Intoeing or ‘Pigeon Toed’ Walking in Children

What is intoeing gait?

Intoeing gait or ‘pigeon toed’ is defined as walking with the feet pointing inwards.

What causes intoeing?

In general, intoeing gait in a child can be caused by 3 components:

• Feet – inward curve of the feet bone (metatarsus adductus)
• Knee – inward rotation of lower leg bone (medial tibial torsion)
• Hip – increase internal rotation if thigh bone (femoral anterversion)

These components can occur alone or in combination.
For single side intoeing, conditions, such as the following, have to be ruled out:

• Spastic hemiplegia
• Hip dysplasia in infant or child
• Slip femoral epiphysis or Legg-Calve-Perthes disease in older children