In-Toeing in Children

Overview

In-toeing, often called pigeon-toeing, is when a child’s feet point inward while walking or running. It is one of the most common gait patterns in growing children and, in the vast majority of cases, is part of normal development. Most children outgrow in-toeing as their bones, muscles, and coordination mature.

Common Causes

• Feet – Metatarsus Adductus: The front of the foot curves inward. Often noticed in infants and usually corrects naturally with growth and mobility.
• Shins – Internal Tibial Torsion: The tibia (shin bone) has an inward twist. Walking and running typically help straighten the bone over time.
• Hips – Femoral Anteversion: The thigh bone rotates inward, often associated with “W-sitting.” This commonly improves as hip strength and control develop.

Natural Development

Most in-toeing improves once children begin walking confidently and engaging in active play. Rotational alignment often settles between ages 6 and 10. Encouraging varied movement, balance activities, and avoiding prolonged W-sitting supports natural correction.

Most Children Naturally Outgrow In-Toeing

Movement, play and muscle development help improve alignment over time.

When to Seek a Podiatry Review

While in-toeing is usually harmless, a podiatry assessment is recommended if you notice:

• Frequent tripping or clumsiness that affects daily play
• Pain in the feet, legs, or knees
• One foot turning in more than the other
• Difficulty keeping up with peers
• In-toeing that is worsening rather than improving
• Concerns about hip or knee alignment

What We Assess

• Foot structure and flexibility
• Tibial and femoral rotation
• Hip strength and walking pattern
• Balance and coordination
• Footwear and activity levels

Footwear & Activity Guidance

• Choose flexible, lightweight shoes that allow natural movement
• Avoid stiff or overly rigid footwear
• Encourage varied play: hopping, squatting, climbing, balancing
• Reduce prolonged W-sitting; promote cross-leg or long-leg sitting
• Indoors: barefoot or socks on safe surfaces to improve proprioception

Strengthening Through Play

Active play improves coordination, balance and natural leg alignment.

Quick Tips

• Encourage activities that promote hip and core strength
• Avoid positions that increase inward rotation (e.g., W-sitting)
• Monitor for pain, limping or persistent tripping
• Support barefoot play indoors in a safe environment
• Book a podiatry assessment if concerns persist beyond age 6