Dr Gavin Spence is a paediatric orthopaedic surgeon with 24 years’ experience, including working at the top paediatric hospitals in London, such as Great Ormond Street Hospital for Children. In 10 years as a consultant, he performed nearly 4,000 procedures independently and taught as a surgical tutor. In 2019, Dr Spence was voted ‘Trainer of the Year’ by the British Orthopaedic Trainees’ Association. He has recently joined the team at Burjeel Hospital for Advanced Surgery

My toddler is pigeon-toed. It doesn’t bother him, but it does seem to slow him down. Is this something he will need help to fix?

“Almost certainly this is something he will grow out of. All children are born with feet that point in and they straighten by themselves with time. Orthotics, special shoes, physiotherapy and special diets make no difference, the only thing that works is time.”

My two-year-old is bow legged. It is a family trait from my husband’s side of the family. Is it too late to do something about this?


“It’s definitely not too late! Most children are born bow legged and, like ‘pigeon-toes’, they usually straighten out by themselves with time. There are a few rare exceptions which do need treatment, but we don’t usually start that until age four at the earliest, because usually nature does the job for us. At two years of age, there’s still plenty of time.“

My baby seems to have his head tilted to one side a lot. Is this normal?

“It can be a sign of a condition called torticollis, a shortening of one of the neck muscles. Physiotherapy often cures this. We have to operate rarely. But it can be a warning of other associated problems, in particular hip dislocation, so it is important to get your child checked.”

My three-year-old has flat feet. Does he need insoles?

“No, flat feet are actually normal in young children. Most develop an arch with time, but about 20 percent go on to become adults with flat feet. Contrary to popular opinion, flat feet don’t really cause disability (the Olympic gold medalist sprinter Usain Bolt has them!). We worry much more about feet with high arches, which often do cause problems. Special insoles in most cases are unnecessary, expensive and single the child out as different when most of them just want to be like their friends.”

My toddler can’t keep up with the others, is there something wrong with her?

“Bear in mind that normal development encompasses a wide range and children develop at their own rates – some rapidly, some need more time. Also remember that human walking is finely tuned and kids don’t get good at it until about age five. Until then, they do tend to stumble and fall a lot. That said, there are some walking ‘styles’ that indicate a problem. These need specialist knowledge to identify. If there is a difference between the two sides, in other words an asymmetrical walk, then a check-up would be a good idea.”

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