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What to Do When Your Child Has Pigeon Toes

What to Do When Your Child Has Pigeon Toes

by | May 31, 2024 | Clubfoot & Foot Disorders

Most feet point forward, aiming at their destination — but not all. Although this condition can cause concern for parents, intoeing, or pigeon toes, is common. Intoeing occurs when children have feet turned inward toward one another. Here’s what you should know to help your child manage this condition and enjoy an active and healthy life.

Why Children Experience Pigeon Toes

Pigeon toes can exist at birth but often become noticeable later in childhood. There are three main causes of intoeing, all of which usually resolve without treatment at different times in a child’s growth. These causes include: 

  • Metatarsus adductus. While in the womb, your baby’s position may force the front of the foot to turn inward. This position can result in metatarsus adductus, a condition in which the toes point inward while the outer edge of the foot is curved outward. Metatarsus adductus is a common cause of pigeon toes in newborns and infants. In rare cases, the condition can cause the foot to look like clubfoot. This condition usually resolves spontaneously by age 2.
  • Internal tibial torsion. In this condition, your child’s tibia, or shinbone, twists and turns the leg inward. This is also related to “packaging” of the legs in an inwardly twisted direction while in the womb. This condition usually resolves spontaneously by age 6.
  • Femoral Anteversion. With femoral anteversion, your child’s thigh bone, the femur, turns inward, causing the feet and toes to point inward as well. This condition usually resolves spontaneously by age 9. 

Intoeing often runs in families. Because of its genetic root, preventing pigeon toes is not possible. 

When to See a Provider

Thankfully, being pigeon-toed does not cause pain, and most infants and children grow out of the condition without requiring treatment. The bones correct themselves as the child grows older. However, some cases of intoeing do not resolve on their own and require medical care. 

Your child’s provider may refer you to a pediatric orthopedic specialist if:

  • Your child’s intoeing is accompanied by other foot abnormalities.
  • The foot cannot straighten out easily and feels stiff.
  • The intoeing causes pain, limping, swelling or difficulty walking.

How to Treat Pigeon Toes

The vast majority of children with intoeing due to any of the above causes will correct their rotational differences without any treatment whatsoever. When intoeing is severe and has persisted beyond the expected age at which the condition causing the intoeing should have resolved, treatment may be considered.

Your child’s provider will consider several factors when determining the most appropriate treatment. These include the cause and severity of the intoeing, your child’s age and how the problem affects your child’s daily life.

Based on this information, your provider may recommend one or more of the following pigeon toe treatments:

  • Serial Casting. A cast on your child’s leg and foot can, over time, correct metatarsus adductus. Your provider may use a series of casts as your child’s treatment progresses to continue straightening the foot.
  • Stretching. Babies with metatarsus adductus may benefit from gentle stretching. Parents can perform this physical therapy technique at home. If appropriate, your provider will show you how to stretch the foot in a way that encourages it to straighten out. 
  • Surgery. Older children with severe symptoms that don’t respond to other treatments may require surgery. During surgery, an orthopedic surgeon cuts the twisted bone and resets it in the proper position. Surgery is typically for children older than 9 who have difficulty walking due to intoeing.

You may see advertisements for special shoes or exercise programs designed to address the conditions that cause intoeing. However, the American Academy of Orthopedic Surgeons has stated these are not effective. Your best resource for help with pigeon toes is your child’s provider or orthopedic specialist. 

If you are concerned about intoeing, schedule an appointment with a foot conditions specialist at Scottish Rite for Children.

Clubfoot Treatment: What Are Your Child’s Options?

Clubfoot Treatment: What Are Your Child’s Options?

by | Apr 26, 2024 | Clubfoot & Foot Disorders

If your baby is diagnosed with clubfoot, your first question may be, “What can we do?” Fortunately, effective nonsurgical clubfoot treatment options are available, and most children don’t need an operation. A pediatric orthopedic surgeon can help you decide what treatment makes the most sense for your child.

The Basics of Clubfoot Treatment

One of the most common foot-related deformities that may be present at birth, clubfoot occurs when your child has an inward-turned, high-arched foot. It isn’t painful for your baby, but if left untreated, the condition can lead to foot pain in the future. In addition, untreated clubfoot can cause an abnormal gait and restrict activities later in childhood.

Usually beginning soon after birth, clubfoot treatment can provide correction to the condition, so your child’s foot will have normal function, and your child will be able to walk without pain. With a pediatric orthopedic surgeon’s help and your commitment to following the treatment plan, clubfoot doesn’t have to be a permanent deformity. Treatment can help prepare your baby to walk, run, jump and skip through childhood.

The Ponseti Method: The Gold Standard of Nonsurgical Clubfoot Treatment

For many babies, correcting clubfoot involves a multi-step treatment called the Ponseti method, which is named after the orthopedic surgeon who pioneered it. This treatment starts with stretching and casting.

Over four to five weeks, your child will see a pediatric orthopedic surgeon for weekly manipulations. This gentle stretching gradually moves the foot into the correct position. After each session, the surgeon will apply a full-leg Ponseti cast to help the foot maintain its position.

A tight Achilles tendon contributes to clubfoot, and most patients receiving the Ponseti method have an Achilles tenotomy procedure. This procedure is quick and simple, is done in the clinic and is not major surgery.

With local anesthesia numbing the back of your child’s ankle, his or her orthopedic surgeon will cut the Achilles tendon to loosen it. The cut is so small and precise that it won’t require stitches. Afterward, your baby will wear a cast for three weeks while the tendon heals to the correct length.

Clubfoot can return, even with treatment. Your child will have to wear a brace with a metal bar attached to special shoes for four years. He or she will start out wearing the brace 23 hours a day. Once your baby begins pulling to stand the brace is used during nighttime hours only until it’s time to stop bracing.

The French Method of Clubfoot Correction

The Ponseti method isn’t right for every child. In some cases, another nonsurgical clubfoot treatment, the French method, may be a better fit. For this treatment, you’ll work closely with your child’s orthopedic surgeon and a physical therapist.

  • The physical therapist will teach you how to gently manipulate, tape and splint your child’s foot, which, over time, moves it back into the correct position. You’ll repeat this routine daily for three months.
  • After three months, your baby will likely need to have an Achilles tenotomy to release the tendon.
  • Following the tenotomy, you’ll resume manipulating, taping and splinting the foot each day until your child reaches age 2 or 3. Your pediatric orthopedic surgeon will monitor your child’s progress and let you know when you can stop the daily regimen.

Treating clubfoot takes dedication, but the payoff is worth it. Your effort can set your child up for a lifetime of activity without foot pain.

Wondering what’s next for your baby after a clubfoot diagnosis? Schedule an appointment with a foot and ankle specialist who can recommend a treatment plan.