In 95 percent of children, in-toeing corrects itself by the time the child is 10 years old. Because of this, children with symptoms are observed — usually by their pediatricians — until they are around 10 years old. This allows normal development to take its course, while looking out for potential problems. If significant in-toeing or out-toeing persists, you may want to consult an orthopedic surgeon.

Significant torsion is characterized by the following:

• Functional Problems — In severe cases, the rotation of the lower limbs is so extreme that the child has difficulty running, playing and participating in normal childhood activities. Out-toeing is more likely to present functional problems than in-toeing. In fact, in-toeing may be a functional advantage as athletes tend to be in-toed more often than others.
• Unacceptable Appearance — Your child may regard severe in-toeing or out-toeing as ugly, which may have negative effects on his or her body image and self-esteem. While it may be more acceptable to address a medical problem for functional reasons, appearance can’t be ignored and needs to be factored into treatment decisions as well.