Virtual Children's Hospital: CQQA: Intoeing and Outtoeing

Pediatrics Common Questions, Quick Answers

Intoeing and Outtoeing

Donna D'Alessandro, M.D.
Lindsay Huth, B.A.
Peer Review Status: Internally Reviewed
Creation Date: May 2002
Last Revision Date: May 2002

Common Questions, Quick Answers

What is intoeing?

Intoeing is sometimes called "pigeon toes."
It means that the feet curve in when walking instead of pointing straight ahead.
It may affect one or both feet.

What causes it?

There are a variety of causes.
- metatarsus adductus (front part of the foot turns in)
- internal tibial torsion (shinbone turns in)
- medial femoral torsion or overextension (thighbone turns in)
In some cases, intoeing runs in families.
Doctors do not always know why some children have intoeing.
It can result from a baby being in a cramped position in the womb.

Who can get it?

What are the signs and symptoms?

Your child may have intoeing if you notice her toes point inward while she is resting on her back or walking.
The outer part of her foot may be curved.
Intoeing is not usually painful.
It does not cause delays in your child learning to walk.
Intoeing may cause your child to trip and fall.
Shoes may wear unevenly in children with intoeing.
It does not cause arthritis.

How is it treated?

In young children, intoeing does not usually need to be treated. It will naturally correct itself.
Stretches, exercises, special shoes, shoe inserts, and night braces will not help. They may even hurt a child's normal growth.
Most children can even go barefoot without making the condition worse.
Children with severe intoeing may need to wear a cast.
Children over age 8 with intoeing may need treatment.

How long does it last?

Can it be prevented?

What about outtoeing?

Outtoeing is sometimes called "bow legs."
It is common in toddlers.
The toes point outward instead of straight ahead.
Treatment is not usually needed. They will usually straighten out as your child grows.
Special shoes and exercises will not help.
Outtoeing can sometimes be a sign of developmental dysplasia of the hip, especially if it affects only one foot. Talk to your doctor.

When should I call the doctor?

Call the doctor if your child's intoeing or outtoeing affects how she walks or runs.
If your child still has intoeing by the time she is 8 years old, talk to your doctor.
Call your doctor if your child has outtoeing that affects only one foot.
Call the doctor if your child complains that walking or running is painful.
Call the doctor if you have questions or concerns about your child's treatment or condition.

Quick Answers

Intoeing means that the feet point inward when walking or resting, also sometimes called "pigeon toes."
It can be caused by a number of things, including how the shinbones or thighbones are positioned. Some causes are not known.
Intoeing may run in families.
Intoeing is not usually painful. It does not cause delays in your child learning to walk.
In young children, it does not usually need to be treated. It will usually correct itself naturally. Older children with intoeing may need treatment.
Intoeing in young children usually corrects itself by age 2.
There is no known way to prevent intoeing.
Outtoeing is when the toes point outward, also sometimes called "bow legs."
Call the doctor if your child still has intoeing by the time she is 8 years old. Call if your child complains that walking or running is painful.

References

American Academy of Ortrhopaedic Surgeons. Intoeing. American Orthopaedic Foot and Ankle Society. 2001 March (cited 2002 April 12). URL: http://orthoinfo.aaos.org/fact/thr_report.cfm?Thread_ID=198&topcategory=Pediatrics
American Academy of Pediatrics. Pigeon Toes (Intoeing). Medem. 2000 (cited 2002 April 11). URL: http://www.medem.com/MedlB/article_detaillb_for_printer.cfm?article_ID=ZZZAV1IDDDC&sub_cat=-404
Dr. Hull.com. Developmental Dysplasia of the Hip. Congenital Dislocation of the Hip. 1996-2002 (cited 2002 April 11). URL: http://www.drhull.com/EncyMaster/H/hip_dysplasia.html#hip_click
HON. Musculoskeletal Disorders: Feet. InteliHealth. 2001 Jan 12 (cited 2002 April 11). URL: http://www.hon.ch/Dossier/MotherChild/child_musculoskeletal/muscoskel_foot,html
Park View Orthopaedics.com. Intoeing. (cited 2002 April 11). URL: http://www.parkviewortho.com/pedintoe.htm

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