Kids With Pigeon Toes

In-toeing, sometimes called "pigeon toe", is a condition that causes the toes to turn inward when walking or standing. Is it something children can outgrow? Derek Kelly, MD, an orthopedic surgeon with Le Bonheur and Campbell Clinic, answers some common questions about this condition.

"The three main causes are Excessive Femoral Anteversion, Internal Tibial Torsion and Metatarsus Adductus. Excessive Femoral Anteversion is a twisting of the thigh bone that is commonly present in most children when they are born and tends to correct slowly as a normal part of growth. Some children have more twisting than others, but in the majority of cases, it will usually resolve without any treatment.

Internal Tibial Torsion is a very similar type of twisting, but occurs in the shin bone. It will also typically resolve with growth. Metatarsus Adductus is a turning in of the forefoot, which includes the toes and the front half of the foot. This is likely related to limited room in the womb.

These conditions are likely inherited. Typically one of the parents and one or more of the grandparents might have been evaluated for this as a child.

Treatment is rarely necessary. The majority of the problems will resolve as a normal part of growth. In most cases, in-toeing is completely normal. If you are concerned, then your pediatrician, therapist or orthopedic surgeon should rule out other rare causes of in-toeing like birth defects and neurologic or muscular diseases. Occasionally casting, bracing or physical therapy may be helpful for in-toeing unrelated to normal growth. Surgery is very rarely required."