“Dear Dr. Burk,


I’ve noticed recently that my child walks with her feet turned inward? Should I be worried? Is it possible she has pigeon toe?”

The short answer? It is possible that your child has pigeon toe. However, before you start getting worried, there are a few things you need to know about pigeon toe and what could be causing your child to walk with their feet turned inward.

What is Pigeon Toe?

Pigeon Toe (sometimes referred to as in-toeing or in-toe gait) is when an individual’s toes point towards each other. This is very common amongst babies and small children who are first learning to walk. If your child’s feet are pigeon-toed, it doesn’t necessarily mean anything is wrong with their feet, and it could be no problem at all. The term is simply used to refer to toes that point inward while standing or walking.

However, if your child’s toes point inwards it could be the hallmark of a few different variations in the way the legs and feet line up. These variations are Femoral Anteversion, Tibial Torsion, and Metatarsus Adductus.

What causes Pigeon Toe?

Tibial Torsion

Tibial Torsion is an inward twisting of the shin bone and is usually seen in children under two years of age who are just learning to walk.

Although the shin bone is twisted, the knees remain pointed straight. This torsion could be a result of how the baby was positioned in the womb.

Typically, the legs will straighten out naturally as the child begins to pull up and stand on their own. However, some children will continue to walk pigeon-toed while their leg bones are growing. Surgery is sometimes necessary for children who don’t naturally outgrow Tibial Torsion by the time they turn 10.

Femoral Anteversion

Femoral Anteversion occurs when there is an inward twisting of the upper thigh bone. This twist causes the kneecap to point inwards, along with the feet.

This cause of pigeon toe is prevalent between two and four after a child has begun walking. Children with Femoral Anteversion will often prefer to sit with their legs crossed, and an easy course of treatment is to encourage them to sit in a chair with legs uncrossed. Again, this will typically clear up by itself but could take several years for the thigh bone to completely straighten. Most children outgrow Femoral Anteversion by eight.

Metatarsus Adductus

Metatarsus Adductus occurs when there is an inward curve at the outer edge of the foot, causing the foot to spiral in on itself.

This condition will be noticeable before your child starts walking, and your doctor may even recommend a course of treatment while they are still a baby.

Unlike the other two, this condition is not outgrown. It requires treatment that can vary from passive stretching to a series of specialized shoes or casts. When these treatments aren’t successful, children are typically re-assessed to ensure they don’t have club-foot, which would necessitate a surgical correction.

Can exercise help?

While the causes for pigeon toe are normally outgrown, there are possibilities to help strengthen your child’s hip bones and/or shin bones through exercises. Here are a few to try:

  1. Have your child sit up straight in a chair with their feet firmly planted on the ground. (It helps to have a kid-size chair for this one.) Draw an outline around their feet and have them sit in the chair with their feet inside the outlines for a few minutes each day.
  2. Clear an area in your home or backyard and have your child walk around backwards for 10-20 minutes. Walking backwards will help strengthen their hip joints.
  3. Create a low walking beam for your child to walk on. (Or check to see if there’s a park nearby that has one ready to go!) Help them to walk across the plank 2-4 times a day. Doing so will help your child learn to put one foot in front of the other and strengthen the muscles that keep hip and shin bones straight.

Should I get help from an expert?

Absolutely! Before attempting to diagnose pigeon toe and the potential causes, book an appointment with a certified podiatrist. Book a consultation at Rocky Mountain Foot and Ankle today so we can help you figure out the right course of action for your child’s pigeon toe.