Pigeon toes
Pigeon toes, also known as in-toeing, is a condition where one or both feet point inward while standing normally. This typically occurs in children and is often a temporary phase of development. The condition can arise from various factors, including how the feet, hips, and legs were positioned in the womb, as well as genetic predisposition. Symptoms primarily include improper foot and leg alignment, but they usually do not impede movement skills in infants and toddlers.
For many children, pigeon toes improve as they grow older and gain walking experience. Treatment is generally unnecessary unless the condition affects mobility, with options including corrective shoes, braces, and exercises to enhance flexibility and strength. In cases where pigeon toes persist past the first year of walking, further examination is recommended to rule out associated issues. While older children may require surgical intervention if the condition significantly impacts their movement, many medical professionals now advocate for a natural correction process rather than the use of therapeutic devices that were common in earlier decades.
Pigeon toes
ALSO KNOWN AS: In-toeing
ANATOMY OR SYSTEM AFFECTED: Bones, feet, hips, joints, knees, legs, ligaments, muscles
DEFINITION: Usually a temporary condition in which one or both feet point inward when the heels are placed in a normal standing position
CAUSES: Normal development, curved feet, stiff leg muscles, angle and rotation of hip, leg, knee, and ankle joints and bones
SYMPTOMS: Improper foot and leg alignment
DURATION: Chronic during early childhood
TREATMENTS: None unless condition interferes with movement; may include corrective shoes and braces, casts, exercises
Causes and Symptoms
Pigeon toes sometimes occur in children as a normal phase of development. Patients walk forward on a straight path while a toe or toes turn toward the body’s axis. In infants and toddlers, pigeon toes are usually caused by how their hips, legs, and feet were positioned in the womb. Heredity also influences how pigeon toes are caused.
Patients may have pigeon toes for several reasons. Some are pigeon-toed because their feet are curved. In-toeing can also be caused by stiff muscles that hinder leg flexibility. Many cases of pigeon toes are attributable to how hip, leg, knee, and ankle joints and are angled and rotated.
Rotated tibias cause in-toeing in what is termed internal tibial torsion. Internal femoral torsion refers to when femurs significantly rotate from the hip socket to knee, affecting foot placement. Sleeping and kneeling positions may exacerbate fetal rotation and angling. Infants’ feet often attain correct alignment before they walk, but if they temporarily continue in-toeing, pigeon toes probably will not slow the development of movement skills.
Treatment and Therapy
Usually, pigeon toes improve as children age, particularly as they gain experience walking. Pigeon toes do not necessitate treatment unless they interfere with movement. Corrective shoes and braces designed for specific cases are sometimes prescribed for young children. Casts can straighten curved foot position. Exercises enhance movement by stretching and strengthening muscles and ligaments to support normal positions.
Children who continue to display pigeon toes after walking for one year should be examined because pigeon toes and such hip abnormalities as often occur simultaneously. Asymmetrical in-toeing should also be investigated. Medical professionals will measure body angles, observe patients’ movement while standing and walking, and study wear patterns on their shoes to detect how the hips and legs might affect ankle and foot mobility. X-rays can detect related skeletal disorders. Examinations should look for possible neurological conditions and tumors that might cause in-toeing.
Children aged eight years or older may require additional medical intervention. If pigeon toes significantly hinder motion in older patients whose development did not resolve their pigeon toes, physicians may recommend surgical adjustments to enable patients to gain normal mobility. Such measures aid patients who desire involvement in athletic activities.
Perspective and Prospects
In the nineteenth and twentieth centuries, physicians routinely advised the use of corrective splints and shoes. Often these treatments reassured parents that toddlers’ pigeon toes would not be a permanent condition. Beginning in the 1930s, many patients wore the Denis-Browne splint, in which shoes are rigidly affixed together by a metal bar at a set angle, while they slept.
By the early twenty-first century, such practices were not implemented as often because many physicians questioned the benefits of therapeutic devices expediting improvement. Most advised allowing pigeon toes to correct naturally during development.
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