Children’s In-Toeing Treatment in Winchester and Basingstoke

In-toeing, otherwise known as pigeon toed walking, is when someone walks with their feet pointed inwards. In-toeing is one of the more common presenting issues Lydia sees at Eclipse Foot Clinic, particularly in young children. Parents often have concerns about their child’s walking style and are generally the first one’s to notice there is a potential issue. If you have any concerns and would like to investigate the cause of your children’s pigeon toed gait, contact our Winchester or Basingstoke clinic today on 0800 999 7337.

Pigeon toed walking is when your feet and toes point inwards / towards each other, as you walk. Ideally when walking our feet should be facing forward or relatively close to it. This allows for an easier transition through the walking cycle and allows the foot, ankle, knee and hip joints to be functioning in nice alignment. Due to the altered foot position in children who walk pigeon toed, they are predisposed to falls, tripping and discomfort through their joints. In fact, general clumsiness is one of the more common findings that parents comment on at their child’s initial consultation.

As with the majority of foot and lower limb conditions, pigeon toed walking can vary in severity from mild to severe, as well as being flexible and rigid. Flexible refers to the ability of the leg to turn back to a neutral position when a mild force is applied; rigid being no movement at all. The severity and amount of movement are two main factors that are determined at the initial consultation, as this has a large impact on what children’s pigeon toed treatment path we’ll follow.

Pigeon toed walking can occur for a number of different reasons. The below list contains some of the more common contributing factors:

• Inward twisting of the shin bone (tibial torsion)
• Inward twisting of the thigh bone (femoral torsion).
• Hip Range of motion is dominant internally (Greater internal motion compared to external). This is the most common cause of pidgeon toed walking
• Leg length difference (Shorter leg often compensates this way)
• Gluteal/adductor muscle imbalance (Muscular restriction outwards, allows more movement inwards)
• Structural abnormality of the hip joint
• Idiopathic (Reason is unknown/ no physical reason identified)
• Metatarsus Adductus* (Specific to the foot. It is an Inward position/ abduction from the forefoot to rearfoot). This gives the appearance that the foot is in-toeing but it is only the front of the foot that is
• Medical conditions (although this is quite rare)
• Tight hamstrings

Children’s pigeon toed treatment options will differ, depending on the cause of the pigeon toed walking. However, listed below are some of the common options available:

• Strengthening program to improve muscle weakness
• Stretching program to loosen tight muscles
• Footwear advice
• Gait plate orthotics: these have a rigid extension on the outside of the insole. This makes walking in an in-toed position more difficult and retrains the muscles over time so that the leg straightens up
• Functional activities for the child to do without losing interest e.g. riding a scooter
• For severe cases, braces that the child sleeps in are considered as they hold the leg in an externally rotated position
• Surgery is rarely indicated, however is an option if there is a structural abnormality of the hip or an underlying medical condition involved

Unfortunately, there is no specific timeframe for pigeon toed walking to be completely resolved, as it depends on a host of factors. These include the severity of the case, compliance with exercises / treatment and cause of the issue. It is important to note though, there are no quick fixes and changes occur slowly over time. On a more positive note, the side effects and discomfort that can be associated with pigeon toed walking, often improve relatively quickly.

With the appropriate early interventions for children’s pidgeon toed gait, the majority of pigeon toed cases resolve by the time the child finishes growing in their mid-teens. Our clinics provide effective treatment, for a range of patients. So, if you are concerned that your child is walking pidgeon toed, call our clinic today and book them in for a biomechanical assessment with our Paediatric Specialist Lydia.