Out-toe Walking

Causes and Risk Factors of Out-toe Walking

The causes of out-toeing are often related to structural or positional issues in the legs or hips. Common causes and risk factors include:

• External Tibial Torsion: A twist in the shinbone (tibia) that causes the feet to turn outward. 

• Femoral Retroversion: An outward rotation of the thighbone (femur) that results in outward-pointing feet. 

• Flat Feet: Low or absent arches may cause outward foot positioning to maintain balance.

• Hip Conditions: Conditions such as hip dysplasia can affect the alignment of the legs, leading to the out-toe walking.

• Muscle and Soft Tissue Tightness: Tightness in the muscles or soft tissues especially around the hips and thighs can contribute to outward foot positioning.

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Signs and Symptoms of Out-toe Walking

• Outward-Facing Feet: The feet point outward (toes point away from the body) while walking, running, or standing.

• Gait Irregularities: A noticeable difference in walking style, including a waddling or unsteady gait.

• Frequent Trips and Falls: Out-toeing may affect balance, leading to increased falls.

• Uneven Shoe Wear: Shoes may show more wear on the outer edges.

• Flat Feet: Commonly associated with low or collapsed arches.

Treatment and Management of Out-toe Walking 

• Physical Therapy: Exercises to strengthen and stretch the associated muscles and improve coordination may be recommended.

• Footwear: Ensuring that children wear well-fitted, supportive shoes that allow natural movement.

• Orthotic Devices: Customized insoles or paediatric supramalleolar orthoses can support and assist with the correction of foot positioning, especially if they have flat feet.

• Surgical Intervention: In rare and severe cases, surgery may be considered to correct structural issues in the bones.