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Published on May 19, 2015

The Ins and Outs of Intoeing and Outtoeing

May 19, 2015

toddler toesYou have a new walker on your hands, but something about her gait isn’t quite right. Should you be concerned about your toddler’s inward-turned feet?

The short answer is: probably not. Your child is experiencing intoeing, a typically painless condition involving one or both feet in which the feet tilt inward.

Intoeing during toddlerhood is most often due to a twist in the shinbone or thighbone that may run in families. Tibial torsion is the most common cause of intoeing and occurs when the tibia, or shinbone, rotates inward, sometimes due to lack of space to move in the womb. The condition is most common between 12 and 24 months of age.

Femoral anteversion is a rotation in the upper thighbone that angles the knees and feet inward. It, too, can develop due to restricted movement in the womb. Femoral anteversion typically occurs in late toddlerhood and the elementary school years. If your child’s legs form a “W” when she sits, with knees pointed toward each other and heels angled away from the legs, femoral anteversion may be present.

Tibial torsion and femoral anteversion can also cause outtoeing, outward angling of the knees and/or feet due to counterclockwise twisting of the shinbone or thighbone.

Another cause of intoeing, metatarsus adductus, is an inward rotation of the front of the feet that is most common in infants.

Consult your child’s pediatrician if you’re concerned about in- or outtoeing, if your little one complains of pain related to the feet, or if the problems show no signs of resolving as she progresses through school. Most children outgrow the conditions and learn to put their best feet forward.

Wanted: A Perfect Fit

Now that your child is walking, it’s time to box up his booties and purchase his first pair of shoes. Don’t skip the shopping trip—you might be tempted to pass down an older child’s first shoes to your toddler, but that could transmit germs to your little one and harm his feet if the shoes fit poorly.

As you browse the shoe section, look for leather or canvas pairs that feature the following elements:

  • Flexible toes
  • Lightweight construction
  • Rigid heel
  • Smooth, firm soles

Don’t forget your camera to capture your little one’s first steps in his new footwear!


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