In-Toeing and Out-Toeing in Toddlers: What’s Normal and What’s Not
It’s common for toddlers to walk a little differently as they learn to balance and build strength. Two of the most frequently noticed walking patterns are in-toeing and out-toeing, where the feet turn inward or outward instead of pointing straight ahead.
While most cases are harmless and resolve on their own, some may require medical attention to ensure healthy development.
What Is In-Toeing?
Also called “pigeon-toed” walking, in-toeing occurs when a child’s feet turn inward while walking or running. It can be caused by:
- Metatarsus adductus – Curved foot shape seen in newborns
- Internal tibial torsion – Shin bones rotated inward
- Femoral anteversion – Thigh bone rotated inward, common in preschoolers
What Is Out-Toeing?
Out-toeing is when the feet turn outward instead of straight ahead. It may result from:
- External rotation of the hip or thigh
- Flat feet or tight hip muscles
- Neurological conditions (rare)
Out-toeing is usually noticed when a child starts walking.
When Is It Normal?
In most toddlers:
- In-toeing or out-toeing is part of normal development
- It does not cause pain or affect physical activity
- It improves naturally with age and muscle development
No treatment is usually needed for children under 8 if they are active and pain-free.
When Should You Worry?
Seek an evaluation if your child shows:
- Limping or tripping frequently
- Pain in legs, hips, or knees
- Uneven shoe wear
- Asymmetrical walking patterns
- Symptoms that worsen with age rather than improve
- A family history of orthopedic disorders
Diagnosis & Evaluation
A pediatric orthopedic specialist will:
- Observe your child’s gait and posture
- Assess foot, knee, and hip alignment
- Recommend X-rays if needed
- Monitor changes over time
Treatment Options
Most cases require no treatment, but if intervention is needed, options may include:
- Stretching and strengthening exercises
- Special footwear or orthotics (in select cases)
- Bracing or casting (rarely)
- Surgery – Only in severe, persistent cases that affect function
Helping Your Child Walk with Confidence
If you’re unsure whether your child’s walking style is typical or needs treatment, schedule an evaluation with Dr. Nargesh Agrawal at Child OrthoCare. Early reassurance or intervention leads to better outcomes.
Contact Information
Clinic Name: Child OrthoCare
Consulting Pediatric Orthopedic Surgeon: Dr. Nargesh Agrawal
Address: C-7, Ground Floor, D- Park, Model Town -3, New Delhi 110009
Phone: +91 88517 77145
Website: www.childorthocare.online
