Variations in the position and shape of the feet and legs during childhood
- Sometimes runs in families
- Age and lifestyle risk factors depend on the type
- Gender is not a significant factor
When a young child stands and walks, the position of the legs or feet may look odd or awkward. Different minor foot problems are common at different ages. However, these problems rarely interfere with walking or require treatment. Specific minor problems with the legs and feet can run in families, suggesting that a genetic factor may be involved.
What are the types?
Minor leg and foot problems include in-toeing and out-toeing, bow legs and knock-knees, and flat feet.
In-toeing and out-toeing
The condition known as in-toeing, in which the feet point inwards, is common, particularly in infancy and early childhood. Out-toeing, in which the feet point away from each other, is less common but may occur from 6 months.
Bow legs and knock-knees
If both tibias (shinbones) curve outwards, a child’s knees cannot touch when he or she stands with the feet together. This condition, known as bow legs, is common in children up to 3 years. Severe bowing is uncommon but may be caused by a deficiency of vitamin D (see Osteomalacia and rickets). In knock-knees, the child’s legs curve in at the knees, so that the feet are wide apart even when the knees are touching. Knock-knees is common in children between the ages of 3 and 7 years.
Most children have flat feet until the arch develops between 2 and 3 years of age. Children also have a pad of fat beneath the foot that accentuates the flat-footed appearance. However, some children have persistent flat feet.
What might be done?
Your child’s legs and feet will be examined regularly during routine medical checkups. However, you should consult your doctor if you are worried by the appearance of your child’s legs or feet or if your child has difficulty in walking, has a limp, or complains of pain.
Most children with minor leg and foot problems do not need treatment because walking is rarely affected and the problems disappear as a child grows up. Out-toeing disappears first, usually within a year of a child starting to walk. Bow legs usually disappears by the age of 2–3 years; in-toeing by the age of 7–8; and knock-knees by the age of about 6. Persistent flat feet do not often need treatment unless they cause pain.
Your doctor may recommend physiotherapy if your child experiences difficulty in walking or the shape of his or her legs is abnormal. Rarely, if your child’s legs or feet are seriously affected, he or she may need to have orthopaedic surgery to correct the problem.
From the 2010 revision of the Complete Home Medical Guide © Dorling Kindersley Limited.
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