What Causes Pigeon Toes?

Pigeon toes, or in-toeing, happen when the feet turn inward instead of pointing straight ahead. This condition appears in children but sometimes affects adults. While many cases correct themselves, some persist and cause discomfort, poor balance, or difficulty walking. If you know the causes of pigeon toes and treatment options, it can help you prevent long-term issues.

What Are Pigeon Toes?

Pigeon toes are a walking pattern problem where the toes angle inward rather than forward. Some people notice the symptoms and causes of pigeon toes only while walking, while others see it even when standing.

Many toddlers walk pigeon-toed, especially when they first learn to walk. Pediatric podiatrists Phoenix say that this condition often corrects itself by age 8. In most cases, it doesn’t cause pain or affect mobility. However, severe cases can lead to tripping, difficulty running, or uneven wear on shoes.

Some adults never outgrow pigeon toes. Others develop the condition later in life due to injury, arthritis, or muscle imbalances. While many adults live with mild in-toeing without problems, more severe cases can lead to knee pain, hip discomfort, or balance issues.

Cause of Pigeon Toes in Kids

Most cases of pigeon toes in children result from how their bones develop. Here are the main causes of pigeon toes:

Metatarsus Adductus

This condition affects the front part of the foot. Instead of pointing straight ahead, the forefoot curves inward which creates a C-shape. Pediatric podiatrists Mesa say it usually happens because of the baby’s position in the womb. Some babies are born with flexible feet that straighten over time, while others have stiff feet that need stretching exercises or braces.

Internal Tibial Torsion

It is one of the causes of pigeon toes that affects the shinbone (tibia). Instead of being straight, the bone twists inward. Parents usually notice this when a child starts walking, often between 12 and 18 months. Most cases improve by age 6 without treatment. However, severe cases can cause tripping or an awkward gait.

Femoral Anteversion

This condition affects the thigh bone (femur). The femur turns inward, which causes both the knees and feet to point inward. This often becomes noticeable between ages 3 and 6. Children with femoral anteversion may sit in a “W” position, with their knees pointing outward and feet tucked behind them. Most cases improve by age 10, but severe cases may require physical therapy.

Family History

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.

Neuromuscular Conditions

Rarely, conditions like cerebral palsy or muscular dystrophy are among the causes of pigeon toes. Pediatric podiatrists Gilbert say that these conditions affect muscle control, making it harder for the body to maintain proper foot alignment.

What Causes Pigeon Toes in Adults?

Adults can develop pigeon toes for several reasons. While some cases result from childhood conditions that never corrected themselves, others develop due to injuries, arthritis, or lifestyle factors.

Childhood In-Toeing That Never Corrected

Some children never outgrow pigeon toes. If the bones remain twisted, the in-toeing continues into adulthood. Many adults don’t experience pain or mobility issues, but some develop discomfort over time.

Injuries That Affect Bone Alignment

Fractures or trauma is one of the causes of pigeon toes if the bones heal incorrectly. If an injury affects the tibia or femur, the healed bone may twist slightly inward. Surgery on the foot, ankle, or leg can also lead to alignment issues.

Arthritis and Joint Problems

Arthritis can change the shape of the joints and lead to altered foot positioning. Rheumatoid arthritis, in particular, is one of the causes of pigeon toes and joint deformities.

Muscle Imbalances and Weakness

Weak or tight muscles in the legs or hips are among the causes of pigeon toes. It often happens in people with poor posture, uneven leg strength, or certain neurological conditions. Strengthening exercises and physical therapy can help in these cases.

Poor Footwear and Walking Habits

Wearing unsupportive shoes or walking with an unnatural gait are among the causes of pigeon toes over time. High heels, shoes with narrow toe boxes, or constantly walking on uneven surfaces can all affect foot alignment.

Symptoms of Pigeon Toes

Here are the common symptoms per pediatric podiatrists Scottsdale:

Symptom         Description

Toes pointing inward  Feet angle inward when standing or walking.

Frequent tripping         Increased risk of stumbling while moving.

Difficulty running         Feet don’t align properly, affecting speed.

Knee or hip pain         Extra strain from misalignment.

Uneven shoe wear      Inner soles wear out faster than outer edges.

How Are Pigeon Toes Diagnosed?

Doctors diagnose pigeon toes through a physical exam and, if needed, imaging tests.

• The doctor watches how the patient walks and stands (Observation).
• The doctor checks the foot, shin, and thigh bones for twisting (Physical Exam).
• Imaging helps determine bone alignment issues in severe cases (X-rays or CT Scans).
• A detailed movement study assesses walking patterns (Gait Analysis).

Pigeon Toes Treatments

Now that you know about the causes of pigeon toes, let’s talk about the treatments. Most children do not need treatment. But treatment options include:

• Gentle foot and leg stretches to improve alignment.
• Special inserts or braces to help guide foot positioning.
• Strengthening and balance exercises to improve muscle control.
• Doctors may recommend surgery for extreme bone misalignment.

How to Prevent Pigeon Toes?

Some causes of pigeon toes, like genetics, can’t be prevented. However, parents can take steps to encourage proper foot development.

• Encourage children to sit cross-legged instead of in a “W” position.
• Provide well-fitted, supportive shoes.
• Promote physical activity to strengthen leg and foot muscles.
• Seek medical advice if in-toeing persists beyond age 8.

Treatment for Cause of Pigeon Toes in Phoenix, Arizona

If you have noticed the causes of pigeon toes in your kids, professional treatment can help. At Foot and Ankle Specialty Centers, our pediatric podiatrists Chandler specialize in diagnosing and treating in-toeing in children and adults. Our podiatrists use advanced techniques, including physical therapy, custom orthotics, and, in rare cases, surgical solutions.

We serve patients in Gilbert, Scottsdale, Chandler, Mesa, and Phoenix. Schedule an appointment or visit Foot and Ankle Specialty Centers to learn more.

Conclusion

Pigeon toes are common, especially in young children. The causes of pigeon toes mostly resolve naturally, but some persist into adulthood. Understanding the causes and available treatments helps individuals manage the condition and maintain healthy movement.

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