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Why do my child's feet turn in?

Each child is unique and development may look differently from one child to another. When feet turn inward – a tendency referred to as walking "pigeon-toed" – doctors call it intoeing. Intoeing is a condition common in many children, and most often it is normal.

Intoeing can be caused by a curve in the foot or from a slight rotation of the bones in the lower leg or hip. A child with intoeing is typically not in pain and will likely grow out of the condition on their own without any treatment.

As most children grow, their bones very gradually rotate to a normal angle. If as a toddler, the child's foot is still curved or stiff, they may be treated with casting. If intoeing caused from a rotation in the leg or hip doesn't correct as a child grows, then custom shoes or braces may be needed. Exercises don’t change the shape of the bones, so they are not recommended as a treatment option. For severe cases of intoeing from rotation of the leg or hip, a child may need a surgical procedure.

If you have concerns about the way your child walks, orthopedists at Shriners Children's are here to help determine if intervention is needed. Have your child evaluated if you notice:

  • Curving of the foot that doesn’t resolve by 18 months of age
  • Intoeing that continues after 6 years of age
  • Limping or complaints of leg or foot pain
  • One foot that turns in more than the other
  • Developmental delays, such as not learning to walk or talk as expected
  • Gait abnormalities or walking that worsens instead of improves

Specific treatments and services may vary by location. Please contact a specific location for more information.

Types of intoeing

Toeing-in can come from the foot, the lower leg or the hip. Each type has a different cause and improves over time in almost all cases.

Metatarsus adductus

  • Most common in infants
  • Curvature of the foot causes toes to point inward (hooked forefoot)
  • Outside of the foot will typically have a c-shape to it
  • Can affect one or both feet
  • Treatment can include observation, stretching and/or serial casting

Tibial torsion

  • Most common in toddlers
  • Inward twist of the tibia (shin bone)
  • The foot turns inward while the knee is facing forward
  • Usually seen in both legs, but one may appear worse than the other
  • Normally resolves without any treatment by 6 to 8 years of age
  • Treatment is often not needed but may include bracing, and rarely, surgery

Femoral anteversion

  • Most common in preschoolers and school-age children
  • Inward twist of the top part of the femur (thigh bone)
  • When standing, both the feet and knees turn inward
  • Usually occurs in both legs, and is more common in girls
  • Allows the child to comfortably sit on the floor with the legs in the shape of a “W”
  • Usually lasts from about 3 to 8 years of age
  • Treatment is rarely needed but may include surgery
Intoeing is a common condition that children typically outgrow with time.
Teresa Cappello, M.D., Shriners Children's Chicago

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Shriners Children's multidisciplinary team includes orthotists who create braces to meet the individual need of each child – whether to treat a complex condition or common injury.


Shriners Children's care team specializes in putting children at ease during casting, a common treatment for fractures.

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With their expertise in treating children from toddlers to teens, the pediatric orthopedic surgeons at Shriners Children’s understand the challenges of planning ahead for growing bones and bodies.

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