An in-toeing gait pattern occurs when a child walks or runs with feet pointing toward each other, rather than with feet pointed forward. This can happen as a result of the rotational alignment of the hip, knee, or foot. Sometimes the strength, mobility, and coordination of the hip musculature can promote a more inward rotation of the foot, and contribute to an in-toing gait. Bony alignment can correct as some children get older, but many kiddos need a little extra help in the meantime if their in-toing is causing them to fall more often than other children their age, or causing them to have trouble keeping up with their peers.   

How can physical therapy help? 

Your physical therapist can help to address any strength, mobility, and coordination deficits that may be contributing to, or resulting from, your child’s gait pattern. Depending on the cause of your child’s in-toing (is it coming from the hip, knee, or foot?), your physical therapist can provide suggestions for optimizing your child’s gait pattern and gross motor development. 

Good exercises to try, if your child is in-toeing:

• Walking sideways
• Frog hops (with hands on the floor between feet and toes turned out!)
• Step ups (on stairs/boxes; forward and sideways!)
• Penguin walks (walk on the heels with toes in the air and feet turned outward)
• Kicking a ball with the instep of their foot
• Balancing on one foot
• Crab walking 
• Ring sitting or criss-cross sitting 
• Squatting (especially sumo squatting with feet pointed out!) 

Your physical therapist can help to make these activities more fun, and provide you with additional suggestions tailored to the specific needs of your child. If your child is walking with their toes pointed toward each other, consider discussing the need for a physical therapy referral with your pediatrician!