Intoeing & Out-Toeing

What is in-toeing? Learning to Walk with Turned Toes

In-toeing is a fairly common gait problem in small children that causes their toes to turn inward, creating a “pigeon-toed” look. While this usually isn’t harmful, it’s important to monitor so that your child doesn’t trip over their toes or develop pain.

Why Toes Point Inward

Toes may point inward because of conditions like metatarsus adductus, tibial torsion, and femoral anteversion. Metatarsus adductus is a curve in the middle of the foot, which can range from flexibility issues to rigid deformities. Tibial torsion refers to a natural twist in the lower leg bones, which in turn rotates the foot inward. Femoral anteversion is excessive rotation in the hip bones that twists the legs inward and is most apparent around school age.

Growing Out of Gait Problems

​​Any child with in-toeing should have their growth monitored by a children’s foot care specialist like Dr. Sanjay Patel. Our team will examine your little one’s feet to make sure that no developmental issues are related to the problem, and that your child isn’t struggling with pain. Some conditions can be treated with braces or special shoes, but for most of these issues, the best treatment is waiting to see how they develop. Surgery is a last-resort option if a condition persists.

Out-Toeing in Children

As any parent is bound to know, a child’s first steps are never perfect. They wobble, they weave, and they ultimately fall over before starting to get the hang of things. Once children get moving at a steadier clip, that walk may still not look exactly as one expects. Several different gait abnormalities may develop, but we will concentrate on the feet turning outward, or out-toeing.

Turned-Out Toddling

Out-toeing is a common experience as children take their first steps. The most common cause of out-toeing in children is a small twist in their leg bones. If the tibia rotates outward, the child’s toes will follow suit. Once a child starts to move more confidently, the condition will often correct itself as their bones continue to develop. There are options including surgery, custom orthotics, and braces for kids whose gait stays abnormal, but a majority will grow out of this phase without treatment.

What to Do

In the case of a rotated tibia (tibial torsion), a child’s bones will usually self-correct by the age of 4. If you discover that your child is out-toeing, the best practice is to see an expert for a check-up. A doctor can check periodically for development and to see if the condition persists. If out-toeing persists after 3-4 years of age or your child has a gait that causes them pain, it’s crucial to get a closer look at the problem.

Contact Us

If you have concerns about your child’s in-toeing or out-toeing, you aren’t alone. Our team at Family Foot Care & Surgery would rather cover all the bases and catch any potential problems than let them develop into something worse. Call our Milford office at 203-876-7736 or our Hamden office at 203-288-4055 or fill out our contact form and we would be happy to help!