Between the ages of 9 to 12 months most babies start taking their first steps, and are walking well by the time they're 14 or 15 months old. For some it may take a little longer until they are 16-17 months old.
Once they start taking their first steps it is important to buy them some comfortable, foot-shaped and well fitted, flat and flexible shoes. Children also benefit from spending some time barefoot.
In the early stages of walking it is normal for children to waddle and walk with their feet apart. They may often also appear bow-legged, knock-kneed or flat-footed, they may walk tiptoe or with their toes turned in or out. These are all variations of normal, which naturally resolve with time. For this reason, it is extremely rare for a child to need any intervention to correct their foot or leg posture.
Legs and Knees
- A child has bow legs if, when they are standing with their feet together, their knees do not touch. This is very common in children as they start to walk.
- Before the age of two most children have this small gap between their knees when they stand. If the gap is pronounced or doesn't correct itself, please read more about this on NHS choices and speak to your GP or health visitor. This may be a sign of rickets (a rare bone deformity caused by a lack of vitamin D in most cases).
- Many children start bow legged, then go through a knock kneed stage before their adult leg shape is established around the age of 8.
- A child has knock knees if, when they are standing with their knees together, their ankles do not touch. This is more common in children aged 2-4 years.
- If you lie a child on their back, with their knees together, it is normal to have a gap of up to 10cm between their ankle bones.
- Knock knees usually correct themselves by the age of six. Please see NHS Choices and the leaflet below for more information.
- A child in-toes (sometimes called pigeon toes) if, when they stand or walk, their feet point inwards. Intoeing is frequently found in children aged 1 to 8 years.
- A child out-toes if, when they stand or walk, their feet point outwards.
- Out-toeing is less common than in-toeing, but is still seen, especially in children born prematurely.
- If your child appears to have flat feet, don't worry. If an arch forms when your child stands on tiptoe, and feet are flexible and not painful, no treatment is necessary.
- If your child mostly walks on tiptoe - please see your health visitor.
If you are concerned about variations in leg posture
If you are a parent concerned about any of these conditions, please read the leaflet below for more detailed explanation about these normal variations. If you remain concerned please speak with your health visitor or GP. If your child falls outside of normal expectations they may be referred to a physiotherapist. If your child is referred to a physiotherapist, you will be either be seen in outpatients at Southmead hospital or placed on a waiting list for assessment in a community clinic, please be aware it may take up to 18 weeks to see a physiotherapist. At this appointment your child will be assessed and you will be provided with advice and taught how to improve the condition. If orthotics is required you will be referred for these. Depending on the severity, your child may be not need to see a physiotherapist again, or it will be reviewed in 3-6 months’ time.
Please use the relevant links on the right hand side to explore other CCHP services that may be involved:
- Health Visitor
- Occupational Therapy
For more information about a condition, please visit NHS Choices.