Parents sometimes get alarmed when they notice their child walking differently. You'll notice their feet turned inward rather than pointing forward. This usually occurs when the baby starts to walk. This condition is commonly called intoeing. Those who afflicted also know it as "pigeon-toed." More often than not, the condition always corrects itself. The child won't even need casts or braces or surgery. By itself, intoeing doesn't even cause pain and neither would it result in arthritis. However, if the child should feel pain, swelling or develops a limp, that may be alarming. An orthopedic surgeon should immediately address the condition. Bring your child to the doctor so to administer the necessary treatment. Three conditions can cause intoeing. The first one, metatarsus adductus, is a common foot deformity. It's noted at birth that causes the front half of the foot, or forefoot, to turn inward. Second is tibial torsion. This is the inward twisting of the tibia and is the most common cause of intoeing. It is usually observed at age two years. Finally, there's femoral anteversion. This is an inward twisting of the thighbone. This causes the child's knees and feet to turn inward. This gives the child a "pigeon-toed" appearance. Here are the most common symptoms and the corresponding treatments for intoeing:
Many babies are born with their turned inwards. The turning is most prominent on the front portion of the foot. The condition is usually because of the baby's positioning. This happens while in a confined space inside the mother's womb. There are two ways to determine if the child has this symptom. First, when the child's foot is at rest and the foot turns inward. Second, the outside of the child's foot has a half-moon shape. In most cases, there should be nothing to worry about. These are mild cases and should resolve before the kid's first birthday. But sometimes, the condition can be worse. This is then the foot has other deformities and may lead to a problem known as "clubfoot."
Symptoms of intoeing become more obvious when the child starts to walk. Parents will notice their child's first steps where one or both feet turn inward. Often while they walk, this may lead to tripping or stumbling. Parents should bear in mind that intoeing doesn't cause pain. Although these are symptoms, they should be no cause for alarm.
Babies usually develop in the confined space inside the mother's womb. This may affect the positioning of the child's legs causing them to rotate to fit in such space. After birth, the legs will gradually rotate again for the proper alignment. Should this realignment not happen, the result is another form of intoeing. The condition will again get noticed when your child starts to walk. The foot turns inward since the tibia bone in the lower leg makes the foot point inward. The condition should resolve itself. As your child grows taller, the tibia will untwist. Ordinarily, the child would require no treatment. The child should normally be walking even before school time. Don't waste good money on special shoes, splints or exercise programs. They will not work. Just notice if the condition persists in the child's later years or it gets severe. If it causes major walking problems, consult with your child's doctor. He may perform surgery to straighten the bone.
Many cases of intoeing involve the turning inward of both the foot and the knee as the child walks. This becomes very conspicuous when the child stands in place. Notice if your child sits with his legs flat on the floor and feet out to either side in a W-shape. This is an indication of another type of intoeing - the twisted thighbone intoeing. This type of intoeing will manifest itself in later years of the child's life. It usually comes out between 5-6 years old. When the child's thighbone twists inward, this causes the knees and feet to turn inward as well. Again, the condition will correct itself as your child grows older. Wait for the problem to resolve itself before you run to the doctor.
Usually, intoeing does not entail pain or swelling. As reiterated several times, it will resolve itself without medications or accessories. However, there are times when a child experiences swelling and pain as a result of intoeing. In this case, your child would need some medical attention. Children will complain when they feel discomfort. Check their physical for any signs of swellings. Consult with an orthopedic surgeon for any treatment if required. For severe cases, surgery may even be on the table.
The doctors need only look at your child, physically and in action, to know if there are any signs of intoeing. Just to make sure everything is okay, your doctor may recommend tests and X-rays. This will determine in detail if the child's bones are normal or not. During a child's early age, you can't do anything to prevent intoeing. In most cases, there is no required treatment for intoeing.
Even with internal tibial torsion cases in children, there isn't much treatment required. The condition usually goes away as the child grows older. Do not waste good money your money on treatments or gear you're not sure will work. You might spend a lot of money, and your child will feel uncomfortable wearing them. For some of children, the condition will remain. But it will not cause them pain and will not interfere with running, playing, and jumping.
Like the first two types of intoeing, excess femoral anteversion needs no treatment. This condition usually improves by itself. Your child's feet will point straight ahead when he reaches the age of 6-8 years old. There will be a few who would require some special attention. But only in severe cases where there is a very pronounced inward twisting of the thighbone. A doctor may have to perform surgery to twist the thighbone outward so the feet can point straight ahead.
A doctor may recommend activities while your child is still a baby. A doctor can instruct the parent to do some stretching in the child's foot to get it straighter. But if the curve on the baby's foot is too pronounced or if the curve persists, the doctor may put a cast or brace on the foot. This will stretch the foot into a straight line. Such treatment may not totally remove the curve. The good news is, it won't interfere with your child's activities. Your child can still run, jump, play without experiencing any pain.
Almost all kinds of pigeon toes will self-correct on their own and waiting is the best cure. But when the condition is severe, your orthopedic surgeon may recommend surgery. This is an option only when your child grows older, aged between 9-10 years old. Also, only if the case is severe enough that it interferes with your child's activities. Surgeries for intoed children can involve different things. The doctor may lengthen the Achilles' tendon. Or he may reset the tibia-bone, cutting the femur then rotating it into proper alignment.
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