.

There are a few risk factors that can increase your child’s likelihood of developing one of these orthopaedic conditions. These include:

  • Having a higher-than-normal birth weight or height
  • Being diabetic while pregnant
  • Being the first-born child

Tests and Diagnosis of Intoeing

To diagnose intoeing, your doctor will closely observe how your child moves around. It should be obvious once they start walking that there is a problem. The doctor will also perform a physical exam to see where the twisting is coming from, such as the hips, knees or feet.

For more conclusive results, a doctor might also order an imaging test, such as an X-ray or CT scan.

Treatment and Care for Intoeing

Most cases of intoeing correct themselves as the child grows up. This correction can take a few years. However, if your child has serious metatarsus adductus, they may require a cast on their foot to help straighten it out when they are 6 months old.

If your child has severe tibial torsion or femoral anteversion, they may require surgery once they are between 8 to 10 years old to reset the bone in the correct position.