In-toeing All the Time!

Updated on December 15, 2010
K.E. asks from Champaign, IL
9 answers

My 12 month old son has been "in-toeing" since the day he was born. His feet at all times are extended and pointing inwards with toes curled. Our pediatrician noticed this at about 6 months. He just said our son appeared to be a "little bowlegged". My husband's mother is a bit bowlegged herself, so it could be that he just takes after his grandma.He suggested I try to flex his feet and stretch the ankles in the other direction so that his muscles do not get too tight, exacerbating the problem.However, I have not been as good about doing this as I should have been and when I do try, he fights it. Not that he tries to get away or stop me, but his muscles fight me and it takes a minute to even get his foot to change position. While at rest or while standing (he doesn't walk yet) he is constantly pigeon-toed.

This concerns me more than just an abnormal gait would because, due to a few seizure-like episodes in the first 24 hours of life, he was put almost straight into the NICU and blood tests showed he had slightly elevated ammonia levels. That could have resulted in brain damage (ammonia kills brain cells when not flushed out of the system properly). An MRI done at 2 days old showed a small dark patch in the basal ganglia region of his brain, which *could* mean something (ie cerebral palsy) but at that stage it was unclear. The "wait-and-see" approach has been the plan so far, and other than his feet he has progressed pretty well. No reason yet to be concerned.He has had checkups with therapists every three months to check on his progress. But now this in-toeing (a sign of cerebral palsy) has me very concerned, especially as he seems incapable of keeping a flat foot position.

Other moms have mentioned that their toddlers walk a bit pigeon-toed and that they have grown out of it - but I assume their kids have their feet in normal positions the rest of the time? Does anyone else have a baby that always points his toes/feet inwards? Any advice on how to combat it? Anyone have experience with early stages of cerebral palsy and have some advice? I am very worried that this is abnormal and our first sign of trouble.

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So What Happened?

Well, thanks to everyone for the input! I am glad to hear that others have dealt with this with physical therapy and special shoes/braces. I waited to update until he saw his doctor and his two developmental specialists (he sees every three months). The doctor didn't seem too concerned and said he suggested the wait-and-see method until 15 months. Walking may correct it. The specialists said he is still within the range of normal in general, but the turning in of his feet is odd. The specialist who works with the motor skills said that his toe curling is likely to gain stability, as he is also has a bit low in muscle tone. She didn't say anything about neurological disorders and I should have asked. Although, I have made an appointment with his neurologist (he saw one initially when first born) to see if a second MRI is in order. I think I will insist on one, just to see if brain damage is a problem. But we can't see her until January 18th.

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S.S.

answers from Fargo on

My son who is 18 months also has in-toeing and has had it since birth. I really started to notice it when I would hold him, he would grip my stomach and hang on with his feet. I called him my little monkey. When he walks, it looks like he grips the floor. We brought in to a podiatrist in October and he was fitted for some straight last shoes that he wears all the time. When he gets up in the morning, we put them on. He leaves them on all day and we finally get to take them off when he puts his jammies on at bedtime. We go back in January to see if it has helped (I can see that it has) If it has helped, he will get to wear regular shoes. He really hated them at first, but now he is so use to wearing them that it really isn't a big deal.

I would bring him to see a specialist. That is what we thought. We (my husband and I) thought that if we bring him in and the doctor said he would grow out of it, then at least we tried.

Good Luck.

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C.T.

