My Child’s Toes Point Inward: Can You Help?

As a parent, it’s natural to notice how your child walks and worry if anything looks unusual. If your child’s toes seem to point inward when they walk, you’re not alone — between 25% and 30% of children under age 6 have some form of intoeing.

This condition, often referred to as pigeon-toed, is a common concern that brings parents to us at Mill Creek Foot & Ankle Clinic. The good news? In most cases, it’s nothing to panic about. 

Joseph Hall, DPM, and our team are here to help you understand how to monitor intoeing, when to act, and how we can support your child’s healthy development.

Causes of intoeing

Intoeing can show up in babies, toddlers, and young children for several different reasons. The three most common causes are:

Metatarsus adductus

Metatarsus adductus is when the front part of the foot curves inward. Newborns often have it because of their position in the womb, with up to 1% of infants affected. Most cases improve on their own as the child grows.

Tibial torsion

Tibial torsion is the leading cause of intoeing in 1- to 4 year-olds. It’s due to a twist in the shinbone (tibia), which makes the foot turn inward. You’ll likely notice it first when your toddler starts to walk. The twist often straightens out naturally by age 5.

Femoral anteversion

Femoral anteversion occurs when the upper leg bone (femur) turns inward. It’s more common in children aged 3 to 6 and can cause the whole leg, including the toes, to point inward. Like the other causes, this often gets better with time.

The effects of intoeing

In most cases, intoeing isn’t painful and doesn’t affect your child’s ability to play, run, or keep up with their friends. Most children outgrow it without needing treatment.

Signs that intoeing may be causing issues include:

• Frequent tripping or falling
• Uneven shoe wear
• Pain in the legs or feet
• Delays in walking
• Difficulty keeping up with peers

If you notice any of these signs, schedule a visit with one of our pediatric specialists.

Intoeing evaluations

When you bring your child to us, we begin with a comprehensive physical exam. We look at how your child stands, walks, and moves their legs and feet.

We may gently check the rotation of the hips, knees, and ankles. In most cases, we won’t need X-rays, but we use them if we suspect another issue.

Our goal is to figure out what’s causing the intoeing and whether your child needs any special care or just time and reassurance.

Intoeing treatment

Most children with intoeing don’t need treatment. Their bones naturally realign as they grow, especially during the early stages of development. But in some cases, we may recommend one or more of the following:

Observation and regular checkups

Sometimes, the best plan is to keep a close eye on your child’s development with regular check-ins every few months.

Stretching or physical therapy

Physical therapy can help if tight muscles are contributing to your child’s walking pattern.

Orthotics or braces

We may recommend custom orthotics (shoe inserts) or special braces to help guide the foot into the correct position.

Surgery

Surgery is very rare, and we would only consider it if the intoeing was severe, painful, or not improving by age 10.

Helping your child at home

Here are some easy tips to support your child’s foot and leg health:

Encourage lots of active play

Running, climbing, and walking help with muscle and bone development.

Avoid “W-sitting”

W-sitting is a position some children adopt in which they bend their legs out to the sides with their feet behind their hips. This can make femoral anteversion worse.

Use supportive, well-fitting shoes

Avoid overly stiff or heavy footwear for toddlers. The shoes should be supportive and fit properly.

It’s also vital to attend regular pediatric checkups and mention any concerns early. Schedule a visit with us at Mill Creek Foot & Ankle Clinic if:

• Your child’s intoeing is getting worse instead of better
• They complain of foot or leg pain
• They fall frequently or struggle to keep up with others
• You want peace of mind from a specialist

We know how important your child’s health and development are to you. That’s why we take time to listen to your concerns and explain everything in simple terms. Whether your child’s intoeing is a passing phase or something that needs a little extra care, we’re here to help every step of the way.

At Mill Creek Foot & Ankle Clinic, we treat your child like one of our own. Call our office in Mill Creek, Washington, to schedule an intoeing evaluation, or use our online form to request an appointment.