Should I be concerned if my child’s feet point inward (in-toeing) or outward (out-toeing)?

Childrens Feet

In-Toeing

Causes

1. Metatarsus Adductus: Curve in the front part of the foot
2. Tibial Torsion: Twisting of shinbone common in toddlers
3. Femoral Anteversion: Inward rotation of thigh bone

When it's Normal:

• Common in toddlers' learning to walk
• Often fixes itself by the age of 8

When to Be Concerned:

• In-toeing persists after age 8
• There is pain, tripping, or difficulty walking
• Foot deformities appear rigid

Out-Toeing

Causes

1. External Tibial Torsion: Shinbone twisting outward
2. Femoral Retroversion: Thigh bone rotating outward
3. Flat feet: May contribute to out-toeing during walking
4. Neuromuscular Disorders: Rare but can cause out-toeing

When it's Normal

• Mild out-toeing in toddlers often resolves by the age of 2-3
• Common after periods of rapid growth

When to Be Concerned

• If out-toeing seems severe and asymmetrical
• Constant pain, limping, or difficulty with physical activities
• Associated with other developmental issues