In-toe gait is a very common problem among children and even adults.  Fortunately, most in-toeing that is seen in children is a growth and developmental condition and will correct itself without medical or surgical intervention.  Not all bony foot structures are present at birth and in fact, most of the structures at birth are made of a very soft cartilage.  Therefore, a child’s foot growth is a gradual process and it may go through many phases until the final structure is achieved.  Parents may complain that their child frequently trips over his or her feet and runs in a funny or awkward fashion.  If this applies to your child or even to you, your foot specialist should conduct a proper physical exam of your feet and legs.

What causes it?

There are many possible causes to an “in-toe gait”.  An infant’s first environment is the uterus.  Often times, this area is very cramped as the baby grows in size.  The baby’s legs are usually curled up as the intra-uterine development occurs.  Once the baby is born, the foot may appear flat but as the baby begins walking, a more normal appearing foot develops.  If the child’s hips or lower legs are affected, it usually corrects itself.  However, at times, the torsion on the hips and legs is severe enough that it won’t correct itself and will produce an in-toe gait pattern.  A small amount of in-toeing should not affect one’s daily activities.  However, if the in-toeing is severe, proper treatment should be instituted to prevent further deformities.

How is it treated?

There are many ways to treat an “in-toe gait”.  If your child walks with his/her feet turned in, there are certain things you can do to prevent the condition from worsening.  Positioning your child’s feet when he/she is sleeping so that the feet are pointing outward is one form of treatment.  Encouraging your child to sit Indian style rather than reverse Indian style also helps.  If this condition is caught early enough, there are other forms of treatment that can be instituted.  These treatment modalities include special shoes, stretching exercises, and even special bars to positionally affect the feet and lower legs.  It is important to remember that many “in-toe” deformities correct themselves.  However, if you are concerned or worried about a persistent pigeon toe or in-toe gait pattern, your podiatrist should be consulted.

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