Paediatric Orthopaedic Service/ In-toeing information
Version 4 (Code: 8.2.5.8.5.4 )
Date of Issue: August 2017
Date of review: October 2024
Review Date: October 2027
If review date has passed, the content will apply until the next version is published
Intoeing is when your child walks with their feet turned. Some call this hen-toeing or pigeon toeing. This is normal in childhood.
Although it looks like it's caused by their feet, intoeing is usually caused by the shape of your child’s hip joints.
What causes intoeing?
The shape of a baby’s hips makes their legs turn in. This is not obvious until the baby starts to walk. In most children the hip joints gradually turn meaning that as they grow their feet gradually start to point forwards or slightly outwards when they walk. This takes time and occurs at different speeds. In some cases it takes years to happen. This is why some children appear to be more intoed than others and why most children grow out of it. This should be considered a normal stage of growth and development for your child.
Does intoeing affect how well they can run or walk?
All children trip and fall and can appear clumsy at different stages. This is usually due to spells of rapid growth affecting their coordination and is normal.
Intoeing does not usually make this worse but sometimes children who intoe a lot appear to trip more often.
What can I do if my child is intoeing?
There's not much that needs to be done about this other than to reassure families and children that everything is ok.
Will anything make the intoeing go away faster?
There's no evidence that physiotherapy or special insoles make any difference to the intoeing going away. Children should be encouraged to remain active and take part in sports.
What if my child does not grow out of this?
Intoeing in most children resolves by the age of 8-10 years old.
If this does not occur, it's important to know that intoeing will have no effect on your child’s future. Intoeing is normal for some adults.
Intoeing will not prevent your child from choosing any career they wish and wont make them more likely to develop problems with their legs later in life.
If the amount of intoeing is severe and hasn't improved over time, an orthopaedic surgeon may recommend treatment. This would only ever be in a situation where a child could not turn their hips outwards at all and is causing significant movement problems or pain, which is very rare.
Treatment in these cases is surgery to untwist the hips and is a major procedure. It is only ever considered in children who are fully grown.
When to speak to a healthcare professional
Occasionally there can be other causes for in-toeing which need treatment.
Some symptoms may need further investigation by a healthcare professional, such as:
- intoeing that's much more noticeable on one foot causing problems walking
- a noticeable limp
- persistent or unusual leg pain
- stiffness in the hip
- sudden onset intoeing in children over 5 years old
Your healthcare professional will be able to spot issues by examining your child. Special tests are not usually necessary.
This information leaflet has been produced after an initial review of the literature and where there is a lack of evidence, a consensus of expert opinion is agreed, correct at time of publication.
Accessible formats
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