Intoeing and Outtoeing: Common Children's Foot Abnormalities

Are you concerned about the appearance of your child's feet? Do the feet seem to point inwards or outwards while walking?

At our Palm Beach Orthopaedic Institute offices, we often meet with parents who are worried about "in-toeing" where the toes point in towards each other. This is a common abnormality in young children that is sometimes called being "pigeon-toed."

The opposite condition, somewhat less common, is "out-toeing" where the toes point away from each other.

Both in-toeing and out-toeing are usually observed as soon as the child begins to walk but can occur later. Some causes for these conditions include:

  • The position of the child in the womb before birth.
  • An inherited family tendency.
  • Sitting or sleeping in certain position for long periods.

Fortunately, in-toeing and out-toeing usually resolve themselves in most cases with no special treatment by the time the child turns 8 years old.

Types of In-toeing

Curved foot (also called metatarsus adductus) is when the feet bend towards each other from the mid-foot out to the toes. Curved foot can be either flexible or more rigid. When a baby's in-toeing is already rigid by age 6-9 months, wearing special shoes or a cast for a period of time can help to correct this deformity.

Tibia torsion or twisted shin appears as a twist of the child's lower leg. This condition often starts in the confined space of the womb. In most cases, the leg will appear normal by school age as the tibia un-twists while the child grows. However, if a child aged 8-10 still has a severe twist to the tibia, surgery may be recommended.

A twisted thighbone or femoral anteversion occurs when the femur, or thighbone, turns inward. This condition, where both knees and feet point inside, will appear by age 5 or 6 and in most situations corrects itself. If a child age 10 and above has an abnormal gait or frequently trips, surgery may be indicated.

Out-Toeing Is a Much Less Common Condition

Although less common than in-toeing, out-toeing can cause pain and even disability if left untreated by adulthood. Out-toeing usually is found in both legs.

Although flat feet are not related to out-toeing, sometimes a child with flat feet will exhibit both conditions. With flat feet, the arch doesn't form properly so the foot seems to have turned inside. This type of out-toeing doesn't usually require treatment as it rarely is painful.

We Can Help with any Concerns about Your Child's Feet

Dr. John Schilero, DPM, board certified podiatrist has the right experience to deal with any type of pediatric foot and ankle problem, including deformities like in-toeing and out-toeing. Please call us at 561-694-7776 EXT. 41 to make an appointment at one of our four offices conveniently located in Palm Beach County. You can also request an appointment at the website. Help your child get a good start by closely monitoring foot health.