Many kids walk with an in-toe when they start to walk. This is due to an internal rotation of the lower leg bone (tibia). As a child grows, the tibia bone should start to unwind and straighten (This occurs while the growth plates are still open), thus making the knee and the ankle position the same. However due to environmental and other factors, these bones are not correcting themselves enough, thus leaving the tibia bone in an inward position, which in-turn causes the body to try other means of correcting the foot position. The body uses other muscles to correct the child's walking. This in turn gives rise to other complications like growing pains, strained muscles and over compensation issues. Pediatric assessment needs to be conducted to determine the extent of the tibia torsion.
There are treatments available, which assist in re-aligning these bones. This can only be done when the child is still young, and the growth plates are still open. Treatment may vary from person to person. Biomechanical assessment is necessary to determine the best method of treatment. Orthotic gait plates may be an option for treatment, depending on the nature of the condition and outcomes of the assessments.