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What is in-toeing?

Some children’s feet turn inwards when they stand and walk. It’s known as in-toeing or ‘pigeon toed’ and is very common in young children.

It’s one of the most common normal variants and can be seen in one or both legs.


Usually, children who in-toe have quite flexible joints. The three main reasons for in-toeing are:

  • Metatarsus adductus – the front of the foot curves inwards and it’s often the result of being cramped in the womb. Most cases resolve by the age of 3
    but in severe cases where the foot is stiff, stretches or advice on footwear may be necessary
  • Femoral anteversion – the femur (thigh bone) turns inwards, resulting in an inward turn of the whole leg. It’s most evident between the ages of 2 to 4 years and usually resolves by the age of 10
  • Internal tibial torsion – it’s an inward twist of the lower
    leg (tibia) and is common in early infancy and childhood due to positioning in the womb. This normally resolves by the age of 6 to 8 years.


Children may trip and fall more frequently but this is more likely to relate to their supple joints rather than difficulties with coordination.

This may become more obvious if your child is tired.


There’s no usually no treatment needed for the vast majority of children with in-toeing.  Most cases resolve by 8 years old.

There’s no evidence to suggest that splints or special shoes give any benefit, but we recommend good quality, well fitting shoes

Avoid a ‘W sit’ position as this reinforces the in-turned position.

Encourage cross legged or long sitting instead. In-toeing should not affect your child’s ability to walk or run in the long term.

When to get further advice

Get help for your child if their in-toeing is:

  • severe
  • symptomatic
  • causes problems with normal function
  • still evident after the age of 9 to 10 years old.