What Is Out-Toeing?
Out-toeing is when the feet point outward while walking. It is common in children learning to walk, is not painful, and typically improves as they grow older. Almost all toddlers who out-toe learn to run, jump, and play just like other kids.
What Are the Signs of Out-Toeing?
Children with out-toeing walk or run with one or both feet turned out. Parents might notice an awkward walking or running style or uneven wear on the bottoms of the shoes. Out-toeing usually doesn’t cause pain but can sometimes cause a child to trip and fall.
What Causes Out-Toeing?
Most toddlers with out-toeing have it due to:
- A slight twist in the shinbones, causing the feet to turn out.
- A slight twist in the thighbones, causing the feet to turn out.
- Flat feet (with a low or missing arch), making it look like the feet are turning out.
- A problem with the hipbones (this is rare).
As a baby grows in the womb, some bones twist slightly to fit into the small space. These bones typically untwist over the first few years of life, but in some children, it takes longer.
How Is Out-Toeing Diagnosed?
During well-child checkups, doctors will ask about the child’s growth and development, check the bones and strength of the legs and feet, and observe the child’s walking. Sometimes, they may order X-rays to examine the leg or hip bones if a problem is suspected.
How Is Out-Toeing Treated?
Most children improve without any treatment. As they get older, their bones gradually rotate to a normal angle, and their walking improves with practice.
Special shoes and braces were once used to treat out-toeing but are no longer commonly used, as they did not speed up the improvement process.
Rarely, surgery may be needed if a hip problem is causing out-toeing.
When Should I Call the Doctor?
If your child has out-toeing, call the doctor if:
- Your child is limping or has pain in a hip or leg.
- One foot turns out more than the other.
- The out-toeing worsens.
What Else Should I Know?
Out-toeing improves over time, but the progress can be slow and hard to notice. Recording a short video of your child walking once or twice a year can help you see that the out-toeing is getting better.