Tight hip external rotator muscles: children are born with their hips positioned out wide, and their muscles may become tight in this position, resulting in their legs turning outwardsĮxternal tibial rotation or femoral retroversion: the opposite of femoral anteversion in the “pigeon-toed” post, in which the shin bone is twisted outwards or the hip is positioned in a way that makes the whole leg point outwardsįlat feet (pronation): the most common reason why a child might walk with their toes pointed outwards The vast majority of children with metatarsus adductus do not complain of any symptoms, can participate in all physical activities and have no long-term problems.In pediatrics, out-toeing is a less common concern than in-toeing, but it is still a gait deviation found in many young children.Ĭommon reasons why a child might out-toe include: Very few children need an operation for their feet to be straightened. In some children with more pronounced problems and feet that are less flexible, the doctor may recommend special shoes, splints to be worn at night or, rarely, treatment with plaster casts. If the foot is supple and flexible (the doctor will check that) treatment is not necessary. More than 80 percent of children grow out of this by the age of 3-4 years. It is often seen in children who tend to sleep face down. This can also be due to 'moulding' during pregnancy. In-toe walking can sometimes be seen in children who have feet that are curved inwards (pigeon toes). Tibial torsion does not cause any functional problems and children can participate in all physical activities without suffering any long-term problems. Treatment with splints, plasters or braces does not alter it and is unnecessary. It may persist for a few years but gradually disappears as the child grows. This is very common in babies and toddlers and is due to 'moulding' of the baby during pregnancy. In-toe walking can often be caused by an inward twist of the tibia (shin bone). In extremely rare cases of teenagers who have a severe twist that causes pain at the hips or knees, an operation may be considered to correct it. It is never a functional problem, however, and they can participate in sports or other physical activities without problems. In a very few children, femoral anteversion persists in the long-term. Treatment with splints, plasters or braces does not affect it, but the doctor may advise you to discourage your child from sitting in the 'W' position. In the vast majority of these children, this twist in the bone gradually disappears by the age of 7-8 years. They often like to sit with their legs in the 'W' position. Some children take longer and tend to walk with their knees and feet turned inwards. Most of us grow out of this by the age of two years. We are all born with an inward twist in the femur below the hip joint. In some children in-toe walking may be due to the shape their feet which are curved and tend to hook inwards. Some children may have an inwards twist to their tibia (shin bone). Two thirds of children that in-toe have an inwards twist to the top of their femur (thigh bone) at the hip. Parents of children who in-toe often report that their children fall over more frequently than expected. Some children (and a few adults) walk with their toes pointing in: they have an in-toe(ing) walking pattern or gait. Most adults walk with their toes pointing forward or slightly outward.
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