Pigeon Toes

Intoeing, also known as pigeon toes, occurs when a child’s feet point inward while walking. This condition is common in toddlers and young children and usually resolves naturally by around 8 to 10 years of age.

Intoeing can arise from several factors. Sometimes it results from your child’s foot shape (metatarsus adductus), while other times it stems from a twist in the shin (internal tibial torsion) or thigh bone (internal femoral torsion).

When intoeing is mild and symmetrical, it typically does not require investigation. In most cases, a watch-and-wait approach is sufficient. If pigeon-toeing is caused by torsion in the leg bones, it usually improves spontaneously. Because this is a structural issue, exercises, special shoes, or braces will not speed up correction.

Occasionally, intoeing is due to flexible “banana-shaped” feet (metatarsus adductus) caused by foot muscles. These feet generally straighten as your child grows. In rare cases, metatarsus adductus can be a bony problem, in which case the feet feel stiff. If you are unsure, it’s best to consult your GP or physiotherapist for assessment.

Many parents worry about their child tripping or falling more than usual. Fortunately, most children learn to adapt to their foot position over time. Encouraging your child to stay active and providing plenty of opportunities to practice movement skills can help them develop coordination and confidence.

Some children with femoral torsion may prefer W-sitting. While this sitting position is not considered harmful, it can be helpful to encourage cross-legged sitting to promote variety and better postural control.

When should I get my child’s legs checked?

In rare cases, intoeing can be severe (feet pointing inwards 45degrees or more) or asymmetrical. Where this is the case, you should see your GP so they can assess if you need to see a physiotherapist for further assessment or an orthopaedic surgeon for management.

Many parents’ main concern is their child’s tendency to trip and fall seemingly over nothing. This almost always decreases with time as your child learns to adapt to their foot position.