Out-Toeing

What Is Out-Toeing?

Out-toeing is when feet point outward while walking. It happens to a lot of kids when they are learning to walk. It's not painful and it usually gets better as kids grow older. Almost all toddlers who out-toe learn to run, jump, and play as they grow up, just the same as other kids.

What Are the Signs of Out-Toeing?

Kids with out-toeing walk or run with one or both feet turned out. Parents might notice an awkward style of walking or running or that the bottoms of the shoes don’t wear evenly. Out-toeing doesn’t often cause pain, but it can cause a child to trip and fall sometimes.

What Causes Out-Toeing?

Most toddlers with out-toeing have it because:

• A slight twist in the shinbones makes the feet turn out.
• A slight twist in the thighbones makes the feet turn out.
• Flat feet (with a low or missing arch) make it look like the feet are turning out.
• There’s a problem with the hipbones (this is rare).

As a baby grows in the womb, some of the bones have to twist a little to fit into the small space. Those bones become untwisted over the first few years of life as kids grow. But in some kids, it takes longer to happen.

How Is Out-Toeing Diagnosed?

During well-child checkups, doctors ask how a child is growing and developing. They will check the bones and strength of the child’s legs and feet and watch the child walk. Sometimes they order X-rays to check the leg or hip bones if they notice a problem. 

How Is Out-Toeing Treated?

Most kids get better without any treatment. As they get older, their bones slowly rotate to a normal angle. Kids get better at walking and their feet straighten with practice.

Special shoes and braces once were used to treat out-toeing. But doctors found that these didn't make it clear up any faster, so most don't use them now.

Rarely, a child might need surgery 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 gets worse.

What Else Should I Know?

Out-toeing gets better over time, but progress is slow and can be hard to notice. It may help if parents record a short video of their child walking about once or twice a year. This usually makes it easy to see that the child’s out-toeing is getting better.