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Intoeing in Pediatrics

Intoeing, often referred to as “pigeon-toeing,” is a common condition seen in children where the feet turn inward instead of pointing straight ahead when walking or running. While it may seem alarming to parents, intoeing is usually a normal variation of development in children and typically resolves on its own as they grow. However, understanding the causes, diagnosis, and treatment options for intoeing can help parents navigate this condition with confidence.


What Causes Intoeing?

Intoeing can stem from several factors, including:

  • Metatarsus Adductus: This condition is characterized by a curved or C-shaped foot. It often corrects itself within the first few months of life but may persist in some cases.
  • Femoral Anteversion: In this condition, the thighbone (femur) twists inward more than usual, causing the knees and feet to turn inward. It is typically noticed between the ages of 3 and 5 and tends to improve as the child grows.
  • Tibial Torsion: This involves the twisting of the shinbone (tibia), leading to inward rotation of the foot. Tibial torsion is usually most noticeable between the ages of 2 and 4 and often resolves without intervention.



Pediatricians diagnose intoeing through physical examination and, in some cases, imaging studies such as X-rays. During the examination, the doctor will assess the child’s gait, range of motion in the hips, knees, and ankles, as well as the alignment of the feet and legs.


Treatment Options

In most cases, intoeing does not require treatment, as it tends to improve as the child grows and their bone structure matures. However, there are some strategies parents can employ to help manage intoeing:

  • Monitoring: Regular check-ups with a pediatrician can ensure that the intoeing is not causing any functional limitations or complications.
  • Encouraging Physical Activity: Engaging in physical activities like walking, running, and playing can help strengthen muscles and improve coordination, which may aid in the natural correction of intoeing over time.
  • Footwear: Proper footwear, such as supportive shoes with good arch support, can help promote healthy foot alignment and gait.
  • Orthotics: In rare cases where intoeing persists and causes significant issues, orthotic devices may be prescribed to provide support and promote proper alignment.
  • Surgical Intervention: Surgery is rarely necessary for intoeing and is only considered in severe cases that do not respond to other forms of treatment.


Intoeing is a common condition in children that typically resolves on its own without intervention. However, it is essential for parents to consult with a pediatrician if they have concerns about their child’s gait or foot alignment. Remember, each child is unique, and what works for one may not be necessary for another.


If you have questions about your child please contact our board-certified pediatricians by booking a telemedicine appointment, calling 855-576-8745, or using our chat feature on the homepage.