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Feet pointing inward: growth and reasons for assessment

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

A child standing, viewed from above with the toes of the shoes pointing inwards, observed by the mother and doctor. — Feet pointing inward
In-toeing can arise from the foot, shinbone or thighbone. In children it is often a developmental variation.

A child standing, viewed from above with the toes of the shoes pointing inwards, observed by the mother and doctor. — 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. — 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 child walking in a park beside the mother, wearing ordinary play shoes. — 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. — When assessment is needed
Pain, limping, stiffness or a clear difference between sides need assessment rather than waiting for growth to resolve them.

A seated girl pointing to discomfort in her leg during an appointment with the mother and doctor. — 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

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