“My granddaughter turns her foot in when she walks. Can anything be done?”



Yes. And the earlier a child is seen, the better. One of the biggest problems I find with children is a failure to recognize structural abnormalities early on. At other times, the general thinking is “they will outgrow the problem.” Unfortunately, children don’t usually outgrow their problems, but instead they often grow into them! Indeed, untreated (often easily corrected) childhood problems often become fixed, permanent abnormalities.

A common cause of this problem is a twist in the long bones of the foot (metatarsals) just behind the toes. Called metatarsus adductus, this condition can often be treated with simple exercises or at times casting (if seen early). Left untreated, surgery may be necessary in severe cases. However, a foot that turns inward when walking can have many causes and may not be a foot issue at all. But because it’s the foot that is seen as turning inward, that’s generally thought to be the problem. This can lead to taking a normal foot and improperly forcing it outward in an attempt to fix the problem which is actually occurring at a different level.

Another cause of turning one’s foot inward when walking is often due to an excessive amount of inward rotation at the hip. Simple stretching exercises to increase the amount of outward rotation of the hip are often very helpful. One of the bones in the lower leg, the tibia, can also be twisted (internal tibial torsion) and cause the same problem.

Many of these structural problems are inherited and when seeing different generations of the same family, not only can the same problems be seen, but the progression of those problems readily visualized. Bunions or bumps at the big toe joints are a perfect example of an inherited condition that can be seen very early in children, and that can become a significant problem as we age. Often simple exercises can fix such problems.

All children should be evaluated structurally for flattened feet, rotational problems, abnormal leg lengths and other abnormalities. Doing so can prevent many significant problems that may develop later on. These include lack of optimal sports performance, unsightly walking patterns, and arthritic conditions.

A structural evaluation does not need to be done as routinely as seeing a dentist, but it should be done!



A former reconstructive foot and ankle surgeon and past clinical instructor of Medicine at Emory University School of Medicine, Dr. Pack practices at MCG Medical Associates in Greensboro. He specializes in biomechanical structural analysis and works with patients who have arthritis and wish to decrease joint symptoms and remain active. Dr. Pack also treats athletes at all levels. In the 2004 Olympics he had a silver and gold medalist and helps the UGA Golf Team (2005 NCAA national champions). For further information please see www.drloupack.com, drloupack.blogspot.com or contact him directly at 706-454-0040.