answers from Chicago on

Because of the episodes your son had, do you have a neurologist and get visits from a county nurse and therapists?
I'm sure he meets the qualifications because my son does and I know that having a seizure qualifies for it. My son is also 12 months old but hasn't shown any signs of complications. He had some seizures as a result of a bleed on his brain which started when he was 36 hours old. He was in the NICU for 10 days. He had a angiogram at 6 months old and it came back normal. He is developing perfectly fine which we are very thankful for.
I live in McHenry County but I know these programs are state-sponsored but I also know that they are voluntary, meaning we don't have to participate so perhaps you didn't choose to participate or perhaps the availability of services weren't made known to you, regardless you should be able to request these services which you don't get charged for the checkups. The only way there may be a cost associated is if therapy is necessary and then insurance would kick in before you are charged for anything but most of the time the therapists just shows you what you can do to help the problem. For example, at one of my son's check-ups, the therapist said his stomach muscles were slightly delayed so she showed me exercises/games I could play with him to make them stronger.
Seperately we do see a neurologist for checkups and we also participate in the NICU follow-up clinics at Lutheran Hospital in Park Ridge.
You son is only 12 months old and probably hasn't been walking very long and babies walk funny. If he has a little pigeon toe, get him a good pair of shoes from Stride Rite. Then have him wear them on the wrong feet which if it's just slight, will correct the problem. My mom was offered this advice with my brother 38 years ago and it worked just fine.

S.P.

answers from Los Angeles on

I don't know if I had any brain damage around birth.
Probably not.
However, I toed in as a child.
I even used to kick my ankles sometimes while walking.

Some time after I was an adult, I made a conscious choice
to practice walking with my feet facing straight ahead and,
over time, I trained myself to do so.

Don't know if this is helpful.
Just thought of sharing this when I read your question.

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C.D.

answers from Chicago on

For what it's worth, my older son toes in (metatarsus adductus, the ends of his feet curve inward). He was always a toe-walker from when he started standing upright. His feet finally came down to flatten somewhere around 18 months. At around 3 years old he got straight-laced shoes (medical shoes that have neither a right or left) and that helped a LOT, then he had orthodics to keep working on it, now insurance is not paying for it anymore and we are about to do over the counter orthodics from the medical store that the physical therapy department is then going to customize to try to correct it in this window of opportunity while he is still growing. He is 6 years old now. We were told to do the exercises too, but I too had a hard time being consistent with doing them. Did them when I thought of it, but between all the other daily things we needed to do for my other son with some developmental issues, I just wasn't extremely diligent with it. I think they were really secondary to the medical shoes anyway. Best wishes to you as you navigate through all this!!

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K.S.

answers from Chicago on

I would personally see a specialist, like a child orthopedist. If you do have an issues, then a specialist (or even one then a second opinion) will be worth it. My cousin wore braces for about a year around age 2, which was better than any surgeries or years of chiropractic later on.

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G.B.

answers from Tulsa on

Our's has bow legs and pigeon toes. We take him to the Podiatrist who is rather confused by the big deal we are making out of it. He says he walks, talks, and runs. He also says most kids just get used to it and hardly anyone goes to the extreme of surgically trying to fix it. He says it is just how the bones are formed and that we can do exercises to strengthen the hips so they will give better support but there isn't anything to do until the kid is much older and the bones are finished hardening and forming. Then he might consider braces at night.

When we have him laying on his back we take his foot and bring it up towards his crotch and push his knee towards whatever he is laying on, like the ground. It stretches his inner thigh too.

M.L.

answers from Houston on

Keep doing the excersizes, even if it means doing them while he is sleeping, nursing, watching a little baby einstein movie. do them.

also, a friend was bowlegged and she had to wear braces as an infant/early toddler. Has that option been presented yet?

http://emedicine.medscape.com/article/1235248-treatment

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L.J.

answers from Minneapolis on

Chiropractors are excellent for this type of thing. My own child had ankles that turned in. HIs dad had that too and had to undergo years of special shoes that were very uncomfortable.

Instead a few visits to the chiro and everything is straight. Get a free consult and go from there.

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A.T.

answers from Chicago on

My husband has been "pigeon toed" since he was a kid. He wore special shoes when he was younger but it was too late to correct the problem. He still walks and stands with his toes pounting in. With that said when my two year old was born they noticed she was toed in. They sent us to a pediatric orthopedist when she was 1 week old. We too had to do the exercises. They weren't helping so at 6 weeks she had to get both legs casted from her ankle to her upper thigh. Poor thing had to wear these for two weeks in the middle of summer. The doctors were so helpful and we were pleased with everything. We haven't had to do anything since but once she started walking we noticed she was still a bit "pigeon toed." But it is so much better than before. They too told us this can run in families. Hope this helps and if you would like info on her doctors I could send it to you!

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