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In-toeing describes the position where the feet are turned inwards to face one another and is often coined as being ‘pigeon-toed’. While variations in foot position are not uncommon for young children, in-toeing should resolve by the age of seven or eight years. If it hasn’t, it is likely that the feet may need some assistance in straightening.

What causes in-toeing?

Intoeing, or the appearance of it, may be caused by one or more of the following three conditions:

1. Metatarsus Adductus

Metatarsus adductus describes a “c” shape of the foot, where the front half of the foot turns inwards. It is a condition that is present at birth, occurring in approximately 1 in every 1000 births. It is this bent position of the forefoot on the rearfoot that gives the appearance of in-toeing and will resolve if the condition resolves on its own, which happens for a majority of children. Others may need assistance correcting the foot position.

2. Tibial Torsion

Tibial torsion describes the inwards twisting of the shin bone (tibia), which in turn twists the feet inwards to give the ‘pigeon-toed’ appearance. Tibial torsion is usually a result of a confined position of the legs in the womb. While tibial torsion should correct itself before the child reaches school age, if it doesn’t then assistance may be needed to encourage the tibia to turn outwards.

3. Femoral Anteversion

Similar to tibial torsion but affecting the thigh bone, femoral anteversion describes the inwards twisting of the thigh bone. This twisting at the femur causes both the knees and feet to twist and point inwards too, causing in-toeing. The exact cause of femoral anteversion is unknown, but it is most pronounced around the age of five or six years. Again, femoral anteversion should correct itself as the child grows, but if it doesn’t may need some assistance.

What are the symptoms?

The inward-facing position of the feet is the main symptom. In-toeing does not usually result in any pain, or interfere with any developmental milestones like learning to walk. In-toeing can cause regular tripping and falling if the feet get in the way of one another.

How is in-toeing treated?

If the intoeing does not resolve on its own, our expert team of podiatrists can help encourage the foot to turn outwards and straighten. This can be done through:

  • A special type of orthotic called a gait plate that is designed to encourage the foot to turn outwards
  • Strong, supportive footwear that will help stabilise the new position of the foot
  • Stretching exercises to loosen tight muscles that may be preventing the foot from turning back out
  • Strengthening weak muscles to help maintain good foot positioning and alignment

If you’re worried that the position of your child’s feet is interfering with their ability to walk, play or do any of the activities that they enjoy, don’t hesitate to bring them in.

Two weeks with Calcaneal Spur and finally got to see Doc. He sent me to Kevin @ Eleven and with One Appointment, he had me walking without Crutches. Yes! It still hurt. Did the Stretching, Rolling my Foot on a Spikey ball and Iced it occasionally. Return visit, after he had his Holiday, and I' am walking fine. They do NOT want to see me again, unless it deteriorates. Which it has not :-)
- Ivan CooKe