IN-TOEING & OUT-TOEING Frequently Asked Questions

It takes children time to learn how to walk. They wobble and stumble as they figure out how to balance and propel themselves forward. Even when they master the mechanic, they don’t walk quite like adults.

However, some walking patterns aren’t normal, even for kids. Gait abnormalities like in-toeing and out-toeing are common issues that are usually monitored to ensure they don’t cause walking difficulties.

Intoeing and out-toeing are gait abnormalities that arise when toes don’t point straight forward when the child stands.

The result matches the name: in-toeing is a problem with the toes appearing turned inward, while out-toeing shows the digits pointing outward. Multiple lower limb issues can lead to each of these.

How seriously either affects your child’s feet can vary. In the majority of cases, neither condition impairs your son or daughter’s ability to learn to walk. Other times, however, it can trip up your child.


Intoeing and out-toeing are both gait abnormalities in young children, but they have key differences.

In-toeing is a problem where your son or daughter’s toes appear to point inward toward the other foot when he or she stands. This is often the result of the way your baby’s feet were positioned in the womb.

Out-toeing is simply the opposite. The toes appear to point outward and away from the other foot. This can be normal, but it can also be a side effect of a neuromuscular disorder.

In-toeing is one of the most common gait abnormalities in children.

It can have several different causes, such as; Metatarsus adductus, tibial torsion, and femoral torsion are the main culprits for digits that appear to point inward.

Metatarsus Adductus

Metatarsus Adductus is a birth defect, where a baby’s feet curve inward at the middle of the arch.

Tibial Torsion

Tibial Torsion is a slight twist in the shin bone that rotates the feet inward and is most visible in early childhood.

Femoral Torsion

Femoral Torsion is an inward twist of the thigh bone and can be seen best when your son or daughter is about school-aged.

Out-toeing is a fairly uncommon gait issue for children, but it does happen and can be the result of a couple different causes.

Usually it’s an issue with an outward rotation at the hip. This situation typically resolves on its own shortly after your child begins walking.

However, outward-pointing toes can also be caused by rotations in the shin or thigh bones. This is unusual in healthy children and is more likely to be a symptom of a serious neuromuscular disorder.

You don’t need to be concerned about the way your child’s toes point when he or she is learning to walk. You should have the condition monitored, though, particularly if it interferes with normal walking for your son or daughter. 

Looking out for your children’s feet and their future.

Being pro-active with your children’s feet is as easy as taking the next step toward happy feet and scheduling today!

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quick links:

In-Toeing and Out-Toeing: Learning How to Walk


treatment options


Dr. Darren Silvester and our staff at Next Step Foot & Ankle Clinic will need to evaluate your child’s lower limbs to determine the extent of the gait abnormality and how significantly it’s affecting your son or daughter’s ability to walk. We will also look for underlying issues like neuromuscular disorders that may be connected to the problem. From there we can decide what action, if any, is needed to manage the condition.

In-toeing and Out-toeing normally fix themselves on their own as your child grows and his or her muscles and bones develop. General children’s foot care should be enough to maintain healthy lower limbs.

conservative treatment options:



For many of the underlying causes for in-toing and out-toeing, active measures like splints & special shoes used to correct the toes’ position don’t make much of a difference.



In the case of metatarsus adductus there may need to be some stretching or casting—similar to the treatment used for clubfoot—if the condition lasts longer than a few months or is particularly severe.

For rotations in the shin or thigh bones, surgery may be an option when your child is over the age of ten and the rotation makes walking difficult or otherwise bothersome.

If either condition is connected to neuromuscular diseases, the underlying problem will need its own treatment.

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