From the Research
For a 10-year-old with in-toeing (pigeon toe), observation and monitoring is typically the recommended approach as most cases resolve naturally with growth. No specific medications, surgeries, or braces are routinely recommended at this age. Parents should ensure the child wears properly fitted, supportive shoes and can encourage activities that promote natural foot positioning such as walking barefoot on varied surfaces, swimming, and bicycling.
Key Considerations
- Physical therapy exercises may be beneficial in some cases to strengthen specific muscle groups, as noted in a study on the use of TheraTogs versus twister cables in the treatment of in-toeing during gait in a child with spina bifida 1.
- These exercises might include activities like walking with feet pointed outward, marching with knees high, or sitting in a "W" position.
- Medical evaluation is warranted if the condition causes pain, interferes with normal activities, or if there's a sudden onset or worsening of symptoms.
- In-toeing at this age is usually due to residual femoral anteversion (inward rotation of the thigh bone) or tibial torsion (twisting of the lower leg), both of which typically improve as skeletal development continues through adolescence, as discussed in a study on the intoeing child: etiology, prognosis, and current treatment options 2.
- A more recent study on the evaluation of orthotics on in-toeing or out-toeing gait also suggests that orthotic devices may be beneficial in some cases, particularly those with neuromuscular disorders 3.
Treatment Approach
- Surgery is rarely indicated and is reserved only for severe cases that cause functional limitations and don't improve with time.
- The effectiveness of exercise interventions to improve gait and balance in individuals with lower limb amputations has been studied, but the findings may not be directly applicable to the treatment of in-toeing in children without amputations 4.
- A systematic review on the non-surgical management of a pediatric "intoed" gait pattern found limited evidence to inform treatment, but suggested that gait plates and orthotic devices with a gait plate extension may be beneficial in some cases 5.