Should You Worry If Your Child Walks With Their Feet Turned Out?

What is out-toeing in children?

Out-toeing is when a child's foot, or both feet, point outwards instead of straight ahead during walking or standing. You might hear it described as "duck walking." It is a rotational variation, meaning the bones of the leg are turned slightly outward compared to what you might expect.

The foot progression angle describes the direction each foot points relative to the direction of travel. A small outward angle is considered normal. A larger angle, especially if it is very noticeable or only on one side, is what parents tend to notice and ask about.

Out-toeing is distinct from in-toeing, where the feet point inwards ("pigeon-toed"). Both are rotational variations and both are common in childhood. The direction of the rotation and its cause differ, but the reassurance is often similar: most children outgrow it.

How can you tell if your child has out-toeing?

You can usually spot out-toeing by watching your child walk on a flat surface. Look at their feet from behind as they move away from you. If one or both feet clearly point outwards rather than straight ahead, that is out-toeing.

What causes a child's feet to turn outwards?

Out-toeing usually comes from the way the bones of the hip, thigh, or shin are shaped or rotated. These are normal variations in how a child's skeleton develops. The three most common causes are listed below.

Less commonly, out-toeing can be linked to tight or lax ligaments, neurological conditions, or problems within the foot itself. These are uncommon, but a specialist can rule them out if there is any concern.

When does out-toeing resolve on its own?

For most children, out-toeing improves gradually as they grow. The timeline depends on the cause.

• Hip rotation tightness from the womb typically loosens during the first two years of life. This is the most common cause in babies and young toddlers.
• External tibial torsion often corrects or improves through childhood. The shinbone naturally adjusts its twist as the child grows and becomes more active.
• Femoral retroversion tends to be more stable. It may improve partially with growth but can persist into the teenage years or adulthood in some people.

Watchful waiting is the standard approach for the vast majority of children. There are no special shoes, braces, or exercises proven to speed up the process. The body simply grows into better alignment in most cases.

When should you see a specialist about out-toeing?

Most out-toeing is harmless and does not need medical attention. However, there are situations where it is worth speaking to a GP or paediatric specialist.

If your child develops sudden leg weakness, numbness, or is unable to bear weight, seek urgent medical attention through your GP, 111, or A&E. These are not typical of out-toeing and need prompt assessment.

How is out-toeing assessed with standing imaging?

If a specialist wants to understand the structure behind your child's out-toeing, imaging can help. A standard X-ray taken lying down does not show how the leg is aligned under the child's own body weight. When muscles relax in a lying position, rotational differences can be masked.

An EOS scan captures the full leg from hip to foot while the child is standing naturally. This shows the true alignment of the bones, including any rotation at the hip, thigh, or shin, in a position that matches how the child actually walks. It uses about 90% less radiation than a standard X-ray, around ten times less, which matters for growing children.

At ScanAlign, low dose standing imaging, full-length standing views give specialists a clear picture of how the whole chain, from hip to foot, lines up. This is particularly helpful when out-toeing affects only one side, or when a child has pain alongside the rotation. Learn more about paediatric imaging at ScanAlign.

Frequently asked questions about out-toeing in children