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The Causes of Intoeing from Infancy to School Age

“This little piggy went to market, this little piggy stayed home.” This classic nursery rhyme is a staple of parents and grandparents alike—an excuse to tickle the toes and hear the giggles of their favorite little people. From birth, children’s feet are a focus—counting the toes, capturing the foot print—we even buy the smallest shoes we can find. So it’s no surprise that when an abnormality is discovered, panic rises. Intoeing is a common concern that is also commonly misunderstood.

The Effect, Not the Cause

Most people believe that Intoeing is a condition, but this inward turning of the feet is actually the result of something skeletal or neurological. Determining the cause is an important first step in developing a treatment plan. Before your child’s appointment, identify when you first noticed that your child’s feet and/or gait was different. The age of onset provides important clues to the root problem.

You should also share any history of neurological concerns or missed milestones. Don’t forget to include any problems that arose during pregnancy and delivery. While these details might seem unimportant, your child’s medical history from womb to present is critical for a complete picture of their current health. Remember that the condition of your feet is a reflection of your overall health.

At Birth

If you notice an abnormality in your child’s feet at birth, these are the likely causes:

Hallux varus—This condition affects the big toe, causing it to turn toward the inside of the foot.

Metatarsus adductus—Most commonly identified as the cause of this abnormal turning, it involves the foot from the tips of the toes going all the way to the middle. Its severity can vary from feet that can be flexed into normal position to feet that are not flexible. In most cases, the condition corrects on its own. However, some children require casting or prescription shoes. These types of conservative treatments are typically very successful.

Talipes equinovarus—You most likely know this as clubfoot. It results from shortened connector tissues between the muscles and bones. The result is that the foot sits at a sharp inward angle. This congenital condition should be treated right away so that it does not inhibit mobility. The Ponseti and French methods are the most common conservative treatments, but surgery is sometimes necessary.

Cavus deformity—An extremely high arch is the hallmark of this foot deformity that typically indicates a neurological condition is present.

The Toddler and the School Age Child

Tibial torsion—The tibia, the lower part of the leg, can turn to the inside as well. This cause may not be noted until a child begins to move around. Continued growth generally resolves the issue before a child is of the age to go to school. Typical conservative methods of treatment are not helpful, and if the problem persists beyond age 8 to 10, surgery may be considered.

Femoral Anteversion—Even as your child enters school, you should watch for gait changes. The femur, or thighbone, can also twist inward and cause problems. In addition to the thigh turning inward, the knee does as well. If your child tends to use the “W” position while sitting, you should watch for signs of this condition. You can expect that this condition will correct on its own, but monitor it with the help our experts to insure that surgical intervention is not necessary.

Rest Easy with Help from the Experts

Parenting has an array of challenges, but the health of your children’s feet doesn’t have to be one of them. Dr. Craig H. Thomajan DPM, FACFAS and Dr. Shine John, DPM, FACFAS at Austin Foot and Ankle Specialists are here to answer all of your questions. Don’t worry, just call (512) 328-8900, or schedule an appointment online today.

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