In-Toe Walking

Some children’s feet turn in when they walk. This is called in-toeing or ‘pigeon toe’ and is very common in young children. It is one of the most normal foot positions in children. 

There are 3 main causes of an in-toeing gait in a healthy child: 

Femoral Anteversion

This is the most common cause of in-toeing and can run in families. The thigh bone (femur) turns inward causing the whole leg to turn in. It is most evident between the ages of 2-4 and usually improves by age 8-10. 

Metatarsus Adductus

This is often caused by being in a cramped space in the womb and can be seen from birth. It usually improves over time but in severe cases where the foot is stiff and inflexible there may be a need for specialist footwear, stretches or specialist referral. 

Tibial Torsion

This is when the kneecaps point forwards but the shin bone is twisted, causing the foot to turn in.  It generally corrects by age 4-5. 

Good quality, well-fitting shoes are recommended. 

It is important for children to play and be active to encourage bone growth and motor skill development. General sporting activities, such as swimming, are beneficial.

Practice activities to strengthen the hip muscles such as out-toed walking (like a penguin) and hamstring stretches. Discourage ‘W sitting’, where the bottom, knees and feet touch the ground with the feet resting outside of the knees.