A child's musculoskeletal system is constantly changing. Flat feet, legs that are slightly bowed outward or inward, and feet turning in or out while walking are often part of normal development and improve with growth.
However, not all changes are harmless. Pain, clear asymmetry, loss of previously acquired abilities, or a sudden change in gait are reasons to have the child examined.
Legs bowed outward or inward
Mild bowing of the legs outward is common in infants, while inward positioning of the knees is often seen in the preschool years. In most cases, the alignment changes spontaneously as the child grows.
An examination is needed if the change is pronounced on only one side, is getting worse, causes pain or limping, lasts longer than expected for the child's age, or is associated with short stature and other health problems.
Flat feet
Young children naturally have a less visible arch because of the fat pad and developing muscles. Flexible flat feet without pain usually do not require treatment and do not prevent a child from playing sports.
Pain, stiffness in the feet, frequent injuries, difficulty walking, or a difference between the feet require professional assessment. Orthotics can relieve symptoms in selected patients, but not every child with flat feet needs them.
Walking with the toes turned in or out
The position of the feet while walking may result from the shape of the foot or rotation of the lower or upper leg. It most often improves spontaneously with growth. Special shoes, braces, and exercises are not needed for most developmental variations unless an orthopedist determines otherwise.
Walking on the toes
Occasional toe walking can occur while a child is learning to walk. If it is constant, continues beyond early childhood, occurs only on one side, or is associated with tightness, weakness, or developmental difficulties, an examination is needed.
When should you see an orthopedist?
During the examination, the child's posture, gait, range of motion, strength, and development are assessed. Additional tests such as ultrasound or X-rays are performed only when they are needed based on the findings.
- the child has persistent pain or pain that wakes them at night
- the child limps, refuses to bear weight on the leg, or stops taking part in play
- a joint is swollen, red, or severely restricted in movement
- there is a clear difference between the left and right sides
- the deformity is progressing or appeared after an injury
- a parent notices the loss of previously acquired motor skills
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