Metatarsus Adductus – Pigeon Toe

Pigeon Toe (Metatarsus Adductus) is a common deformity of the foot generally noticed at birth, though subtle deformity can be overlooked and not picked up till later. It presents with the front part of the foot positioned inward in comparison with the rear of the foot, giving the foot a ‘kidney-shaped’ appearance. The rearfoot and ankle are usually in a normal position. The inside border of the foot appears concave with an exaggerated arch and there is often a wider space between the first and second toes. Metatarsus adductus that is undiagnosed at birth can become more apparent later in life as an in-toed gait.

What causes Metatarsus Adductus?

A single cause remains unclear but genetic and environmental factors have been suggested. These factors include:

  • Muscle imbalance and soft tissue contractions
  • Family history of metatarsus adductus
  • Position of baby in uterus
  • Sleeping position of baby
  • Stunted development of foot in utero (8-9wks)
  • The incidence is approximately one in 1000 births. It affects boys and girls equally and there is some evidence that first born children are at a greater risk.

Treatment Options:

Chosen treatment options for metatarsus adductus will depend on several factors including the age of the child, severity, rigidity, compliance and expectation levels. Metatarsus adductus responds best to early conservative treatment and may resolve spontaneously without treatment in some children. It is particularly crucial that treatment begins prior to the child commencing walking (ie before 12 months of age). Treatment options may include:

  • Manipulation and stretching
  • Padded shoes
  • Changing sleeping position of child
  • Serial casting
  • Splints and braces

The most well acknowledged treatment prior to 12 months of age is the use of plaster casts, changed periodically over a 1-3 month period to correct the deformity. Usually if treatment is left until after weight-bearing commences the likelihood of success drops considerably.

Ladies feet


What is Proprioception?

Proprioception is our body’s unconscious awareness of itself in space. It helps us to achieve quality movement, posture, and solid balance. There are certain parts of our body that contain high amounts of proprioceptive tissue including our feet and pelvis. These areas of our body relay messages to our brain to let our body know where it is in space. If something is wrong with any of these areas (for example an injury to your foot) this can change the messages being sent to the brain and can in turn affect your balance, movement patterns and posture, and then lead to injury and pain.

Two ladies discussing proprioception


Hippie Stretch

  1. Sit as tall as you can in a chair with your legs out in front of you, knees straight, and feet flexed.
  2. Inhale. As you exhale, slowly bring the fingers down to the toes.
  3. Hold this stretch for 15 seconds. Inhale and slowly come back up into starting position.

Lady performing a hip stretch to help her pigeon toe

If you think you have over pronation, please respond to this email with ‘Please Help!’ and we will be in touch. Alternatively, you can visit our website or call 02 4702 0221 to make an appointment.