Have you noticed your child’s feet turning inward when they walk? This is known as intoeing (or “pigeon-toed” walking), and it is very common in young children. In most cases, it is simply a normal part of growth and development.

Does Intoeing Cause Problems?

Many parents worry when they first notice intoeing, but the good news is:

• Children with intoeing may trip a little more when learning to walk, but this usually improves on its own.
• Intoeing does not affect their long-term ability to walk, run, jump, or participate in sports.
• Most children grow out of it without any treatment.

What Causes Intoeing?

Intoeing can occur for various reasons, usually related to how the bones and muscles develop. The common causes are:

1. Femoral Anteversion

• The thighbone (femur) rotates inward, causing the entire leg to turn in.
• Most commonly seen between 2–4 years of age.
• Usually resolves naturally by 10 years.

2. Tibial Torsion

• The shin bone (tibia) is twisted inward.
• Corrects itself as the child grows, typically by 4–5 years.

3. Metatarsus Adductus

• The front part of the foot curves inward.
• Often caused by limited space in the womb.
• Most cases straighten out on their own.

4. Muscle Tightness or Weakness

• Tight hamstrings (muscles at the back of the thigh) can contribute to intoeing.
• A gentle stretching programme can help improve flexibility.

How Can Parents Help?

Most of the time, no medical treatment is needed, but a few supportive steps can help:

• Avoid splints or special shoes — studies show they do not help.
• Discourage “W sitting”, as it can worsen inward rotation.
• Encourage out-toeing activities, such as:
  • Ballet
  • Horse riding
  • Martial arts
  • Breaststroke swimming

These activities naturally promote outward leg movement.

Dr. Gururaj S Puranik

MBBS, DNB (Ortho), MRCS (Edin), FRCS (Ortho), Fellowship in Limb Reconstruction (Liverpool)

Senior Consultant – Trauma & Orthopaedic