Children’s Gait & Posture Concerns

Many parents notice that their child’s legs, feet, or walking pattern look different from other children’s. Concerns such as knock knees, bow legs, flat feet, in-toeing, and toe walking are extremely common, and many are a normal part of growing up. Our paediatric physiotherapists carefully assess whether a pattern is typical for your child’s age or needs treatment, and provide targeted exercise programs where helpful.

Common Concerns We Assess

Knock Knees (Genu Valgum)

• Knees angle inward and may touch while the ankles stay apart
• Very common between ages 2 and 6
• Usually a normal stage that improves with growth
• Assessed if severe, one-sided, painful, or persisting

Bow Legs (Genu Varum)

• Legs curve outward so the knees stay apart
• Common in toddlers and often corrects naturally by age 2-3
• Reviewed if severe, worsening, or only on one side

Flat Feet (Pes Planus)

• Arches appear flat when standing
• Normal in young children, whose arches develop over time
• Most flexible flat feet need no treatment
• Assessed if there is pain, fatigue, or difficulty with activity

In-Toeing and Out-Toeing

• Feet point inward (“pigeon-toed”) or outward when walking
• Usually due to natural rotation of the hips, legs, or feet
• Most cases improve as the child grows

Toe Walking

• Walking on the toes rather than heel-to-toe
• Common and often habitual in early walkers
• Assessed for calf tightness or underlying causes if it persists past age 2-3

When to Seek Assessment

We recommend an assessment if you notice:

• Pain, frequent tripping, or fatigue with activity
• A pattern affecting only one side of the body
• A concern that is getting worse rather than better
• Difficulty keeping up with peers or avoiding physical play
• Toe walking, in-toeing, or knock knees persisting beyond the typical age
• Any worry about your child’s development or comfort

Assessment

Our physiotherapists complete a thorough, child-friendly evaluation:

• Gait analysis: Observing how your child walks and runs
• Alignment check: Hips, knees, and feet in standing and movement
• Flexibility and strength testing: Identifying tightness or weakness
• Foot posture assessment: Arch height and foot mechanics
• Developmental review: Confirming overall motor development
• Reassurance or action plan: Clarifying what is normal and what benefits from treatment

Physiotherapy Treatment

Where treatment is helpful, we use:

Targeted Exercise

• Strengthening for the hips, legs, and feet
• Stretching for tight muscles (e.g. calves in toe walkers)
• Balance and coordination activities through play

Movement Retraining

• Practising heel-to-toe walking patterns
• Improving foot and leg alignment during activity
• Building confidence in running, jumping, and sport

Footwear and Orthotics Advice

• Guidance on supportive, appropriate footwear
• Referral or advice on orthotics when genuinely indicated

Family Education

• Clear explanation of what is normal for your child’s age
• Simple home activities to support healthy development
• A plan for monitoring growth and progress

Expected Outcomes

Most childhood gait and posture variations:

• Resolve naturally with growth and reassurance
• Improve with targeted exercise when treatment is needed
• Allow children to walk, run, and play comfortably

Our priority is to identify the small number of children who benefit from treatment, while reassuring families when a pattern is simply a normal part of development.