Correcting Pigeon Toe ~ A Case Report from Lisa M Stowell DC and Charles L Blum DC
●Pigeon-toe or in-towing is a relatively common condition in children causing the toes to point inward or feet to excessively internally rotate when standing or walking.
●While this condition usually resolves as the child ages, it does appear to affect a child’s gait ~ causing repetitive falls.
●A child’s self-esteem may also be adversely affected by this condition.
●This case report discusses care rendered to a 2 ½ year old female presenting for chiropractic care with bilateral in-toeing in an interdisciplinary clinic.
●The mother noted that her child would often trip over her feet and fall, believing it due to the child’s foot position when walking or running.
●Because the patient was so young and only compliant to a certain extent, the initial examination was somewhat minimal and brief.
●Upon checking her iliotibial band bilaterally, I observed the patient was hypermobile on passive pronation.
●Visual examination showed hyper-pronation with toe adduction bilaterally in her stance and gait.
●Although the patient appeared to walk in a somewhat normal fashion (without any limp or other impaired action), in-toeing bilaterally was notable.
●Palpation of iliotibial band’s bilaterally demonstrated some sensitivity illustrated by the patient’s apprehensive response.
●Treatment consisted of a chiropractic technique informally called “Low Force Technique”, resulting in gentle realignment of the entire spine using a force that is not defined by an audible/cavitation and is applied with my right thumb and middle finger contact to the patient’s vertebra on either side of the transverse process.
●Due to the unusual tension in the iliotibial bands, trigger point therapy to the iliotibial bands bilaterally was also administered until relaxation was obtained.
●During the course of the first two treatments, the patient appeared to be able to sit with less tension in her body, allowing her feet to not relax in a hyper-pronated position.
●By the third/fourth office visit, the patient felt safer and more relaxed, so I was able to administer some cervical spine adjustments and by the sixth office visit some cranial manipulative care as well.
●During this time SOT pre and post assessments for pelvis and cervical spine balancing could be performed, which also seemed to confirm improved static and functional position of the spine and lower extremities.
●By the third office visit the patient was walking with one foot straight, by the fourth visit she was walking with both feet mostly straight ahead ~ though the left foot still had some signs of in-toeing.
●The fifth and follow up visits showed her to continue to walk without in-toeing.
●The patient’s mother reported that the child does, on occasion, tend to stand somewhat in-toed for a bit, yet sometimes still trips a bit. Her coordination and ability to catch herself, however, has vastly improved, since receiving treatment.
●Further care continues to sustain progress, with intervals between treatment extended as the patient’s progress is maintained.
●This case may demonstrate a conservative, effective treatment for a subset of children presenting with in-toeing ~ particularly when watching and waiting is not preferred and the child’s gait, repetitive falls, and self-esteem are being adversely affected by this condition.
