ntoeing or pigeon toed walking in a common concern that podiatrist’s are often presented with. Intoeing can be observed as a part of normal development however, some forms of Intoeing can create additional problems for the child and warrant intervention. Intoeing can be caused by one or a combination of the structural following factors;
- Metartarsus adductus: Is when the digits deviate inwards in comparison to the rearfoot giving a C-shaped or banana foot appearance. Matatarsus adductus is the most common foot condition that gives rise to an intoed gait pattern.
- Internal tibial torsion: Is an internal twist of the tibial-fibular unit (shin bone) which causes the foot to pronate and the knees to become knocked (Genu Valgum).
- Femoral Anteversion: Is a twist in the shaft of the femur and causes the knees to become knocked and the lower limb and foot to rotate inwards.
In addition to the structural factors, intoeing gait is commonly seen in children with cerebral palsy. Cerebral palsy can cause internal rotation through the hips and spasticity of the adductuor muscles and medial hamstrings which can manipulate the femur and tibia into internal rotation and thus create an intoed gait.
Treatment for intoeing gait is dependent on the cause and contributing factors to the condition however, common treatment options include;
- Changes to sitting and/or sleeping position
- Exercise games to strengthening and stretch specific muscle groups
- Footwear advice and/or specific shoe selection
- Serial casting
- Gait plates (orthotic devices) to correct alignment and rotation of the foot and lowerlimb
- Night splitting
- Surgical intervention