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Toeing-In

more about Toeing-In


  • Toeing-In refers to a condition where the feet point inward, not straight.  The in-toeing trait is commonly seen in young children.

  • Metatarsus adductus is seen right after birth.  In-toeing due to internal tibial torsion or femoral anteversion is detected when the child begins walking.
  • In-toeing does not cause pain or gait difficulties
  • The incidence of bow legs (genu varum) is high in children with in-toeing

  • The cause is unknown, but there are some factors that may play an important role.
    1. Family history
    2. Position of fetus in the womb
    3. Habitual awkward positioning after birth (i.e., reverse-tailor position, kneeling position and lying face down with the feet twisted inward)
  • The are three types of deformities that cause toeing-in:
    1. Metatarsus adductus -- in this condition, the feet are bent inward.  A slight inward bending of the foot is a normal condition in newborn babies.  This usually disappears without treatment one year after the birth.
    2. Internal tibial torsion -- In-toeing results from the inward twisting of the shinbone (tibia).  It usually returns to its normal position by the age of 4.
    3. Excessive femoral anteversion -- Femoral anterversion is the inward twisting of the thigh bone (femur).  It usually corrects itself before the age of 6

  • The diagnosis is based on a clinical examination
  • Doctors will determine the type of deformity that causes in-toeing by a physical examination.

  • Metatarsus adductus usually corrects itself, so treatment is not necessary.  If the deformity is persistent after 6 or 7 months, it can be straightened by manual stretching, passive stretching exercises and corrective shoes.  Surgical correction is considered if the severe deformity persists after 2 years.
  • Internal tibial torsion, femoral anteversion -- Spontaneous correction usually occurs with age.  Poor sitting or lying positions should be avoided.  Special shoes or braces are not helpful.





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