Parents Internal Tibial Torsion?

[Taximother]

DD's coach called to our attention that has a problem with turnout and we've been working with her to try to improve it, mostly by reminding her to walk with her feet pointed out. She says it hurts and as do the stretches she does at gym to try to improve it.

I took her to an orthopedic surgeon today for evaluation of another problem and asked him about it. He examined her and said that she has internal tibial torsion - basically her tibias are twisted, causing her ankles to be at the wrong angle, forcing her feet to turn in. He said it will not impair her in any way and he does not recommend the surgery to correct it.

Does anyone here have a gymnast with this condition? Her coach told me last month at the yearly evaluation that if she doesn't improve her turnout, she won't be consistent and she will eventually become frustrated and likely quit. It doesn't seem like improving her turnout is an option so I'm wondering if the coach is right about the rest of it.

 

[my4buffaloes]

Will the stretches she does to improve it ever be effective? If it is truly turned bones, I don't see how they really will be. Hopefully your coaches will be understanding with her and not try to force something that is not physically possible for her to do. As far as how she does down the road in gymnastics - it just might be a deduction that she takes on floor - and she might be just fine with that. you really don't know how it will play out in a few years. I wouldn't give up now because of it.

 

[sevenatenine2]

My daughter is the same way...starting to affect her on beam and floor and so very hard for her to correct!

 

[sevenatenine2]

One thing she struggles with a lot now is heels together in a tight body. Her toes will be together and pointed but heels apart.

 

[LMV]

How old is your daughter? With young children a small degree of internal tibial rotation is often attributed to their position in utero. This usually corrects itself without intervention by the time the child is starting school.

Did the orthopedist tell you what angle of internal rotation (calculated with the child prone for thigh-foot angle and the transmaleolar angle at the ankle) your daughter has? You can try to correct the torsion with a tibial osteotomy but that is usually reserved for kids with significant rotation where it is interfering with functional status (i.e. can she walk, run, jump, climb without pain or problems). A final thought would be to make sure that her hips and foot alignment themselves are ok because there does seem to be an association between both of these conditions and tibial torsions. The thought is that these can also be caused and influenced by womb position.

Good Luck!

 

[cbifoja]

How old is your daughter? With young children a small degree of internal tibial rotation is often attributed to their position in utero. This usually corrects itself without intervention by the time the child is starting school.

Did the orthopedist tell you what angle of internal rotation (calculated with the child prone for thigh-foot angle and the transmaleolar angle at the ankle) your daughter has? You can try to correct the torsion with a tibial osteotomy but that is usually reserved for kids with significant rotation where it is interfering with functional status (i.e. can she walk, run, jump, climb without pain or problems). A final thought would be to make sure that her hips and foot alignment themselves are ok because there does seem to be an association between both of these conditions and tibial torsions. The thought is that these can also be caused and influenced by womb position.

Good Luck!

This was the case for my daughter. I was very concerned when she was an infant...worried that she wouldn't be able to walk properly.

The orthopedic people we took her too said the same thing...that it will correct itself and it has. But like the OP's daughter, mine has NO turnout to speak of.

I believe (no hard data to back it up) that it does affect her on floor and beam and even on bars. When she casts to HS, the foot that I was concerned about as an infant has a definite sickle shape. And it is really noticeable on beam that her feet are turned in. But when she walks, you can't see any sort of turnout.

I'm not trying to be disrespectful to your coach, but it seems kind of dramatic to think that she will quit just because of it. Now, I don't know how much turn in we're talking here so I'm trying to keep that in mind as well. Mine is training L8 this summer so it hasn't hurt her with skill progression. She does lose in the artistry department though. LOL

 

[Taximother]

Thanks for the insight. DD is 10.

The doctor said that it is probably set now as most improvement is usually seen by age 9 or 10. But he also said had we come to him 5 years ago, he wouldn't have recommended intervention then either since most kids do outgrow it. She also plays soccer and he said that it may actually help her in soccer as there is some evidence it increases sprint times. It does not bother her in any way other than during gymnastics so there is no need for surgery to correct the condition.

DD does believe it affects her on beam, not so much on artistry but balance when landing because it's hard to get her feet into the right position.

Did the orthopedist tell you what angle of internal rotation (calculated with the child prone for thigh-foot angle and the transmaleolar angle at the ankle) your daughter has?

I remember he said something was 30% but I don't know if it referred to angle of internal rotation.

A final thought would be to make sure that her hips and foot alignment themselves are ok because there does seem to be an association between both of these conditions and tibial torsions.

It's interesting that you brought this up because the reason she was seeing the orthopedic surgeon in the first place is because she sprained her hip on Saturday doing a straddle jump. She thinks it was because she was trying to make sure she had the right turnout on the landing. However, the doctor didn't mention anything about hip or foot alignment.

 

[Faith]

Would ballet help? As in proper, correct technique ballet.

The focus on turn out might help her strengthen relevant muscles at least.

 

[Taximother]

Would ballet help? As in proper, correct technique ballet.

The focus on turn out might help her strengthen relevant muscles at least.

It had been our intention to try to get her into a ballet clinic later this summer but now I have no idea whether or not it will make a difference.

 

[Amusibus]

One thing she struggles with a lot now is heels together in a tight body. Her toes will be together and pointed but heels apart.

Sounds like what Rebecca Bross looked like, for instance, on bars. Wonder if she had that? And look how far she got!

 

[Deleted member D3987]

Sounds like what Rebecca Bross looked like, for instance, on bars. Wonder if she had that? And look how far she got!

no, Becca had Valgus. and let's not make a mountain out of a molehill here. no body is born perfect. and i can tell you that no body in gymnastics is perfectly made for gymnastics. the body has a brilliant ability to adapt to almost anything that is thrown at it.

so Taximother, have your daughter's coach watch this video. tell the coach to stop postulating about something he/she knows nothing about. as shown below, countless other gymnasts had the same "problem". but from a coaches point of view, a problem that was no big deal and was not insurmountable.



and here's another:

 

[Deleted member D3987]

and as far as beam goes:

 

[gracyomalley]

Dunno - I want to save those videos for every parent of a toddler who brings the kid in because grandma wants us to do something (usually put them in the braces they used in the first half of the last century...) about the kids in-toeing/tibial torsion....

 

[Deleted member D3987]

those were just the first 2 that came to mind. there are so many others. real athletes overcome most any physical obstacle. it's one of those things that have amazed me over all these years.