In-toe and Out-toe Walking

Is your child exhibiting in-toeing or out-toeing? It is essential to recognise that these are common gait abnormalities in children.

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If your child’s feet turn inward while standing and walking, it is likely that they are experiencing in-toeing, also known as pigeon-toe gait. This condition is commonly observed in children under the age of 2 and can make them appear clumsy, increasing the risk of tripping over their own feet. Witnessing an abnormal gait in a child can understandably be a concern for parents.


Various musculoskeletal conditions can contribute to in-toeing, including:

  • Hip Dysplasia
  • Femoral Anteversion
  • Internal Tibial Torsion
  • Clubfoot
  • Metatarsus Adductus

Failure to address In-toeing may lead to muscle and joint pain as the child grows older, and in some cases, it can result in postural deformities such as scoliosis or lordosis of the spine, which may worsen with age. Although some instances may self-correct over time, seeking a specialist's assessment and prognosis is advisable.


Out-toeing refers to another gait abnormality where the feet turn outward excessively during walking. It is characterised by the child's feet pointing away from the body, resembling the waddling gait of a duck.

This condition is often associated with femoral retroversion, where the thigh bone (femur) is rotated outward in relation to the hip joint. When a child exhibits out-toeing, it can lead to difficulties in maintaining a normal gait posture, which will affect their posture in the long run. If unaddressed, this abnormality may result in secondary pain and affect the proper development of the hip, knee and foot joints.

Out-toeing may be contributed by these conditions:

  • Femoral Retroversion
  • External Tibial Torsion
  • Genu Valgum
  • Flat Foot

Parental Tip: Parents should discourage their children from sitting in habitual ‘W’ positions, as this can exacerbate rotational deformities and hip joint contractures.

If you suspect that you child may have in-toeing or out-toeing, it is recommended to consult a foot specialist for a professional evaluation. A podiatrist can assess your child and determine the right care strategy to help him or her develop a healthy gait and posture. Podiatric modalities may include specific footwear or specialised orthotics that are customised to your child’s foot and lifestyle needs.

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Common Symptoms

Feet turned inwards while standing and walking
Feet turned outwards while walking

How It Looks Like

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Related Conditions


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Visited East Coast Podiatry for a regular review for my child who have her in toe condition successfully managed with ankle braces and in-sole management and very timely the team Jon Dungan and Ms Georgina are very detailed and sharp to quickly observe a toe nail bed infection caused by pedicure service just a day before the review that was cut too deep and pus was hidden inside causing some redness and pain. Jon and Georgina explained patiently the cause of the inflammation and carefully managed the infection and explained on the wound care. Jon is very attentive and provided excellent support to answer to our questions and show us all the core building exercises. It was a good and pleasant experience overall for the management journey. The admin team is always friendly and provide warm service too.


Our Podiatry Care Strategy

100% Non-Invasive In-Toe Out-Toe Therapy

A podiatrist will be able to perform a comprehensive in-toe out-toe evaluation and assessment. Physical examination, gait analysis, range of motion assessment, muscle strength and flexibility testing, and footwear analysis are all a part of the assessment process. Based on the findings, the podiatrist can recommend a tailored treatment plan to improve alignment, stability, and mobility.

Visual observation and history taking

Gait analysis

Physical examination

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Senior Podiatrist & Head of Department

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