Intoeing: everything parents need to know

Intoeing is a common condition found in young children and toddlers. In his latest online article, consultant paediatric orthopaedic surgeon Mr Nigel Kiely offers his expert insight into this condition.

What causes in-toeing in young children?

Intoeing in young children is very common. This is normally in the toddler age when they start walking. It can be entirely normal.

It's a phase of development. We can look out for specific things that might cause in-toeing. So, for example, if the foot's turned in, or if there's a rotation of the bones in the shin or in the hip. We also have to bear in mind that sometimes there could be more serious diagnoses causing intoeing, such as neurological problems or muscle weakness problems. Nevertheless, the commonest one is just a normal variation of walking.

At what age is it most commonly diagnosed?

Most referrals we get for intoeing are toddlers. We see intoeing when children start walking at about the age of two. We do sometimes see older children who have persistent intoeing, as well as in adolescents and teenagers.

Can this condition be corrected without surgery? Are there any options that are different for surgery or surgery to go to?

 Most children who present with intoeing will get better on their own in time. The child’s intoeing improves or they adapt their walk-in to cope with it. There are no proven non-surgical treatments for in-toeing.

Special shoes and physiotherapy don't really make any difference to the condition. Most of the time, the condition will improve with growth and time.

Are there any long-term complications or consequences associated with intoeing and its so, how can they be prevented?

The vast majority of children who are intoeing will get better. If we look at adults, quite a lot of adults walk intoeing and some walk out-toeing. Most people are absolutely fine with it. Potentially, someone who has excessive in-toeing in older life, as an adolescent or an adult life, can have some problems with their knee or their hip, but that's relatively uncommon. There's not necessarily anything we can do to prevent that, apart from just general healthy lifestyle advice, keeping fit and active and making sure your muscles are strong.

What kind of diagnostic tests or imaging studies might be recommended to evaluate intoeing in young children?

For most young children, it's a clinical examination and assessment. Imaging isn't typically required. If it's an older child and we suspected there was a persistent problem with the rotation of the bones, then we may do an X-ray.

Sometimes we do some CT scans to look at the rotation of the bones, and often this is a build-up to whether we think there might be some surgical intervention required to help realign the bones.

Mr Nigel Kiely is a renowned paediatric surgeon based in Oswestry. If you would like to book a consultation with Mr Kiely, you can do so today via his Top Doctors profile.