My Child is “Pigeon Toed”, Is This Bad? The Facts Behind Intoeing in Children

Intoeing, sometimes referred to as being “pigeon-toed”, is a relatively common condition that primarily effects toddlers and children and can involve one or both feet. Intoeing is typically first noticed when children begin walking. However, there are cases when intoeing presents itself later on in childhood!

In many cases, intoeing doesn’t interfere with a child’s activities. Conversely, more severe cases of intoeing can cause children to trip or stumble on their feet, hindering their ability and confidence to engage in certain sports or activities. These incidences may become more frequent when walking on uneven surfaces, when running, or when the child is tired or distracted.

There are a number of causes for intoeing in children ranging from alignment problems such as metatarsus adductus (toes shifted inwards), internal tibial rotation (shin’s rotated inwards), or excessive femoral anteversion (hips rotated inwards). Intoeing can also be caused or exacerbated by weak or overstretched muscles of the hip such as the extensors and external rotators of the hip.

In some cases, intoeing can resolve itself automatically with time. Some, however, require other interventions ranging from physiotherapy and exercise plans to surgical interventions in extreme cases.


how physio can help

An assessment by a physiotherapist can help determine the source of the intoeing and consecutively create a personalized treatment plan to address the specific areas of concern. The role and efficacy of physiotherapy for your child will be determined and discussed with you so as to keep you fully involved in your child’s treatment.

Physiotherapy for intoeing focuses on attaining ideal alignment through gentle mobilizations as well as fun and engaging exercises that aim to strengthen specific muscle groups that may be stretched or weakened. Education regarding positions and activities to avoid, such as “W-sitting”, will also be discussed with both the child and family.


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The Canadian Physiotherapy Association (CPA) represents physiotherapists, physiotherapist assistants and physiotherapist students across Canada. CPA members are rehabilitation professionals dedicated to the health, mobility and fitness of Canadians.

Physiotherapists are primary health care professionals who combine their in-depth knowledge of the body and how it works with specialized hands-on clinical skills to assess, diagnose and treat symptoms of illness, injury or disability.

More than 20,000 registered physiotherapists work in Canada, in private clinics, general and rehabilitation hospitals, community health centres, residential care and assisted-living facilities, home visit agencies, workplaces, and schools.

The CPA presents its educational references as a public service and for informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. The opinions expressed do not necessarily represent the opinions of the CPA membership.