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Physical Development: Understanding Intoeing in Children

written by: Jacqueline Chinappi • edited by: Elizabeth Wistrom • updated: 9/11/2012

Have you noticed you child toes pointing inward as he walks? Is it getting better or maybe even worse? Here we will see causes of intoeing and what needs to be done for conditions such as Metatarsus Adductus, Tibial Torsion, and Femerol Anteversion in children.

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    Causes of Intoeing

    When your child begins to pull himself up and then eventually wobble around the living room, you may or may not notice the way he places his feet. Most babies have some type of intoeing where the feet point inwards. The normal tibial intoeing and awkward walking usually decreases in time. What does it mean, though, if the intoeing continues?

    There could actually be three possible reasons why your child has an awkward stance. These reasons include Metatarsus Adductus, Tibial Torsion, or Femoral Anteversion. All three causes for intoeing involve the lower extremities.

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    Metatarsus Adductus

    Metatarsus Adductus affects the child’s feet. When a child has been diagnosed as having this condition there will be a curve in the foot. Many children have this condition due to the way they were laying cramped up in the womb and normally nine out of ten children see improvement.

    So what happens if the feet do not straighten out on their own? Casts or braces can be used for the child’s feet. Orthopedic doctors or podiatrists can be consulted to see when and which brace would be most effective for your child. Some doctors think that the child should start using the braces between four and six months of age, while other doctors like to wait later in case the child outgrows the condition. Usually doctors want the braces put on before the child learns how to walk.

    Braces are usually put on for several hours a day or at night, depending on the severity of the condition. The child will have to leave the braces on anywhere from six months to a year. Additional bracing may be necessary with certain children. If the feet do not straighten out after bracing, there is no need to be worried. The intoeing will not normally interfere with sports, running, playing, and will not cause pain. The intoeing will make it difficult to fit shoes properly.

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    Tibial Torsion

    The Tibia is the bone found between the knee and the ankle on the leg. A child with Tibial Torsion actually has a twisting of the Tibia bone. With Tibial Torsion the knees are pointing straight ahead and the feet turn inward along with the shins. Most children have some kind of tibia intoeing but many will improve as they grow.

    Studies have shown that braces do not work for Tibial Torsion and the only thing parents can really do is to wait it out. The Tibial Torsion remains in a small percentage of children. Fortunately, the condition does not interfere with any playing, sports, running, and it is not painful nor does it cause arthritis.

    With very severe conditions surgery may be an option. The surgery entails cutting the bone and literally turning the feet straight, then reconnected bones. This is a very major surgery and usually is done for the sake of appearance as the child is not in pain.

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    Femoral Anteversion

    Femoral Anteversion is the twisting of the Femur, also known as the thigh bone. This condition will be noticed in toddlers between the ages of two and fours years old. Many times it can get worse as childhood progresses. With Femoral Anteversion not only do the feet point inward but the knees also point inward.

    As with Tibial Torsion braces do not work for Femoral Anteversion. Many doctors will state that it is a waste of money because the condition will get better on it’s own. Usually by eight years of age, the feet point straight and the tibial intoeing will have improved.

    In some cases the intoeing does not improve and the only way to help the condition is surgery. Surgery with Femoral Anteversion would involve cutting the bone and twisting it to a normal position. Surgery is only considered for very severe cases. The intoeing will not get in the way of any everyday activities and does not interfere with sports, running, playing, or cause pain.

    Children who have had any of these causes for intoeing or who still have these conditions lead very normal lives. My own two year old daughter has Femoral Anteversion and also had Tibial Torsion. When she was one, we brought her to an orthopedic doctor who told us she would get better in time. A year later her Tibial Torsion and bow legged stance has improved. The Femoral Anteversion has also gotten better and we will see in time.

    As with any health issue it is best to consult your physician and specialist specializing in these conditions.