By Brandon Macy, DPM, Clark, NJ
Many parents notice that their child’s toes point in when they walk—also known as an “intoe gait”. At times it is also referred to as being “pigeon toed”. It can look awkward and sometimes a child can not only look clumsy, they may indeed trip and fall more than is usual.
There are several reasons toes point inward and sometimes more than one can be at play. The key to treating is to identify the source of the problem.
Most commonly there are biomechanical issues at the root of the problem. Disproportionate hip rotation where they turn inward more than outward is often the problem. As similar situation can also happen at the level of the knee. There can also be torsional problems of the leg or thigh bones.
Within the foot, if the front part of the foot is tilted towards the outside as compared to the back part of the foot, the forefoot will rotate or flop inwards as the ball of the foot lands in the gait cycle. Alternatively, due to congenital issues the front part of the foot can turn inward as compared to the back part of the foot. Known as metatarsus adductus, this is treated by serial casting in the very young and may become a surgical problem if older.
How is the intoeing best treated? By utilizing an orthotic—often one of our LittleSteps children’s orthotics which help balance the foot properly. Very often we’ll use a specialized orthotic called a gait plate for a while and this helps encourage the foot and leg to turn outward and function more normally.
Asymmetrical hip rotation is made worse when a child in the “W” position with their feet outside their hips. They should be encouraged to sit cross-legged and to participate in activities such as skating or horseback riding to increase external hip rotation. We may also recommend certain exercises and possibly refer for physical therapy to help strengthen and balance the muscles, tendons and ligaments.
The takeaway point is this: don’t let well meaning people tell you to let your child “grow out of” intoe issues!
For more information or an appointment, visit Dr. Macy's website at www.clarkpodiatry.com.
"At Clark Podiatry Center and the New Jersey Children’s Foot Heath Institute, we want to keep you and your child walking!"
For more information EMAIL US