Foot & Ankle Problems in Children

Most babies start to walk on their own from 10-18 months old, but what if your baby is still crawling then? Should you be concerned about delayed walking and other baby leg and foot problems?

All children’s first steps are awkward and look more like lurching than walking. As their leg muscles grow strong from crawling, babies begin pulling themselves up to standing and start “cruising”. They walk along the edge of a couch or table, using furniture or your outstretched hands for support.

There is a wide variation from one baby to another in learning to walk. One happy baby may not walk until three or four months after another. That does not necessarily signal a foot or leg problem or delayed walking. Both children will probably be equally healthy and able to run and play as they get older.


Bow legs are a common concern of new parents, who may not realise that nearly every baby has bow legs at birth. This outward curve of the leg bones usually resolves itself by the age of two. Bow legs do not cause delayed walking or affect your baby’s ability to learn to walk. Toddlers usually sway from side to side rather than move forward, at first, making their bow legs look even more exaggerated.
In a few rare cases, when bow legs do not resolve naturally by age two, your baby’s knees may be turned outward by the curve of the leg bones. This can cause knee problems. If bow legs persist beyond age two, seek medical advice.

Rarely, bow legs are a sign of rickets. This is a condition caused by lack of vitamin D and calcium in your baby’s diet and inhibits bone growth.
If bow legs suddenly appear in your baby when they are around two years old, seek medical advice. This may be a sign of a relatively rare condition called Blount’s disease, which causes abnormal bone growth in the tibia, or lower leg bone.


Many babies have a slight intoeing, also called pigeon toes, when they are born. This usually disappears during their toddler years.
Pigeon toes are often caused by a condition called metatarsus adductus. This is a curve in the whole foot itself, usually created by the baby’s position in the womb before birth. You can see metatarsus adductus when you look at the soles of your baby’s feet. They will curve toward each other like two half-moons.
Doctors disagree about whether to put foot braces on a child with severe pigeon toes. Some doctors advise bracing or casting if the feet are still severely curved when a child is four to six months old. The brace or cast is usually removed when a baby starts to walk. Other doctors do not feel that bracing helps pigeon toes or speeds up the development of the feet and legs toward a more true alignment.
If your baby’s knees point straight ahead with intoeing, your baby may have internal tibial torsion. This condition is caused by an inward turning of the tibia (lower leg bone). It usually resolves itself as a baby learns to walk. If it doesn’t, seek medical advice about possible treatment. If your baby’s knees point inward with intoeing, your baby may have a condition called excess femoral anteversion. This condition is caused by an inward turning of the whole femur (upper leg bone). Again, it usually resolves itself as a baby learns to walk. If it does not, seek medical advice about possible treatment.

pigeons-toes‘Pigeon’ Toes

Toe walking

It is common for most babies as they take their first steps. Walking on tiptoes should disappear by the time a child is three years old. Many babies practise walking on tiptoe when they are first learning to walk. Only later, after six to twelve months or so of practise, will they learn to walk with a mature gait, walking heel-to-toe.
Usually, walking on tiptoes is not a problem. If toe walking persists beyond the age of two, or is done constantly, seek medical advice. Persistent toe walking, or toe walking on only one foot, can be a sign of a central nervous system problem such as cerebral palsy or undiagnosed spina bifida.

Flatfoot Deformity


Just about every baby has flat feet at birth. It takes time for the foot’s natural arch to develop. Flat feet rarely cause any problem with walking and usually disappear by the age of two or three. Extremely flat feet can make your baby’s ankles appear to bend inward as he or she walks. This happens if the arches do not fully develop to realign the foot and ankle. Treatment is rarely needed except in the most severe cases, and is not generally considered until a child grows past the early infant years. This condition can sometimes run in families.