Parents have been asking me to step to it and provide some information on intoeing in their infants and toddlers.

Let me put my best foot forward about this topic.

Definition and causes

Intoeing is a condition in which the feet curve inward instead of pointing straight ahead. It can affect one or both feet. It may be due to a twist in one of the leg bones — the foot itself, the shin bone or tibia which is the most common cause during late infancy and early toddlerhood, or the thighbone or femur which commonly causes intoeing during the pre-school and school age years.

Intoeing can run in families and only rarely is it associated with other orthopedic problems like clubfoot.

If intoeing is due to a foot problem, it is often seen at birth due to the baby’s foot being cramped in the womb. This condition can get better with stretching exercises and will rarely need casting.

If the intoeing is not visible until your child starts walking, then it probably represents a twisting of the shin or thighbone.

Correcting intoeing

The good news is that intoeing of the shinbone gets better with tincture of time — often before your child is two years of age and almost always by school age. The same goes when the problem involves the thighbone.

Only rarely, especially in older children, is surgical treatment or a cast warranted. Be aware that stretching, exercises, special shoes, and night braces have not been found to help if the problem involves twisting inward of the shinbone or thighbone.

The good news is that there is no evidence that persistent intoeing leads to any significant problems in your child’s ability to walk, run, or play sports and does not cause arthritis as your children get older.

If you are concerned about your child’s intoeing because it does not seem to improve by three or four years of age or is associated with pain, a limp, or seems to be getting worse, simply talk with your child’s health care professional. They will examine your child’s feet and legs and can then tell you which bone is the problem.

Based on their examination, your child’s health care professional may then decide if and when a bone or orthopedic doctor needs to see your child to make sure further casting or surgery is not in order — although such treatments are rare compared to passage of time fixing this common problem.

Hopefully, tips like these will not allow you to experience the agony of defeat when it comes to knowing a little bit more about your child’s feet that may be intoeing.

——

Lewis First, MD, is Chief of Pediatrics at The University of Vermont Children’s Hospital and Chair of the Department of Pediatrics at the University of Vermont’s Larner College of Medicine. You can also catch “First with Kids” weekly on WOKO 98.9FM and NBC5.