Steps to Understanding Intoeing

Steps to Understanding Intoeing

Parents have been asking me to step to it and provide some information on intoeing in their infants and toddlers, so 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 slight twisting or natural rotation in one of the leg bones – the foot, the shin bone or tibia or the thighbones or femur. The problem of intoeing can run in families and only rarely is intoeing 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 get better with stretching exercises and will rarely need casting.  If the intoeing is not visible until your child starts walking, then it probably represents a mild rotation of the shinbone during toddlerhood or thighbone if you note it in during the preschool or early school age years.

What do we do about it?  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, and the same goes when the problem involves the thighbone. Only rarely, especially in older children, is surgical treatment or a cast warranted.  Be aware that exercises, special shoes, and night braces have not been found to help.

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 and does not 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 limp, or seems to be getting worse, simply talk with your child’s doctor.  He or she will examine your child’s feet and then can tell you which bone is the problem and then decide if and when a bone specialist or orthopedic doctor needs to see your child to determine if further casting or surgery is needed to fix this problem. However, such treatments are rare.

Hopefully, tips like this will not allow you to experience the agony of “de-feet” when it comes to knowing a little bit more about your child’s feet that may be intoeing.

Lewis First, M.D., is chief of Pediatrics at Vermont Children's Hospital at Fletcher Allen Health Care and chair of the Department of Pediatrics at the University of Vermont College of Medicine. 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.FletcherAllen.org/firstwithkids.