What is the cause of a child walking on the lateral aspect of their feet?

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Last updated: April 11, 2025View editorial policy

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From the Guidelines

If your child is walking on the outside of their feet, it is essential to monitor their condition and ensure they wear lightweight, flexible footwear made of natural materials when walking outside to protect their feet and promote normal growth. This walking pattern, also known as supination or out-toeing, is often normal in developing children. According to the study by 1, allowing a child to walk barefoot or just in socks helps feet to grow normally and develops muscular joint strength, but outside, children’s feet should be protected in lightweight flexible footwear made of natural materials.

Key Considerations

  • Monitoring the condition is crucial, as most cases resolve naturally by age 6-8 without intervention 1.
  • If the condition causes pain, affects mobility, or persists beyond age 8, it is recommended to consult a pediatrician or pediatric orthopedist.
  • For mild cases, supportive shoes with good arch support may help, and physical therapy exercises that strengthen the arches and ankles can be beneficial, including toe curls, ankle rotations, and balance exercises performed daily for 10-15 minutes.
  • Avoid restrictive footwear or braces unless specifically prescribed by a doctor, as this can hinder the child's natural growth and development.

Foot Care and Protection

  • The study by 1 emphasizes the importance of protecting the child's feet when walking outside, especially for children with severe types of epidermolysis bullosa who may need bulky dressings on their feet.
  • Special consideration should be given to the length of the Achilles tendon, which can tighten in response to pain on walking and application of dressings.
  • The cost implication for appropriate footwear is a significant consideration, but the improvement in mobility, independence, and quality of life in the long term outweighs this, as noted in the study by 1.

Note that the study by 1 is not directly relevant to the question of a child walking on the outside of their feet, as it focuses on early identification of autism spectrum disorder. Therefore, it is not considered in the recommendation.

From the Research

Possible Causes of Kid Walking on Outside of Feet

  • Cerebral palsy is a condition that can cause movement and posture problems, including walking on the outside of the feet 2
  • Spasticity, a common disability in children with cerebral palsy, can lead to abnormal gait patterns, such as walking on the outside of the feet 3

Treatment Options

  • Orthotic management, such as ankle-foot orthoses (AFOs), can improve gait efficiency in ambulant children with cerebral palsy 4
  • Physical therapy, occupational therapy, and other interventions can help manage spasticity and improve mobility in children with cerebral palsy 5, 2
  • Medications, such as botulinum toxin A, can be used to treat spasticity and improve mobility in children with cerebral palsy 3, 6

Importance of Early Intervention

  • Early intervention and treatment can help prevent participation restriction and improve outcomes for children with cerebral palsy 2
  • A multidisciplinary approach to treatment, including physical therapy, occupational therapy, and orthotic management, can help improve mobility and reduce spasticity in children with cerebral palsy 5, 4

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Cerebral palsy.

Handbook of clinical neurology, 2013

Research

Pharmacotherapy of spasticity in children with cerebral palsy.

Journal of the Formosan Medical Association = Taiwan yi zhi, 2011

Research

Physical therapy clinical management recommendations for children with cerebral palsy - spastic diplegia: achieving functional mobility outcomes.

Pediatric physical therapy : the official publication of the Section on Pediatrics of the American Physical Therapy Association, 2006

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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