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Pediatric Orthopedics

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Abnormal Gait in Children

Abnormal gait is a walking style that is irregular or different from the normal walking pattern of a typical child. Most abnormal gait issues resolve on their own and do not require any medical intervention. At or around age 5, children should develop a mature gait; and by age 7, most children display an adult gait when walking.
There are several types of abnormal gait in children to be aware of, which include:

  • Toe walking
    • While toe walking is normal in most young children, it usually resolves by age 3.
  • Bowlegs
    • The toes point forward and the ankles touch but the knees do not. This resolves around the age of 4 or 5 and may be seen as late as 8 years of age in some children.
  • Knock knees
    • The toes point forward and the knees touch but the ankles do not.  Considered a normal stage of growth and development.
  • In-toeing or out-toeing
    • The most common of gait abnormalities where feet are either angled in (in-toeing) or out (out-toeing). These resolve on their own as children age.
  • Metatarsus adductus
    • The shape of the foot is curved, causing it to turn inward and may resemble clubfoot.
  • Femoral anteversion
    • The thighbone (femur) is tilted or turned and causes the foot to turn.
  • Internal tibial torsion
    • The lower leg (tibia) is turned either inward or outward, causing the foot to turn in the same direction.

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Causes of Abnormal Gait

Developmental Hip Dysplasia
Neurological disease (cerebral palsy, spina bifida, Charcot-Marie-Tooth)
Juvenile Idiopathic Arthritis
Autism Spectrum Disorder


In order to properly diagnose an abnormal gait, the physician will need to perform a complete history and physical examination of the child.  The physical exam will include height and weight, spine, leg length, and a test of the range of motion present in the hips, knees and ankles.  A neurological exam may also be done to rule out neuromuscular disorders. 

Imaging & diagnostics

Additional imaging such as X-rays and MRIs may also be conducted in order to properly diagnose and/or rule out other, more serious conditions.

Treatment of Abnormal Gait

Non-operative treatments may be beneficial in correcting certain types of abnormal gaits.  These include:

  • Casts (if condition doesn’t resolve by eight months of age)
Physical therapy to stretch and strengthen the foot muscles

Surgical treatment is also an option if the abnormality is severe and causing pain.  There are risks and complications associated with surgery, which is usually recommended for older patients with a more severe case of gait abnormality.

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If you have any questions, use the online tool below to help us connect with you. To schedule an appointment, please contact our clinic using the information below.

Children' s Memorial Hermann Hospital
6411 Fannin
Houston, TX 77030

Phone: (713) 486-4880
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