During the early years, there can be some obvious abnormalities in children’s gait (walking style). While many of these walking issues are quite common and can correct themselves on their own, some require physiotherapy assessment and treatment.
In-toeing or ‘pigeon-toed’ walking
In-toeing is a common condition where a child’s toes point inwards when standing, walking or running.
It is commonly caused by inward rotation of the:
– The front half of the foot (forefoot) or ‘metatarsus adductus’ in the first year of life
– Shinbone (tibia) or ‘tibial torsion’ in toddlers
– Thighbone (femur) or ‘femoral anteversion’ in early childhood
Common associated signs and symptoms include:
– Inward turning of hip, leg or forefoot
– Knee caps face inwards (kiss or squint) or the child is knock-kneed
– Increased frequency of sitting in ‘W position’
– Increased flexibility or hypermobility
– Reduced or low muscle tone
– Walking can be described as clumsy or awkward
– Increased incidence of tripping or falling
– In-toeing is worse when the child is fatigued
Out toeing or ‘duck feet’ walking
Out-toeing is less common than in-toeing and is where a child’s toes point outwards when standing, walking or running. It is caused by outward rotation of the hip, knee or foot.
Common associated signs and symptoms include:
– Outward turning of hip, leg or foot
– Reduced hip mobility
– Knee caps face or turn outwards
– Reduced or low muscle tone
– Walking can be described as clumsy or awkward
– Flat foot posture (common in early childhood as foot arches are beginning to develop).
Physiotherapy treatment for in-toeing and out-toeing:
– Assess cause for in-toeing or out-toeing (hip, knee or foot positions, screen for other conditions)
– Provide core, pelvic and hip stability exercises
– Provide taping to increase hip stability and joint awareness
– Education on active stretching exercises
– Walking/gait retraining and education
– Advice on footwear and referral to a podiatrist for customised orthotics if required
– Monitoring and onward referral to a medical practitioner as indicated
Children who have in-toeing/out-toeing that exceeds normal age limits is asymmetrical or progressively worsening should be assessed by a physiotherapist and referred onwards as required.
Bow-legs
Bow-legs are a condition where a child stands with their feet and ankles together but their knees stay apart. It is common in children aged 0-3 years and generally resolves as the child develops. Children over three years of age who continue to have severe or asymmetrical bow legs, walk with pain or a limp or have a leg length difference should be first assessed by a physiotherapist and referred onwards if required.
Knocked knees
Knocked knees are a condition where a child stands with their knees together or touching but their ankles remain apart. This usually becomes apparent when a child is 3-5 years of age and generally resolves as the child develops.
Knocked knees are common in children with hypermobility disorders or low muscle tone. Children over eight years of age who continue to have severe or asymmetrical knocked knees, walk with pain or a limp or have a limb length difference should first be assessed by a physiotherapist and referred onwards if required.
To get a full assessment by one our Physiotherapists for your child’s walking issues, please call (08) 6389 2947 or click here to make an appointment online.
Bow-legs
Bow-legs are a condition where a child stands with their feet and ankles together but their knees stay apart. It is common in children aged 0-3 years and generally resolves as the child develops. Children over three years of age who continue to have severe or asymmetrical bow legs, walk with pain or a limp or have a leg length difference should be first assessed by a physiotherapist and referred onwards if required.
Knocked knees
Knocked knees are a condition where a child stands with their knees together or touching but their ankles remain apart. This usually becomes apparent when a child is 3-5 years of age and generally resolves as the child develops.
Knocked knees are common in children with hypermobility disorders or low muscle tone. Children over eight years of age who continue to have severe or asymmetrical knocked knees, walk with pain or a limp or have a limb length difference should first be assessed by a physiotherapist and referred onwards if required.
To get a full assessment for your child’s walking issues, please call (08) 6389 2947 or click here to make an appointment online.
