The opposite of pigeon toed, or in-toeing, is called out-toeing. Both in-toeing and out-toeing occur in infants and children and is usually a normal variant. Out-toeing is uncommon and occurs far less frequently than pigeon-toe. If out-toeing occurs when a child first begins to walk, it normally dissipates within a year.
Causes of Out-toeing
Flat feet, a condition that causes the arch of the food to be underdeveloped, can cause out-toeing. External tibial torsion, a condition in which the bones in one or both legs twist outward, can also cause out-toeing. External tibial torsion usually develops in late childhood or early adolescence, and can cause pain in addition to out-toeing. Hip contracture, a condition that causes babies to be born with hips facing outwards, can also contribute to out-toeing in early childhood.
Out-toeing in Babies
It’s normal for babies to exhibit out-toeing when they begin to walk for the first time. Because their muscles are in the early stages of development, abnormal gaits are common in young children. Parents concerned about out-toeing in their baby can monitor the condition by comparing videos of the child walking every six months to a year to the child’s current gait.
Long Term Effects
Most cases of out-toeing resolve on their own as children grow. Leg and hip bones that were originally turned outward tend to slowly shift to a normal position as a child gains practice walking. As leg muscles strengthen with age, children are able to walk without out-toeing more easily. In some cases, however, out-toeing can persist into adulthood. If left untreated for a long period of time, adult out-toeing can cause lower back and leg pain, ankle injury, and muscle and joint strain.
Those who are unsure whether their gait suffers from out-toeing are encouraged to pay close attention to the position of their feet when they are at rest. If their feet regularly point out to either side instead of straight ahead when they are standing still or sitting down they may suffer from out-toeing.
Treatments for out-toeing in the past included specially fitted shoes and leg braces. However, these methods were proven to be ineffective and are no longer used. Treatments for out-toeing today include orthotic inserts, stretches that are specifically designed for gait correction, and massage to relieve muscle soreness and discomfort. More severe out-toeing may require a consultation with a doctor, physical therapy, and surgery to rotate leg and hip muscles.