Last reviewed: September 29, 2026

Usually yes. In most children, in-toeing slowly straightens on its own as they grow.

The cause depends on age. In babies, it is usually a foot that curves inward (metatarsus adductus), which often improves in the first year. In toddlers, it is usually an inward twist of the shinbone (internal tibial torsion). This usually straightens by ages 3 to 4. In school-age children, it is usually an inward twist of the thighbone (femoral anteversion). This usually straightens by about age 8, though it can take longer.

Special shoes, braces, night bars, insoles and exercises have not been shown to change the outcome. W-sitting does not cause in-toeing and does not need to be stopped. A baby’s foot that is stiff and stays curved is sometimes treated with casts, which work best when started early.

Some inward twist of the thighbone is common, especially in girls. One study of normal hips found that women had more of it than men. In most people it causes no problems and needs no treatment. When the twist is extreme, studies have linked it with kneecap problems, including a kneecap that slips out of place, and with some hip problems. These studies looked at people who already had those problems, so they do not show that the twist caused them.

According to the American Academy of Orthopaedic Surgeons, in-toeing on its own does not cause pain or lead to arthritis. In-toeing does not seem to hold children back in sports. One study found that high school sprinters were more likely than other students to have a slightly inward-turned shinbone.

Surgery is rarely needed. For a severe twist of the thighbone (femoral anteversion) or the shinbone (tibial torsion) that causes real problems with walking, surgery is considered in children older than about 8 to 10. In teenagers and adults with an extreme thighbone twist, correcting the twist is sometimes part of surgery for a kneecap that keeps slipping out of place.

In general:

  • See your child’s doctor if the in-toeing is on one side only, is getting worse, or has not improved by school age.
  • Pain, a limp, swelling, stiffness or delays in development also need a doctor’s visit.

Drafted with AI assistance from published sources, reviewed and edited by Babak Sheikh, MD.

Sources:

This is general information about what published research shows. It is not medical advice and it is not about your situation. Reading it does not create a doctor-patient relationship with me. I am a retired orthopedic surgeon and I do not see patients. Talk with your own doctor before changing anything about your care. If something feels suddenly or seriously wrong, get medical care promptly rather than waiting.

This page is provided as is. I make no guarantee that it is accurate, complete or current, and medical evidence changes. Use of it is at your own risk.

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