Dr. Abbie Clinics

Out Toe

Out-toeing in children, where the feet point outwards when walking. Assessed the same way as in-toeing.

  • Assessed as they grow
  • Children seen at every clinic
  • About 45 minutes
  • Nine NSW clinics

Trusted by patients from Sydney to Narrabri

Podiatry NSW/ACT American Academy of Podiatric Sports Medicine (AAPSM) Sports Medicine Australia AHPRA — Australian Health Practitioner Regulation Agency
What you notice

Symptomsand causes

If this sounds like your pain, there is a structural reason for it. The assessment is what finds it.

Common symptoms

  • Feet that turn outwards when walking or running
  • A waddling appearance to the walk
  • Tiring quickly compared with other children
  • Uneven wear on the outside of the shoes

What causes it

Like in-toeing, out-toeing can originate at the foot, the shin or the hip. Some is expected at particular ages and resolves with growth. What matters is whether it is within the expected range for your child and whether it is causing symptoms.

A young child standing barefoot, showing foot position
A young child standing barefoot, showing foot position
In detail

Understandingout toe

Out-toeing often comes from the shin bone being twisted outwards, called external tibial torsion. Like pigeon toe, it is often inherited.

A dancer on pointe, where turnout should come from the hip

The measurements behind it

13–18° from age 6

Shin angle

Some outward turn is healthy. Well beyond that range, the foot points out from the knee down.

45° each way

Hip rotation

Tight groin and hip-flexor muscles show the body is compensating for an outward-turned shin.

0–4°

Heel position

Checked alongside the shin, because the two affect each other.

Turnout from the hip, not the foot

In dancers, forcing turnout from the knee or foot, rather than the hip, can lead to knee, groin, lower back and stomach pain over time.

A link to Osgood-Schlatter

An outward-turned shin compensated by tight groin muscles twists the knee. That adds to the pull on the growing area below the kneecap in active teenagers.

What a plan can include

Stretches, in-toe gait-plate orthotics to guide an outward-turned shin, and re-measuring every few months. See children’s podiatry.

How we diagnose it

The cause,not the sore spot

Out Toe is diagnosed with the Najjarine Biomechanical Assessment, so treatment is prescribed against a finding rather than a symptom.

Dr Abbie Najjarine assessing a patient’s gait on a treadmill
01

Assess

We assess how your child stands, walks and runs against what is expected for their age.

02

Diagnose

We identify which level the rotation is coming from and explain what we found.

03

Treat

Where nothing needs doing we say so and set a review. Where it does, treatment is staged around growth.

Dr Abbie Najjarine demonstrating a lower limb assessment, with alignment marked on the leg and practitioners observing
Start here

Book an assessment

Find out what is actually causing your out toe.

Patient feedback

What patients sayabout out toe

Google 4.9 Based on 286 Google reviews across our clinics
Tanya R. Dr. Abbie Clinics · 3 weeks ago Google

Reassuring and thorough. We knew where we stood by the end of the appointment.

Mark E. Dr. Abbie Clinics · 1 month ago Google

Took the time to show us what they were seeing as our son walked.

Leanne W. Dr. Abbie Clinics · 2 months ago Google

Honest about what did and did not need doing.

Questions

Out Toequestions

Neither is automatically worse. Both are assessed the same way.

It can affect comfort and efficiency. Whether it is worth addressing is what the assessment establishes.

There is no fixed age. If you have noticed it or your child is complaining, that is the time.

Some rotational patterns do. Your podiatrist will ask about family history as part of the assessment.

No. You can book directly.

Treating lower limb pain since 1990

Book yourassessment

Choose your clinic and book straight into its diary, or call and we will point you to the right practitioner.