Dr. Alan Greene on Foot Problems

What causes my child's feet to turn inward?


My 10-year-old son has pigeon toes, especially in his right foot. With his knees in normal position (forward), his right toes point inward at about 25 to 30 degrees. With his right foot pointing forward normally, his right knee points outward. He often sits with his feet out to the sides. He also wears orthotics for flat feet, prescribed by a podiatrist. Prior to getting them, he complained of a weird feeling in his feet that he couldn't explain. What is this possible condition called and what are treatments for it?


Turning in of the feet can arise at three different locations or at a combination of the three. If the turn is within the foot itself, it is called metatarsus adductus. You can tell if this is a problem by looking at the outer edge of the foot, which should have something of a straight line. If the turn is between the knee and the ankle, it is called tibial torsion. That condition is easiest to detect when the child is lying on the stomach with the knees pointing straight and the legs sticking straight up from the knee. You then look at the angle of the foot to the line of the thigh.

The other common cause is called internal femoral torsion or femoral anteversion. It is the most common of the three conditions in kids over age 2. (Tibial torsion is the most common cause before then.) Here, the turn is between the hip and the knee, usually arising from loose ligaments.

It sounds like it would be wise to have a pediatric orthopedist take a look and pinpoint the source (or sources). Kids can outgrow internal femoral torsion on their own up until about age 10 as long as they are not doing something that is making it worse, such as sitting in the "W" position (with the legs out to both sides).

I'd have a pediatric orthopedist look at the whole situation. Orthotics can also cause some foot problems for kids and are no longer recommended for some types of flat feet.


The information on this Web site is designed for educational purposes only. It is not intended to be a substitute for informed medical advice or care. You should not use this information to diagnose or treat any health problems or illnesses without consulting your pediatrician or family doctor. Please consult a doctor with any questions or concerns you might have regarding your or your child's condition.

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