Will my child grow out of being pigeon-toed?

Most children do — in-toeing from the foot, shin, or hip typically improves on its own over the first several years. Special shoes or braces are rarely needed. Persistent, worsening, one-sided, or painful in-toeing is worth checking.

Does W-sitting cause in-toeing?

Habitual W-sitting is associated with the hip-rotation pattern that can contribute to in-toeing in older preschoolers. Encouraging other sitting positions and, if needed, physical therapy can help.

Do I need a referral for physical therapy?

Yes — physical therapy requires a referral from your child's primary care provider, faxed to 901-589-9001.

physical therapy · Awareness

In-Toeing (Pigeon-Toed): Is It Normal, and When to Get Help?

Written by MTG Physical Therapy Team, Licensed Pediatric Physical Therapists

Physical Therapy

Updated 2026-06-20

Watching your toddler trip over their own feet because their toes point inward can be unnerving, but in-toeing — being “pigeon-toed” — is common in young children and, most of the time, resolves on its own as they grow. Here's how to tell the routine kind from the kind worth a closer look.

What is in-toeing?

In-toeing is when the feet point inward while walking or running. It usually comes from the natural way a young child's feet, shins, or hips are rotated — positions that tend to gradually straighten out over the first several years as the bones mature.

Common causes

Foot curving inward (common in babies, often resolves early).
Inward twist of the shin bone (common in toddlers).
Inward rotation at the hip (more common in older preschoolers, often linked to W-sitting).

When in-toeing is worth checking

It's only on one side, or clearly getting worse rather than better.
It causes frequent tripping, pain, or trouble keeping up.
It's stiff, or you can't move the foot/leg through a normal range.
It persists well into the school years.

Most in-toeing needs reassurance and time, not treatment — special shoes and braces are rarely needed. But have your pediatrician take a look, especially if any of the signs above apply.

Unsure if your child's in-toeing is routine? An evaluation can tell you.

Request an evaluation

How physical therapy helps

When in-toeing causes tripping or is linked to muscle and movement patterns (like habitual W-sitting), physical therapy can help with strengthening, stretching, and better positioning. PT is a new service at MTG and we're accepting referrals (required from your child's primary care provider, faxed to 901-589-9001).

Frequently asked

Will my child grow out of being pigeon-toed?: Most children do — in-toeing from the foot, shin, or hip typically improves on its own over the first several years. Special shoes or braces are rarely needed. Persistent, worsening, one-sided, or painful in-toeing is worth checking.
Does W-sitting cause in-toeing?: Habitual W-sitting is associated with the hip-rotation pattern that can contribute to in-toeing in older preschoolers. Encouraging other sitting positions and, if needed, physical therapy can help.
Do I need a referral for physical therapy?: Yes — physical therapy requires a referral from your child's primary care provider, faxed to 901-589-9001.

Sources

These links point to external organizations for general education and are not a substitute for an evaluation by a qualified professional.

About the author

MTG Physical Therapy Team, Licensed Pediatric Physical Therapists

Our licensed pediatric physical therapists help children build strength, balance, coordination, and the gross-motor milestones that let them move with confidence. Physical therapy is a newer service at Midsouth Therapy Group, and we're accepting new referrals.

Meet the full team →

Learn more about physical therapy at Midsouth Therapy Group.

Questions about how your child walks?

Our pediatric physical therapy team can assess in-toeing and gait and tell you whether support would help. Reach out.

Request an evaluation