IN-TOEING (PIGEON TOES)
In-toe refers to individual with their toes pointed inwards when walking or standing. It is most common in children under age of two who are developing posture and balance, and may involve one or both feet.
In-toe can be triggered by one of more of the following:
1. Metatarsus Adductus (also known as Metatarsus Varus)
A common foot deformity noted at birth that causes the front half of the foot, or forefoot, to turn inward.
2. Tibial Torsion
An inward twisting of the shin bones (the bones that are located between the knee and the ankle). Children with in-toe caused by internal tibial torsion tend to trip easily.
3. Femoral Anteversion
An inward twisting of the thigh bone (known as the femur, the bone that is located between the hip and the knee). There is a greater-than-normal bend in the upper part of the leg, which causes the upper leg to rotate inward. It is typically detected when the child is 4 years to 6 years old, can be a result of stiff hip muscles due to the position of the baby in the uterus.
In-toe has a tendency to run in families. It can also be related to existing medical problems such as cerebral palsy.
It usually self-corrects without the need for medical intervention. However, if in-toeing is severe and involve leg and hip rotation, and isn’t improving by the age of two, it may be appropriate to seek medical advice from a Paediatrician or a certified Orthotist.
What determines correction treatment?
* Age, overall health and personal/family medical history
* Severity of the condition
* Individual’s tolerance for required procedures and/or therapies
* Personal/caregiver’s decision of treatment options
* Adults with in-toe conditions not treated when young can be prescribed with a customised orthoses to prevent deterioration.
Treatment may involve therapy special footwear and/or bracing.
Customised in-toe gait biomechanical insoles
Insoles that are designed to restrict in-toeing caused by rotational deformities of the foot (metatarsus adductus). It alters the break of the ball of the foot during propulsion to encourage realignment of the hip.
Spiral Thigh Brace™
The brace is designed to limit excessive internal rotation (femoral anteversion) at the hip. Ideal biofeedback tool for motor memory and proprioception for gait retraining. Indications for use include knock knees (inturned knees), pigeon toeing and scissoring gait. Brace is often used by children with hypermobility disorders, coordination or developmental disorder, cerebral palsy, autism spectrum disorders and children with awkward running styles, gait abnormalities who trip and fall chronically. The Spiral Thigh Brace™ is a unique and innovative flexible brace that stabilises the hip and legs, while allowing freedom to facilitate a more normal sequencing and flow of movement.