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Growth Illustrated guide

# Feet pointing inward: growth and reasons for assessment

An illustrated guide to in-toeing: possible contributing areas, observing walking and signs that warrant assessment.

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![A child standing, viewed from above with the toes of the shoes pointing inwards, observed by the mother and doctor.](https://ortopediaevolutiva.com/illustrated-guides/intrarotazione-passi-v4.webp)

![A child standing, viewed from above with the toes of the shoes pointing inwards, observed by the mother and doctor.](https://ortopediaevolutiva.com/clinical-print-figures/6f16037a744dd053.webp)

01

## Feet pointing inward

In-toeing can arise from the foot, shinbone or thighbone. In children it is often a developmental variation.

![A child walking in a park beside the mother, wearing ordinary play shoes.](https://ortopediaevolutiva.com/illustrated-guides/intrarotazione-funzione-v1.webp)

![A child walking in a park beside the mother, wearing ordinary play shoes.](https://ortopediaevolutiva.com/clinical-print-figures/6c8ebb5d14fdf473.webp)

02

## Observe function

Discuss walking, tripping and changes with the paediatrician. Special shoes and exercises do not correct bony torsion. A programme may be selected for an identified strength or coordination difficulty; a painless physiological variation with comfortable play and walking does not need corrective exercises.

![A seated girl pointing to discomfort in her leg during an appointment with the mother and doctor.](https://ortopediaevolutiva.com/illustrated-guides/intrarotazione-visita-v1.webp)

![A seated girl pointing to discomfort in her leg during an appointment with the mother and doctor.](https://ortopediaevolutiva.com/clinical-print-figures/f746d8309470a4c9.webp)

03

## When assessment is needed

Pain, limping, stiffness or a clear difference between sides need assessment rather than waiting for growth to resolve them.

General information; this guide does not replace an individual medical assessment.

[Dr Daniele Priano — Paediatric orthopaedics](https://ortopediaevolutiva.com/en/about)

[Condition information →](https://ortopediaevolutiva.com/en/conditions/in-toeing)

## Sources
- [AAOS/POSNA — Intoeing](https://www.orthoinfo.org/diseases--conditions/intoeing/)
- [POSNA — Torsional Problems](https://posna.org/physician-education/study-guide/torsional-problems)

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