In-toeing

About In-toeing

In-toeing or femoral anteversion (also called pigeon-toed) may affect up to 10% of children. If your child has this condition and it negatively affects their mobility or causes pain, turn to our Doctors at the Mill Creek Foot & Ankle Clinic, in Mill Creek, Washington. Our doctors can diagnose and treat in-toeing in patients of all ages. Schedule an evaluation by phone or request one online today to learn more.

In-toeing Q&A

What is in-toeing?

In-toeing, or femoral anteversion, is a gait abnormality. It’s the inward twisting of the femur (thigh bone), tibia (shin bone), or hip bone, causing a child’s knees and feet to turn inward and creating a pigeon-toed appearance.

In-toeing may result because of developmental or genetic issues, but it’s highly treatable with the help of the foot and ankle specialists at Mill Creek Foot & Ankle Clinic.

What are the symptoms of in-toeing?

The following signs can indicate in-toeing:

• Legs or feet turning inward
• Inward-pointing toes
• Difficulty walking, running, jumping, or doing other activities
• Foot pain
• Pigeon-toed appearance when walking
• Irregular gait
• Inability to walk with the legs straight or feet close together
• Tripping and falling frequently

In-toeing can affect one or both of the legs. It often becomes apparent when a child is 2–4 years old and is most obvious at 5–6 years old.

What are the risk factors for in-toeing?

The cause of in-toeing isn’t entirely clear, but possible risk factors include:

• Being female
• Being a twin
• Breech position during pregnancy
• Large fetus during pregnancy
• Lack of enough amniotic fluid during pregnancy
• Clubfoot
• Developmental abnormalities in the hip
• Skewfoot
• Other foot malformations
• Cerebral palsy

However, the exact cause of in-toeing isn’t apparent.

How is in-toeing diagnosed?

Diagnosing pigeon toes typically involves a discussion about your child’s medical history and symptoms. A foot and ankle specialist examines their feet, observes the gait while they walk or run, and completes flexibility and angle tests. Your child might need X-rays, a CT scan, or an MRI in some cases to confirm a diagnosis or rule out additional foot or ankle problems.

How is in-toeing treated?

Many children don’t require treatment for in-toeing because the condition often resolves itself in kids aged 8 and younger by the time they reach adolescence.

Mill Creek Foot & Ankle Clinic offers bracing, casting, specialized shoes, physical therapy, and surgery in severe cases to correct femoral anteversion. However, few cases are serious enough to need surgery. In about 99% of patients, femoral anteversion self-corrects over time.

Schedule an evaluation at Mill Creek Foot & Ankle Clinic by phone or request one online today to get evaluated for in-toeing.