In-toeing

Why does my child walk in-toed?

Your child walks with his/her feet turned in which is called in-toeing. Some call this hen-toeing or pigeon toeing. This is very common in childhood. Although the problem seems to be caused by their feet, in-toeing is usually caused by the shape of your child’s hip joints.

The shape of a baby’s hips makes their legs turn in and all newborn babies are in- toed but this is not noticed until the baby starts to walk. In most children the hip joints gradually “un-twist” meaning that as the child grows his or her feet gradually start to point forwards or even slightly outwards when they walk.

This takes time and occurs at different speeds in children and in some children it takes years to happen. This is why some children appear to be more “in-toed” than others and why most children grow out of it. This should be considered a normal stage of growth and development for your child.

Very occasionally there can be other causes for in-toeing which need treatment. Your doctor will be able to spot these by examining your child. Special tests are not usually necessary.

Does it affect how well they can run or walk?

All children trip and fall and can appear clumsy at different stages. This is usually due to spells of rapid growth affecting their coordination and is quite normal. Intoeing does not usually make this worse but sometimes children who intoe a lot appear to trip more often.

Unfortunately there is not much that can be done about this other than to reassure your child that everything is ok. Special shoes or insoles do not seem to help much with tripping up with intoeing.

Will anything make the in-toeing go away faster?

There is no evidence that physiotherapy or special insoles make any difference to the normal resolution of the in-toeing. Children should be encouraged to remain active and take part in sports. Surgery to speed up the process is not recommended.

What if my child does not grow out of this?

In-toeing in most children resolves by the age of 8-10 years of age. If this does not occur it is important to know that some in-toeing will have no effect at all on your child’s future. In-toeing is normal for some adults. In-toeing will not prevent your child from choosing any career they wish and will not make them more likely to develop problems with their legs later in life.

Very rarely, when the amount of in-toeing is very severe and has not improved over time, an orthopaedic surgeon may recommend treatment. This would only ever be in a situation where a child could not turn their hips outwards at all, which is very rare. Treatment in these cases is surgery to untwist the hips and is a major procedure. It is only ever considered in children who are fully grown.

This information leaflet has been produced after an initial review of the literature and where there is a lack of evidence, a consensus of expert opinion is agreed, correct at time of publication.