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Richardson Podiatry Center

Intoeing and Out-Toeing

It is certainly understandable if parents become nervous when they start to notice that their son or daughter’s feet are pointing either in or out. It is only natural that you want the best for your children, especially when it comes to health issues. You may be concerned that intoeing and out-toeing conditions could potentially affect development and lead to issues later in life. There is good news with regard to these gait abnormalities. Most cases will resolve themselves in time, but it is still helpful to know more about them for your peace of mind.


In-toeing and Out-toeing

More often referred to as “pigeon-toed,” toeing in is a condition where a child’s feet are turned inwards instead of pointing straight ahead in a “normal” manner. This condition can certainly be observed earlier, but it is often noticed for the first time when a child starts walking.

Causes of this condition depend on the location in the foot or leg where the problem originates:

  • Metatarsus Adductus – This common birth “defect” results in the feet being curved inward, starting at approximately the middle of the foot and extending down to the toes. This will typically improve over time as the newborn starts growing.
  • Tibial Torsion – In this particular form of intoeing, the tibia (shinbone) is turned inward, often because it did not rotate into the proper, turned-out position. This will often resolve before a child turns 4 years old.
  • Femoral Anteversion – Sometimes called “overextension,” this condition is found further up the leg and marked by a femur (upper leg bone) that has twisted inward. Femoral anteversion is most apparent when a child is 5 or 6 years old. In many cases, the condition will spontaneously correct itself as a child grows older.

Intoeing does not cause pain or arthritis or interfere with a child’s ability to learn how to walk, as had previously been thought. Basically, the primary symptom is simply the fact that a child’s toes can be observed as pointing inward while he or she is walking or resting on his or her back. Additionally, the outer part of one or both feet might be curved. This can lead to uneven wear patterns in the child’s shoes and, in severe cases, more frequent falling and tripping.


When a child’s legs turn the other way, and the toes point outward, it is called out-toeing. This condition is fairly common in toddlers and is potentially an indicator of developmental dysplasia of the hip, particularly when it only affects one foot. As with the case for the various forms of in-toeing, this issue will often simply go away as the child grows.

Treatment for Intoeing and Out-Toeing

The good news for both gait abnormalities is that treatment is usually unnecessary and the conditions correct themselves over time as the child continues to grow. Since a young child’s bones are still soft and pliable, pain from the condition is rarely an issue. For mild to moderate cases, special shoes, inserts, night braces, exercises and stretches do not help. Some of these approaches have even been found to potentially interfere with normal growth and development.

In the cases of severe in-toeing, children might need to wear a cast on the affected leg. Additionally, when a child hits 8 years of age and still has a gait issue—especially when it causes significant issues with walking—then it is time to begin considering treatment. Surgery will likely be recommended at that point.

Top Children’s Foot Care in Richardson, TX

Our Richardson, TX office provides effective foot and ankle care for patients of all ages. Whether your son or daughter needs the treatment we offer or you would simply like more information on this topic, we are here for you. Contact Richardson Podiatry Associates today and set up your appointment with our professional staff by calling (972) 690-5374. Feel free to use our online form for scheduling purposes as well.