Are Your Children In-toeing or Out-toeing?

Parents often bring their children to our office to ask about the appearance of their feet and legs. Sometimes the child’s feet point in towards each other when walking. This abnormality is called “in-toeing” and is also referred to as being “pigeon-toed.”

Less commonly we see the opposite – the child walks with the toes pointing outward, or “out-toeing.”

Both of these conditions can be caused by:

In-toeing and out-toeing are often observed as soon as the child walks, but can happen later as well. The good news is that, in most cases, these abnormalities resolve themselves without special treatment, usually by the time the child reaches age 8.


Most cases of in-toeing really can’t be prevented because they often run in families. There are three types of in-toeing:

Curved foot (metatarsus adductus) – the child’s feet bend in towards each other beginning at the mid-foot. Milder cases may be flexible but more serious in-toeing can be extremely rigid. If a baby’s in-toeing is severe or very rigid when they reach age 6-9 months, special shoes or a cast can be very effective in correcting this deformity.

Twisted shin (tibia torsion) – here the child’s lower leg, or tibia, twists inward, often beginning before birth in the womb’s confined space. The tibia will usually un-twist as the child grows taller and by school-age should appear normal. Surgery may be called for in a child age 8-10 for a very severe twist.

Twisted thighbone (femoral anteversion) – this deformity where the thighbone (femur) turns inward often becomes obvious around age 5 or 6. Here both the feet and knees point inside. In almost all cases, this condition corrects itself. Surgery may be indicated in severe cases where a child over age 9 continually trips or has an abnormal gait.


Out-toeing is much less common than in-toeing and may cause disability and pain as the child becomes an adult. This deformity usually affects both legs.

Children with flat feet may also exhibit out-toeing. Because there is not a properly formed arch, the foot may appear to turn outside. Treatment is usually not required as this type of out-toeing is rarely painful.

Please Visit Us To Discuss Concerns About Your Child’s Feet

If you are concerned about the appearance of your child’s feet, please don’t hesitate to contact Stavros O. Alexopoulos, DPM. We will perform a comprehensive examination of the foot and arch and evaluate range of motion and flexibility. In more serious cases, orthotics, splints, corrective shoes or night braces can help.

Dr. Alexopoulos, board certified podiatrist has experience with a wide range of pediatric foot problems. Please call us at our Chicago office at 773-561-8100 or request an appointment via the website.

Stavros Alexopoulos One of Chicago’s top podiatrists, Stavros Alexopoulos, DPM, treats routine to complex foot and ankle issues. Dr. Alexopoulos is currently accepting new patients at My Chicago Foot Expert located near Ravenswood, North Park, and Jefferson Park.

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