Tibial torsion is inward twisting of the tibia (tibia/shinbone:the bones that are located between the knee and the ankle) and is the most common cause of intoeing. It is usually seen at age 2 years. Males and females are affected equally, and about two thirds of patients are affected bilaterally. The differences in normal tibial torsion values are expected to be caused by the different lifestyles and postures of the different populations, such as cross-legged sitting positions.
![]() Signs and Symptoms:
Tibial torsion causes the feet to turn inward, or have what is also known as a “pigeon-toed” appearance.
Torsion refers to a twist in the bone. Tibial torsion occurs when there is a twist in the lower leg bone (tibia). The tibia can either twist inward, called internal tibial torsion, or outward, called external tibial torsion. Males and females are affected equally.
The ability to compensate for tibial torsion depends on the amount of inversion and eversion present in the foot and on the amount of rotation possible at the hip. Internal torsion causes the foot to adduct, and the patient tries to compensate by everting the foot, externally rotating at the hip, or both.
Similarly, persons with external tibial torsion invert at the foot and internally rotate at the hip. Whereas medial torsion improves with time, lateral torsion often worsens because the natural progression is toward increasing external torsion.
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Summary:
Orthopedic Exam / Special Tests for Physical Therapy: LegSpecial Test: Tibial Torsion Test (Seated, Supine, Prone)Video Instructions, Procedure, Positive Test:1. Tibial Torsion Test – SEATED Video Instructions (Procedure below)Special Test: Tibial Torsion Test PROCEDURE (Seated):![]()
Tibial Torsion Test: POSITIVE TEST:
2. Tibial Torsion Test – SUPINE Video Instructions (Procedure below)Special Test: Tibial Torsion Test PROCEDURE (Supine):
POSITIVE SIGN:
3. Special Test: Tibial Torsion Test PROCEDURE (Prone):
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