Pigeon toes (intoeing) are typically caused by inward twisting of the thigh bone (femoral anteversion) or shin bone (tibial torsion), often from fetal positioning, or inward curving of the foot (metatarsus adductus), which usually self-corrects as children grow, but can stem from genetics or conditions like cerebral palsy, notes The Sydney Children's Hospitals Network, Elite Foot Care, and Cleveland Clinic. The primary culprits are developmental, involving bones twisting to fit in the womb, but sometimes underlying issues require attention, say kidshealth.org and Raising Children Network.
Treatment Options for Pigeon Toes
The issue usually takes care of itself by the time your baby is six months old. If your little one still has a severe or particularly rigid curved foot by nine months old, your doctor may recommend casts or special shoes, which are very effective. Surgery isn't usually needed.
Generally, pigeon toes go away on their own without treatment as children grow and develop muscle strength and coordination. Your child's healthcare provider will keep an eye on their pigeon toes. Very rarely, serial casting or surgery may be discussed as options to fix pigeon toes.
Intoeing during infancy
Most commonly it is due to the foot being positioned in a certain way inside the uterus before the baby is born. You can suspect that metatarsus adductus may be present if: At rest, the front portion of your infant's foot turns inward.
Certain strengthening and flexibility exercises can help correct imbalances allowing the muscles around the lower leg to become more mobile, allowing them to maintain a more comfortable position.
The Myth: Toe Walking is Neurological
Many parents are told that their child's toe walking is a result of a neurological condition, such as autism or sensory processing disorder. While it's true that some children with these conditions may exhibit toe walking, it's not always the case.
Cyclopia is a rare genetic disorder occurring as a birth defect [1]. Its incidence rate is reported to be 1 in 13,000 to 20,000 newborns [2].
Seeking medical advice is crucial because toe walking can sometimes be associated with underlying conditions such as autism spectrum disorder, cerebral palsy, or muscular dystrophy. Early identification and intervention are key to addressing these conditions and promoting optimal development.
Family history is one of the causes of pigeon toes. If a parent had in-toeing as a child, their child has a higher chance of developing it. Bone structure and muscle development play a role in how a child's legs align.
Pigeon toes, or in-toeing, are common in children whose feet turn inward when walking. It is usually due to the natural alignment of the bones and muscles in the child's legs but can also be caused by issues such as hip dysplasia or spasticity.
Intoeing, which is commonly referred to as a child being pigeon toed, means a kid's feet turn inward when walking or running, instead of pointing straight. In most young children, intoeing will correct itself without treatment. However, if it is still present after age 10, it is more likely to be permanent.
Toe walking in children, often seen as they just start walking, typically resolves as they adopt the usual heel-to-toe stride. However, when this behavior persists past the age of two, it could indicate autism spectrum disorder (ASD).
When a child's pigeon toes are caused by femoral torsion, chiropractors can correct the problem by stretching and strengthening the hip. Participating in sports that work the areas, such as ballet, gymnastics, and biking, can also help.
If left untreated, pigeon toes can cause pain and difficulties in other areas of the body, such as your ankles, knees, hips or lower back. Adults who walk pigeon toed usually have muscle imbalances, such as tight calf muscles, hamstrings and adductors, and often a weakness in one or all of their quadriceps muscles.
The most common birth defect in the United States, a congenital heart defect results when the heart, or blood vessels near the heart, don't develop normally before birth. One in 110 babies are born with a CHD.
Sirenomelia, which is also known as mermaid syndrome, is an extremely rare congenital developmental disorder characterized by anomalies of the lower spine and the lower limbs. Affected infants are born with partial or complete fusion of the legs.
In December 2024, the Korean Society of Perinatology documented a female infant with cyclopia who survived for 8 months on palliative care, which is the longest known to date.
Symptoms may include:
The "6-second rule" for autism is a communication strategy where a speaker pauses for about six seconds after asking a question or giving information, giving the autistic person extra time to process it without feeling rushed, which helps reduce anxiety and allows for a more thoughtful response, reducing frustration for both parties. Instead of repeating or rephrasing, which can be confusing, you wait, and if needed, repeat the exact same words after the pause.
The most noticeable gait differences among autistic people are: toe-walking, walking on the balls of the feet. in-toeing, walking with one or both feet turned inwards. out-toeing, walking with one or both feet turned out.
Five key signs of autism (ASD) involve difficulties with social communication, repetitive behaviors, intense interests, sensory sensitivities, and strict routines, such as trouble with small talk/eye contact, hand-flapping/lining things up, deep focus on specific topics, sensitivity to sounds/lights, and distress over schedule changes, though these vary widely.
Adults can have ADHD.
Inattention: Difficulty paying attention, staying on task, or being organized. Hyperactivity: Excessive activity or restlessness, even at inappropriate times, and difficulty engaging in quiet activities. Impulsivity: Acting without thinking or having trouble with self-control.
The 10-3 rule for ADHD is a productivity strategy involving 10 minutes of focused work followed by a 3-minute break, designed to match the ADHD brain's need for short bursts of effort, making tasks less overwhelming and procrastination easier to manage by building momentum with quick, structured intervals. It helps individuals with ADHD ease into tasks, offering a tangible goal (10 mins) and an immediate reward (3 mins) to keep focus without burnout, often incorporating movement or preferred activities during breaks.