Massage therapy · Kitchener–WaterlooIn-Toeing
Foot
What It Is
In-toeing means that the child's feet turn inward when the child runs or walks instead of pointing straight ahead. The condition is also termed pigeon-toed. Often the condition is first noticed by the child's parents when the child begins walking. Children at various ages might display the condition for different reasons (AAOS, n.d.). In-toeing is common in childhood and is usually outgrown (West Suffolk NHS Foundation Trust, 2021).
On occasion, severe in-toeing might cause younger children to trip and stumble as they catch their toes on the heel of their other foot. In-toeing by itself doesn't cause pain, nor does it lead to arthritis (AAOS, n.d.).
In the vast majority of children who are younger than eight years of age, in-toeing will correct itself without surgery, braces, casts or any other special treatment (AAOS, n.d.).
In-Toeing Anatomy
The leg is the entire lower limb or extremity within the human body. It includes the foot, hip and thigh. The skeleton is a living structure that works to support the entire body. Bones are composed of an outer shell of dense bone surrounding a honeycomb structure of softer bone. Bone is composed mainly of calcium and protein. If the bones don't have calcium, they will become weak. Two sections make up the human skeleton: the axial section, which consists of 80 bones including the spine, skull and chest, and the appendicular skeleton, which consists of 126 bones that includes the limbs, hands, feet and pelvic girdle.
Not a diagnosis — for more information, contact me or another trusted healthcare provider.
Treatment
Self-Care & Treatment
How In-Toeing Is Managed
Treatments you may want to discuss with your family doctor or nurse practitioner
Tips
- Children who in-toe when they first start walking may have a twisted shin bone (AAOS, n.d.).
- A twisted thighbone is often most noticeable around 5 or 6 years of age (AAOS, n.d.).
- Twisting of the bones tends to run in families.
- A curved foot usually improves by itself in the first months of life (AAOS, n.d.).
- A curved foot and a twisted shin bone are thought to be linked to the baby's position in the womb (AAOS, n.d.; West Suffolk NHS Foundation Trust, 2021).
Treatment
My Approach
Most in-toeing is outgrown without treatment, and I can't change the shape or twist of the bones. Your child's doctor or specialist leads any treatment. My role is to check how your child moves, ease tight or tired muscles and support you at home. If your child has had surgery, I need the surgeon's okay before any hands-on treatment, and please bring any X-ray or scan reports and the specialist's notes.
I start by assessing how your child stands, walks and runs, and how the feet, hips and legs move. If I see warning signs, such as pain, swelling, a limp, in-toeing on one side only or stiff feet, I'll point you to your family doctor or nurse practitioner first.
Babies With a Curved Foot
- Where the foot is flexible, I'll show you gentle stretches to do with your baby at home, and you're welcome to stay throughout
As Your Child Grows
- Gentle hands-on work for tight or tired leg and hip muscles
- Play-based balance and strength activities to keep your child active and confident, not to correct the bones
After Casts or Surgery
- Easing stiffness, scar work once any wound has healed, and rebuilding strength within the specialist's plan
- Care for parents and caregivers too, such as neck or back strain from carrying a child in a cast
What to Expect
Typical Course
What I Focus On
Please read
When to See a Doctor First
When to get your child checked
A child whose in-toeing comes with pain, swelling or a limp should be checked by an orthopaedic specialist (AAOS, n.d.). Also see your child's doctor if the in-toeing affects only one leg, is severe and not improving with time, is making a school-age child trip so much that it affects their activities, or if the feet are stiff and not improving (West Suffolk NHS Foundation Trust, 2021).
The cause of the condition depends on where the change in alignment is. Three common conditions cause in-toeing: curved foot (metatarsus adductus), twisted shin bone (tibial torsion) and twisted thighbone (femoral anteversion). Each of these conditions may run in families. Because they come from developmental or genetic differences, they usually cannot be prevented (AAOS, n.d.).
Sources
References
- American Academy of Orthopaedic Surgeons (AAOS) (n.d.) Intoeing. OrthoInfo. Available at: https://www.orthoinfo.org/diseases--conditions/intoeing/ (Accessed: 7 October 2026).
- West Suffolk NHS Foundation Trust (2021) Intoeing in children. Available at: https://www.wsh.nhs.uk/CMS-Documents/Patient-leaflets/TraumaandOrthopaedics/6083-1-Intoeing-in-children.pdf (Accessed: 7 October 2026).