In-Toeing in Children

In-toeing is when a child walks with their feet turning inwards and is commonly referred to as 'pigeon toed'. It is a variation of normal and is part of normal development for many toddlers when just learning to walk. It will usually resolve as the child grows and the musculo-skeletal system matures, normally by the age of ten years. During this period of in-toeing the child may tend to trip and fall a little more than their peer group. Hip rotation is most reliably assessed in the prone position.


  • Insoles are not recommended.
  • Physiotherapy referral and exercises are of no benefit


Consider referral for orthopaedic opinion if:-

  • asymmetric, leg length discrepancy or hip abduction reduced

Referral Instructions

e-Referral Service Selection

  • Specialty: Children's and Adolescent Services
  • Clinic Type: Orthopaedics
  • Service: DRSS-Western-Child&Adolescent -Devon CCG-15N

Referral Forms

DRSS Referral Proforma

Supporting Information

Pathway Group

This guideline has been signed off by the Western Locality on behalf of NEW Devon CCG.

Publication date: May 2017


Home > Referral > Western locality > Children & Adolescents > In-Toeing in Children


  • First line
  • Second line
  • Specialist
  • Hospital