In-toe and Out-toe Walking in Children

If you’re a parent who has noticed that your young child seems to walk with their toes pointing inward, you may be concerned that this “in-toe” walking will affect them as they grow.

You may rest assured that most in-toe walking (and even “out-toe” walking) corrects itself in time.

Also known as walking “pigeon toed,” in-toe walking often is caused by what is known as a femoral ante version, in which the top of the child’s thigh bone (femur) has an inwards twist.

For some children, in-toe walking is caused by an inwards twist to their shin bone (tibia), called internal tibial torsion.

Finally, a very few children with in-toe walking do so because the shape of their feet curve and hook inwards. This is called metatarsus adductus.

You may notice that your in-toe walking child may trip a bit more than children who do not walk in-toe. Again, most children outgrow in-toe walking by the time their around ages 7-8.

If, by chance your child’s in-toe walking is caused by the top of the femur twisting inward (femoral anteversion) and the condition doesn’t correct itself as the child ages, you needn’t worry that your child will not be able to play in sports or be physically active. Some children have a severe twist to their femur (this is very rare) that can cause pain at their knees and hips when they become teenagers. You may think of an operation to correct it.

Most in-toe walking decreases as the child ages and special shoes, braces or splints generally are not necessary to correct the condition.

Naturally, if you have any concerns at all, a health care provider, particularly a podiatrist, will be happy to take a look at your child.

“Out-toe” walking is even less common in children. As with in-toe walking, out-toe walking may be caused by the upper thigh or shin twisting outward. If your child doesn’t walk out-toe and then starts doing so, you’ll need to have him or her see a health professional for x-rays of the “lateral hip view” so that the a “slip” of the hip can be ruled out.

The best treatment for out-toe, as well as in-toe? As with the child who walks in-toe, braces, special shoes, etc. are unnecessary. Simple walking is best and, as time passes, most all in-toe and out-toe walking self-corrects as the child grows.

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