How to Help Kids With In-Toeing

In-toeing is a condition in which the feet turn inward. This condition is usually caused by one of three problems: metatarsus adductus (curved feet); internal tibial torsion (twisted shins); or excessive femoral anteversion (twisted thighbones). Failure to treat in-toeing does not usually result in long-term problems except in extreme cases. Depending on the underlying condition, stretching, corrective footwear and/or leg braces can eliminate in-toeing; however the condition is usually left untreated and goes away on its own. If pain, severe limping or appearance is a concern, speak with your child's physician about other treatment options, such as surgery.

Instructions

Metatarsus Adductus (Curved Feet)

• 1

  Recognize the condition. Examine your child's feet while he is lying back and relaxed. Hold your right hand upright with your palm towards the child. Spread your middle and pointer finger forming a "V." Place the child's right foot in the "V" and look for a sharp curve away from your middle finger or a bend/crease near the knuckle of your pointer finger. Switch to the left hand and left foot to examine the other side.

• 2

  Notify your doctor; twisted feet usually self-correct by six months, but if they do not, treatment must begin immediately to avoid a more severe condition.

• 3

  Perform stretches as instructed by your doctor. (One example is to hold the child's heel firmly and gently stretch the foot upward, toward the body. Stretch for five seconds and release. Repeat at regular intervals, such as diaper-changing times or before a meal.)

Tibial or Femoral Torsion (Twisted Shins or Thighbones)

• 4

  Identify the problem. Instruct the child to lie face-down on a bed or carpeted floor. Flex his knees to a 90-degree angle. Imagine two lines: one following the center of the thigh and the other running along the center of the feet. Examine the angle of the intersection of these two lines; this is the thigh-foot angle (TFA). Compare the TFA to the normalcy chart for your child's age group. (See Resources)

• 5

  Walk and exercise regularly; sedentary lifestyles provide little to no opportunity for self-correction. Plan ahead for occasional trips and falls.

• 6

  Consider a Denis-Browne splint, an apparatus that holds the legs at a specific angle and distance apart; this is a medical device that should only be used if prescribed by your doctor. Consult with your child's physician if you are concerned with the severity of your child's in-toeing.

• 7

  Request evaluation for surgery; surgical procedures that straighten the tibia and femur can alleviate severe pain and a debilitating gait. Postpone this option until the child reaches an age at which self-correction is unlikely given his medical history.