Intoeing can occur due to bone deformities or movement disorders and, in some cases, can be a combination of both.
Fortunately, most of the cases of intoeing fall into the normal category and do not hold any threats for normal development of the child. However, while diagnosing the condition, the neurological status of the child should always be assessed carefully. Certain problems during pregnancy or during childbirth such as bleeding during the early phase of pregnancy, premature birth, intracranial hemorrhage, etc, may cause neurological disturbances, which may contribute to intoeing by creating an imbalance in muscle strength.
There are also certain diseases associated with intoeing such as:
Rickets: Predominantly caused by vitamin D deficiency in children; the bones become soft and more liable to fracture and deformation, such as bowed legs
Blount’s disease is a bone growth disorder, characterised by outward bowing of the legs below the knees.
In normal children, intoeing is mostly due to skeletal problems and frequently more than one deformity is involved. The age of the child plays an important role in pinpointing the cause of the problem.
Intoeing due to deformity of the feet:
When present at birth, intoeing is mostly the result of a problem within the skeleton of the foot. Several conditions can appear as intoeing in newborns such as:
- Metatarsus adductus: the foot bends inwards from the middle (metatarsus: bones of the midfoot, adductus: from adduction, movement towards midline)
- Hallux varus: the big toe points inwards, away from the second toe (Hallux=big toe, Varus= inward angulation)
- Club foot: feet are turned inwards at the ankles, also present at birth
- High arched feet (pes cavus)
Metatarsus adductus is by far the most common cause of intoeing in newborns. In this condition the feet are curved, i.e., they are bent inward from the middle. The defect becomes obvious when you observe the soles of the feet that appear curved inwards. The defect is obvious at birth and the suspected cause is the position of the baby in the uterus, which may have pressed the feet in this way.