Intoed Gait
Children with an intoed gait have feet that are abnormally rotated inward towards each other, affecting their walking pattern. Also known as ‘pigeon toes’, an intoed gait may be caused by an inwards rotation of the bones within the foot, a twist or internal rotation within the shinbone, or an internally rotated hip position.
In an infant, the most common cause of an intoed foot position is congenital metatarsus adductus, in which the entire forefoot is turned inward and resembles a kidney bean shape. This results from the curled-up position of a baby before birth. It may affect one or both feet, and usually resolves spontaneously within the first three months after birth.
If metatarsus adductus does not resolve spontaneously, treatment will depend on the severity of the condition and the age of the child, which determines how hardened the bones have become. Treatment of metatarsus adductus may include a stretching program, taping or serial casting, footwear modification or corrective bracing.
Between the ages of one and two years, intoed gait is often caused by internal tibial torsion, or an inward twist or rotation of the tibia or shinbone. This may result from the way a baby is positioned prior to birth, or have a hereditary basis. An affected child may trip and fall more easily, and may go on to compensate for their misalignment by pronating (rolling in) their feet.
From three years of age, an intoed gait is often due to an internally rotated hip position, in which the knees are turned inward when the child is standing. Children with an internal hip position often sit, play or sleep in positions that reinforce this internal rotation, such as W-sitting, belly-sleeping or sitting on their feet – positions which should be actively discouraged. Treatment of intoed gait due to an internally rotated hip position will include: exercises; gait plates – specially designed inserts (or orthotics) that sit inside a child’s shoe and actively encourage the foot and leg to turn outward; flexible, lightweight footwear – since children are more likely to walk intoed when fatigued.
If you think your child may have an intoed gait, or are concerned about his or her foot or leg posture, contact us.
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