MANY parents come to see me very concerned about the way their child walks and the shape of their feet. The most common condition causing this concern is pigeon toes.

Pigeon-toed gait refers to a condition where the toes point inwards when weight bearing and walking, instead of pointing straight ahead. This complaint is also known as metatarsus varus, metatarsus adductus, in-toeing gait, and false clubfoot. It is commonly found in children under three and can be first noticed at birth or when a child starts to walk. By the age eight, most cases will have resolved without the use of casts, surgery or specialist treatments.

Children who have in-toed gait tend to trip a little more, but as the child develops the tripping becomes less frequent. About 10 per cent of children between the ages of two and five have this condition to varying degrees, with 90 per cent improving naturally.

Causes

* Metatarsus adductus occurs when the front of the foot curves towards the midline of the body. This is often noticed at birth or during the first few months of life. It can affect one or both feet and the usual cause is due to the way the baby was positioned in the womb. In most cases it will correct itself as the child develops. If the condition continues and the foot is not flexible, minor surgery or casting may be suggested.

* Internal tibial torsion is where the shin bone excessively twists inwards and is usually noticeable when a child starts to walk. Again this is probably caused by the baby’s position in the womb. By the age of five it should have corrected itself.

* Femoral anteversion: Here, the thigh bone or femur excessively twists inwards, thus causing the whole lower leg to turn inwards. This is more commonly found in children aged between three and six. Natural correction usually occurs by the age of 14.

As we have said, most of these conditions are self-correcting during childhood. It is only in the most serious cases where surgery, foot braces and orthotics are considered. Out-toeing activities like ballet are thought to help limit the complaint as well as sitting cross-legged. It is important to note that in-toeing gait does not lead to any degenerative arthritic conditions. It will not cause your child pain and will not prevent the development in walking.

Angela Davis BSc (Hons) DPodM MChS is a podiatrist with offices in Montego Bay (293-7119), Mandeville (962-2100), Ocho Rios (974-6339), and Savanna-la-Mar (955-3154). She is a member of the Health and Care Professions Council in the United Kingdom.