Children’s Foot, Leg & Hip Development:

What Parents Should Know

Foot Development

Children’s feet are not miniature adults’—they have more bones and joints, making them flexible, and as they mature these structures harden and become more rigid, giving us valuable time to guide healthy development.

• Flat feet are normal in young children and usually improve as arches form.

• Many children in‑toe or out‑toe when learning to walk — most grow out of it.

• Any foot pain, limping, or frequent tripping is not normal and should be checked.

A podiatrist is the right person to check for any abnormalities in your child’s feet or gait.

Leg Alignment by Age

• 0–2 years: Bow‑legs are common and usually correct naturally.

• 3–4 years: Knock‑knees are normal at this age.

• 5–7 years: Legs gradually straighten.

• 7–11 years: Adult‑like alignment develops.

Seek assessment if alignment is painful, worsening, or very uneven between legs.

Hip Development

• Babies are born with soft, shallow hip sockets that strengthen as they grow.

• Natural inward rotation of the thigh bone (femoral anteversion) is common in early childhood and often causes in‑toeing.

• Most hip rotation differences improve by age 8–10.

Hip Conditions to Watch

• Developmental Dysplasia of the Hip (DDH):
  May show as uneven leg creases, limited hip movement, or a leg length difference.

• Persistent in‑toeing or out‑toeing:
  Can affect balance and gait if it does not improve with age.

When to Seek Podiatry Advice

• Frequent tripping or falling

• Pain in the feet, legs, hips, or knees

• Limping or avoiding activity

• Toe‑walking after age 3

• Uneven shoe wear

• One leg turning in or out more than the other

A podiatrist can assess any concerns, and it’s important for them to know your child’s birth history, maternity and delivery details, as well as their sitting and sleeping habits, because these factors can influence hip, leg and foot development.

Supporting Healthy Development

• Choose lightweight, supportive shoes that fit well.

• Encourage barefoot play indoors to build strength.

• Promote active play: climbing, hopping, balancing, and running.

• Avoid long periods of “W‑sitting” as it stresses hips and knees.