What is an Out Toeing?

Out Toeing is a condition in which a child’s feet point outward more than normal when the child walks or stands.

This condition usually affects both feet equally. It may be more obvious when a child starts to run. This condition is not painful, and it usually improves as a child grows.

What are the causes?

The most common cause of this condition is bones of the lower leg turning outward (external tibial torsion). Other possible causes include:

• The way your child was positioned in the womb.
• Bones of the upper leg turning outward (external femoral torsion).

What increases the risk?

This condition is more likely to develop in children who:

• Have a family history of out-toeing.
• Were born early (prematurely).

What are the signs or symptoms?

Symptoms of this condition include:

• Feet that turn out while standing or walking.
• Flattened arches of the foot (flat feet).

How is this diagnosed?

This condition may be diagnosed with a physical exam and medical history. Sometimes, imaging tests are done so your child’s health care provider can check whether a bone problem is causing the condition. Tests may include X-rays of the feet, legs, and hips, or a CT scan.

How is this treated?

Usually, this condition does not need treatment. Out-toeing usually goes away on its own. If out-toeing gets worse or does not improve by age 3, your child may need to see a health care provider who specializes in bone disorders (orthopedist). If out-toeing is severe or it is the result of an underlying condition, your child may need:

• Certain kinds of shoes, braces, or casts to help straighten the foot or a twisted bone.
• Surgery. This is rare and may be done when your child is older and nearly finished growing.

Follow these instructions at home:

• Monitor your child for changes in his or her condition. This includes any changes in your child’s legs or feet, and changes in how your child walks.
  • You may want to make a video of your child walking and running every few months to help you notice any changes in your child’s condition. Sharing these videos with your child’s health care provider may be helpful.
• Keep all follow-up visits as told by your child’s health care provider. This is important.

Contact a health care provider if:

• Your child has pain while walking or running.
• Your child seems more unsteady or clumsy when walking or running.
• Your child falls frequently.
• Your child develops a limp.
• Your child is avoiding walking and running and is becoming less active.