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What is it?

Out-toeing is when your child’s foot points outward instead of straight ahead when they run or walk. Out-toeing can be perfectly normal and will often correct itself, however, there are some conditions that cause out-toeing that are more serious.

Out-toeing is less common than in-toeing in children. Out-toeing can also run in families.

Out-toeing can be due to:

1) external rotation at the hip,

2) an outward twist of the shin bone (tibia),

3) flat feet (pes planus) can give the impression that the child is out toeing and this normally improves as the child ages and matures.

Often children with out-toeing have no pain or functional problems.  It is usually parents who notice that the child stands, walks, or runs with the feet pointing outward which causes concern.

How can I help myself?

The best thing to do is watch and wait. As a parent, you know your child best so if you are concerned do access help. Even though out-toeing may not correct completely with age, it is possible that they remain pain free and functionally have no issues.

When to see a Podiatrist?

If your child cannot participate in normal activities and is in pain, or has serious deformity, then we recommend you seek help. A Podiatrist will take a thorough history (including birth history and developmental milestones) and discuss the history of pain or limping. The physical exam might include watching your child walk and run, and checking range of motion of the hips, knees, ankles, and feet.They may also check muscle tightness, nerve / muscle function, and coordination.

If they are concerned they may order x-rays or refer your child to an orthopaedic/paediatric specialist.

Treatment is dependent on the underlying diagnosis that is causing the out-toeing. Normal “developmental” out-toeing can be reviewed periodically. Occasionally, external tibial torsion or femoral retroversion may require surgery but this is very rare.