Cranial stenosis and unilateral in-toeing in a 6-year-old male: A case report
Narrative: A 5-year-old male child presented for chiropractic care at an interdisciplinary clinic. He presented with unresponsive unilateral in-toeing and associated self-injurious behavior due to gait disturbances. After 2-months of regular chiropractic treatments ~ between once and twice-a-week the patient demonstrated diminished or virtually eliminated self-injuries (e.g., falling down and hitting his head purposefully several times daily). Conservative, effective treatment for a subset of children presenting with in-toeing and/or self injury ~ particularly when watching and waiting is not preferred and the child’s gait, repetitive falls and other abnormal or injurious behaviour and self-esteem are being adversely affected by these conditions. Indexing terms: Chiropractic; sacro-occipital technique; SOT; in-toeing.
Objective igeon-toe/in-toeing is a relatively common condition in childhood causing the toes to point inward or feet to excessively internally rotate when standing or walking. This condition usually resolves as the child ages.
Clinical Features A 5-year-old male child presenting for chiropractic care with unresponsive unilateral in-toeing and associated self-injurious behaviour due to gait disturbances at an interdisciplinary clinic.
Intervention and Outcome Treatment consisted of ‘low force techniques’, sacro-occipital technique, and cranial techniques to address spinal, lower extremity, and postural imbalances, as well as abnormal cranial bone imbalance, possibly contributing to the patient’s in-toeing and difficulty walking. After 2-months of regular chiropractic treatments of between once and twice-a-week the patient has diminished or virtually eliminated self-injuries (e.g., falling down). His gait is mostly normal but due to a developmental anatomical left foot caused by in-toeing he is being treated also with short/moderate-term orthotics to enhance his recovery.
Conclusion This case may demonstrate a conservative, effective treatment for a subset of children presenting with in-toeing and/or self injury particularly when watching and waiting is not preferred and the child’s gait, repetitive falls, other abnormal or injurious behaviour and selfesteem are being adversely affected by these conditions
Lisa M Stowell DC
Private practice of Chiropractic Austin, Texas
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