In-toeing and Out-toeing in Toddlers

intoeing and toeing out in children

Whether your baby rises from a crawl with a shaky first step or a full-on sprint across the living room, chances are you’ll be on the edge of your seat. But remember — a child’s first steps usually aren’t picture perfect.
Learning to walk takes time and practice, and it’s common for kids to start walking with their toes and feet turned at an angle. When feet turn inward — a tendency referred to as walking “pigeon-toed” — in-toeing. When feet point outward, it’s called out-toeing.
It can be upsetting to see your child develop an abnormal gait, but for most toddlers with in-toeing or out-toeing, it’s usually nothing to worry about. The conditions do not cause pain and usually improve as kids grow older.
Almost all healthy kids who toe-in or -out as toddlers learn to run, jump, and play sports as they grow up, just the same as kids without gait problems.
In-toeing and Out-toeing
Most toddlers toe-in or -out because of a slight rotation, or twist, of the upper or lower leg bones.
Tibial torsion, the most common cause of in-toeing, occurs when the lower leg bone (tibia) tilts inward. If the tibia tilts outward, a child will toe-out. When the thighbone, or femur, is tilted, the tibia will also turn and give the appearance of in-toeing or out-toeing. The medical term for this is femoral anteversion. In-toeing can also be caused by metatarsus adductus, a curvature of the foot that causes toes to point inward.
The reason some kids develop gait abnormalities and others don’t is unclear, but many experts think that a family history of in-toeing or out-toeing plays a role. So, if you toed-in or -out as a child, there’s a chance that your child could develop the same tendency. Additionally, a cramping of the fetus in the womb during pregnancy could also have led to in-toeing or out-toeing.
As a fetus grows, some of the bones have to rotate slightly to fit into the small space of the womb. In many cases, these bones are still rotated to some degree for the first few years of life. Many times this is most noticeable when a child learns to walk, because if the tibia or femur is tilted at an angle, the feet are, too.

Does Walking Improve?
As most kids get older, their bones very gradually rotate to a normal angle. Walking, like other skills, improves with experience, so kids will become better able to control their muscles and foot position.
In-toeing and out-toeing gets better over time, but the change occurs very gradually. And, it’s hard to notice. Parents can record their child walking, and then wait about a year to take another video. This usually makes it easy to see if the gait abnormality has improved over time. In most cases, it has. If not, parents should speak with their child’s doctor to discuss whether treatment is necessary.
If Walking Does Not Improve
Speak with The Podiatrist if you’re concerned about the way your child walks. For a small number of kids, gait abnormalities can be associated with other problems. For example, out-toeing could signal a neuromuscular condition in rare cases.
Have your child evaluated by The Podiatrist if you notice:
in-toeing or out-toeing that doesn’t improve by age 3
limping or complaints of pain
one foot that turns out more than the other
developmental delays, such as not learning to talk as expected
gait abnormalities that worsen instead of improve
If you are at all concerned, contact The Podiatrist
http://www.thepodiatrist.co.nz
http://www.kidsnmotion.co.nz

Advertisements

About Your feet and podiatry with Caron Orelowitz | Registered Podiatrist - Auckland

Caron Orelowitz was born in Johannesburg and emigrated to New Zealand in 1997. She studied Podiatry at The Witwatersrand Technikon and was in private practice in South Africa for a few years, before setting off to ‘the other side of the world’. Auckland Podiatry. Since 1998 she has been helping people of all ages who have problems with their feet, from the elderly, to sports people, and those who just want some TLC for the feet. At present she has 5 practices (with a satellite Diabetes Practice out West Auckland), owns a children’s shoe shop (Scooters in Remuera), and tries to fit in some exercise when time permits. Caron is an active member of Podiatry New Zealand (NZ), and holds the position of Treasurer for the Auckland Branch, as well as representing the Northern Region on the Executive Council. She is registered under HPCAA (Health Practitioner Competency Assurance Act), and is often seen attending (and organizing) Seminars and workshops. Caron has a special interest in Paediatrics and can often be seen on the floor showing children some exercises. ACC registered Discounts for Super Gold Card Holders, members of Grey Power and Green Prescription participants. www.thepodiatrist.co.nz www.yourfeet.co.nz

Posted on May 13, 2013, in Contact a Podiatrist, Kids n Motion, What is a Podiatrist, Your feet and tagged , , , , , , , , , , , , , , , , , , , , , , . Bookmark the permalink. Leave a comment.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: