Definition: condition in which a child walks/stands with the toes pointing inward; often more noticeable in toddlers and usually improves with age
Medical terminology: intoeing, metatarsus adductus, metatarsus varus, false club foot
In-toeing is the most common reason for referral to a foot clinic or pediatric orthopedic clinic. It can be very worrisome for a parent to see their child having trouble walking, tripping over own feet or complaining of foot, knee or back pain.
If you notice your child walking awkwardly or having difficulty walking, it is important you seek medical attention to prevent the progression of symptoms through adulthood.
What does in-toeing look like?
- Toes are pointed inward
- Awkward walk (unstable)
- Child may trip over own feet while walking
- Tend to sit in the ‘W’ position (encourages in-toeing)
- Complaints of tired, sore feet
- May avoid walking
- Knee or back pain
- Flat feet
What causes in-toeing?
There are many different causes for in-toeing but are related to developmental unwinding from the hip to the foot. The cause of in-toeing may originate from the hip, thigh bone (femur), knee, shin bone (tibia), the foot or a combination of the above.
Hip – Internal femoral position
- The hip is in an internally rotated position allowing the leg to be in an in-toed position
- The thigh bone is internally positioned and the surrounding soft tissue (hip ligaments) help hold the internal position
Knee – Internal tibial position
- Shin bone (tibia) has developed and functions in an internally rotated position
- Sometimes growth disorder of the knee and tibia cause the tibia to be angled inward
Foot – Metatarsus adductus
- Child’s toe bones (metatarsals) have developed in an inward position
- The inward toe bones cause the foot to look intoed