• Rationale and Comments

    Mild in-toeing is usually a physiologic phenomenon reflecting ongoing maturation of the skeleton. Metatarsus adductus, femoral anteversion, and tibial torsion all contribute to in-toeing and tend to improve with growth. Simply monitoring gait for continued improvement at normal well child examination intervals is adequate until the age of seven or eight unless there is severe tripping and falling or asymmetry. It is not possible to alter the natural evolution using physical therapy, bracing or shoe inserts.

    Sponsoring Organizations

    • American Academy of Pediatrics – Section on Orthopaedics and the Pediatric Orthopaedic Society of North America


    • Prospective cohort studies


    • Orthopedic
    • Pediatric


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