What are Pigeon Toes?

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.

Pigeon toeing may become less noticeable as the child grows and their physical structure develops. However, if it persists, treatments are available to help correct the alignment of your child's feet.

What Causes Pigeon Toes?

Pigeon toes, or in-toeing, can be caused by a few different factors, such as an underlying medical condition, injury, congenital disability or being born with it. However, the most common cause is the natural development of the baby's hip and leg muscles during infancy.

Some of the most common medical causes of pigeon toes in children include:

  • Muscular Imbalance: The muscles around the feet and ankles may not be developed evenly, resulting in an inward turning of the feet.
  • Congenital Talipes Equinovarus (CTEV): This is a congenital disability where foot bones are malformed or dislocated, causing the feet to face inward.
  • Blount's Disease: This is a bone disorder that affects the tibia, causing it to bow outward and place pressure on the ankles.
  • Cerebral Palsy: This condition involves damage to the brain's motor regions due to an injury or illness at birth, resulting in poor muscle control and coordination.
  • Neuromuscular disorders: Conditions such as muscular dystrophy or neuropathy can cause the muscles to be weaker and unable to coordinate properly, resulting in pigeon toes.
  • Trauma: An injury, such as a broken bone or ankle sprain, may cause the feet to turn inward as the bones heal.

Taking your child to a medical professional is essential if you think they have pigeon toes, as certain conditions may require medical treatment or physical therapy.

In some cases, however, pigeon toes can be caused by an underlying health issue such as hip dysplasia or a neurological disorder like cerebral palsy.

Signs & Symptoms

Common signs and symptoms of pigeon toes in children include:

  • Walking on the outer edges of the feet or with an exaggerated scissoring
  • Abnormal placement of the feet when sitting or standing
  • Feet that appear to be "locked" in an inward position
  • Uneven wear on the soles of shoes, especially around the heels and outer edges
  • Pain or discomfort in the lower legs, ankles, or feet.
  • Difficulty with balance and coordination when running or participating in physical activities
  • Poor posture, such as walking with a hunched back or leaning forward while standing.
  • Abnormal gait pattern, including a shuffling motion or tripping over one's own feet.

Risk Factors

Pigeon toes are a common condition that can occur in children. The exact cause of pigeon toes is unknown, but certain risk factors have been identified. These include:

  • Genetics: People with a family history of pigeon toes are more likely to develop the condition.
  • Footwear: Wearing ill-fitting shoes or shoes with high heels can increase the risk of pigeon toes.
  • Premature birth: Babies born prematurely have an increased risk of developing pigeon toes.
  • Injury: Trauma to a child's foot, including damage from sports activities, can cause pigeon toes in some cases.
  • Neuromuscular disorders: Certain neuromuscular conditions, such as cerebral palsy, can increase the risk of developing pigeon toes.
  • Developmental delays: Children who are slower to reach milestones such as walking can be more susceptible to developing pigeon toes.


Pigeon toes, or in-toeing, are typically diagnosed during a physical examination of the feet and legs.

The doctor may look for any signs of tight calf muscles, which can cause in-toeing. They might also ask the child to walk so they can observe their gait. X-rays may be taken to help identify any possible underlying causes, such as fractures of bowed legs.

In some cases, an MRI scan may be recommended if a more detailed diagnosis is needed.

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