Children Toeing Out: Keep Calm And Keep Watch


By Dustin L. Kruse, DPM

In the classic ballet first position, the dancer’s feet are turned out at a 90 degree angle from the hip with their heels together and their feet in a straight line, toes pointing out. It takes them years to be able to move their legs into this pose without straining the muscles. Your child’s natural toeing out will not reach that extreme, but it can still cause you to wonder if they will ever walk with toes pointing straight ahead.

Out-toeing in Babies and Toddlers Is Common

It is fairly common for your baby’s feet to point out in the first months of life. Their bones are still soft, and they spend lots of time on their backs with the legs relaxed outward.

Even after they start pulling themselves up by furniture and take those first wobbly steps, their feet can point in all different directions. It is common to see both in-toeing and out-toeing when they first start to walk. Many will outgrow this as their leg muscles strengthen and their bones begin to ossify. You can mention your concerns to your pediatrician, but at this stage the tendency is not normally a cause for concern.

Reasons for Toeing Out in Young Children

Your 2 or 3-year-old child’s feet may turn outward when walking for a variety of reasons. The feet themselves may be twisted out, or they may point out because the shin is rotated outward below the knee. Rotation can also occur in the thigh, and even the hip joint may have an abnormal alignment (femoral retroversion).

Most of the time the out-toeing will be in a normal range and not cause difficulties for your child. You merely need to keep watch over it as they grow. However, in some extreme cases of femoral retroversion, where the problem originates in the hip, it is best to have it checked by foot specialists like our staff at Rocky Mountain Foot & Ankle Center. We can confirm the diagnosis and let you know whether it requires monitoring or more aggressive treatment.

When Your School-age Child’s Feet Point Out

From age 4 to 7, your child’s shin bones may twist out of proper alignment at they grow (external tibial torsion). It often happens on only one side (usually the right). This can cause the foot to point out more on that side. This warrants closer observation, although it may still correct itself as time goes on.

If the turned-out foot persists past 10 years of age, or if there is pain or limitation of movement because of it, it is time to consult us about what should be done. Surgical correction is possible, although not always totally effective. We will discuss options with you and walk you through the process if it is necessary.

Denver Foot Experts Are Here to Help

If you are concerned about your child’s toeing out—or any other foot issue he or she faces—come to Rocky Mountain Foot & Ankle Center and let Dr. Matthew Paden, Dr. Brett D. Sachs, and Dr. Dustin Kruse put their expertise to work for you. Call (303) 423-2520 to reach any of our locations: Wheat Ridge, Golden, Evergreen, and Granby, CO. You can also schedule an appointment through our contact page.

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