In-Toeing and Out-Toeing in Toddlers

Dear Parent or Guardian,

If your child is showing signs of in-toeing (walking with feet pointed inward) or out-toeing (walking with feet pointed outward), you may be hearing a variety of advice on the matter.

Some may say that you have absolutely nothing to worry about – that your child will definitely grow out of it. Others might tell you that such symptoms can be signs of underlying problems.

We understand how frustrating and worrisome it can be to receive such seemingly mixed messages. The truth, however, is that both statements have merit. 

Most cases of in-toeing and out-toeing do resolve on their own as your child further grows and develops. However, there are some cases that do not. The sooner these cases are discovered, the faster and more effectively we can take action to help your child.

Do not let anyone tell you your concerns about in-toeing or out-toeing in your child are unreasonable. But at the same time, do not panic! The chances are still very high that your child will ultimately not need any special treatment.

The key is staying on top of monitoring development and addressing any problems if they happen to arise. We have worked with many parents and guardians to provide regular checkups for their children to ensure their in-toeing or out-toeing is resolving naturally. And if it is not, we are ready to provide prompt, comprehensive care and support – both for your little one, and for you.

Please find more information about in-toeing and out-toeing below, and never hesitate to contact us if you have further questions or wish to schedule an examination for your child.

Always wishing you the best,

The Doctors at Southern California Foot & Ankle Specialists

a child learning to walk with her mother

What Causes In-Toeing and Out-Toeing?

When in-toeing or out-toeing is present, it typically means that part of a child’s skeletal structure is twisted or rotated in some way. 

In the case of in-toeing in toddlers, there are several common causes:

  • The thighbone is rotated inward, also known as femoral torsion or femoral anteversion.
  • The shinbone is rotated inward, also known as tibial torsion.
  • The forefoot is curved inward, also known as metatarsus adductus.

As you might expect, for an out-toeing child, the shinbone or thighbone tends to be rotated outward instead of inward. The hips might also have been rotated and constrained after birth.

In-toeing occurs in about 1 out of every 500 children; out-toeing is much rarer. Both feet are frequently affected equally, but it is not uncommon to see one foot rotated more than the other.

The exact reasons why in-toeing or out-toeing occur in some children are not fully known. It is suspected that the condition may be inherited, so that if you had one of these gait abnormalities as a toddler, the chances may be higher that your children may have them, too.

It is also suspected that in-toeing or out-toeing may be a consequence of a cramped position in the uterus during pregnancy. However, it’s important to note that, should this be the case, it was unavoidable. There is nothing we currently know that parents can do to prevent the appearance of in-toeing or out-toeing.

What to Do About In-Toeing and Out-Toeing

Although the appearance of in-toeing or out-toeing can be quite concerning, the vast majority of cases will resolve on their own. As a child continues to grow and develop, their bones will likely rotate back to their standard positions over time. Attempts at accelerating this correction, such as through bracing or physical therapy, tend not to have much effect.

Furthermore, having either condition rarely tends to serve as any impediment to a child’s comfort or mobility. They can still run and play as normal!

However, as we noted earlier, it is still a very good idea to contact us about your child’s condition. We may recommend periodic evaluations to make sure self-correction is happening as it should, and can take steps as soon as possible to provide support if necessary.

Although uncommon, any instances in which in-toeing or out-toeing is particularly severe or believed to be connected to a child’s discomfort or mobility problems, such as limping or tripping, should receive special attention. Additional action might also be needed if the condition has not resolved itself by a certain age (usually 9 or 10).

When necessary, we might recommend physical therapy, casting, or corrective footwear to treat symptoms, depending on the situation at hand. Surgery is rarely ever needed.

Don’t Worry, But Don’t Ignore

If you have any concerns whatsoever about your child’s feet turning inward or outward as they walk, you can always count on the doctors at Southern California Foot & Ankle Specialists to provide careful diagnosis, compassionate treatment, and peace of mind.

Whether it’s in-toeing, out-toeing, or any other of many pediatric foot conditions, we are here to help. Schedule an appointment at our Ladera Ranch office by calling (949) 364-9255. You can contact us online if you prefer, and we also have telemedicine appointments available if you wish to consult with us remotely.

Contact Us

Robert Spencer, DPM

Nitza Rodriguez, DPM

Han Nguyen, DPM

Map & Directions

333 Corporate Drive, Suite 230, Ladera Ranch, CA 92694
Tel: (949) 364-9255 (WALK)
Fax: (949) 364-9250
Office Hours:
Monday - Friday: 9am - 5pm
*(Lunch 12 noon - 1pm)