 What Is In-Toeing? In-toeing, sometimes called “pigeon-toeing,” is when a child’s feet turn inward while standing, walking, or running. It’s a common concern parents notice in toddlers and preschoolers. In-toeing can arise from different areas of the leg or foot, including the hips, shins, or feet. While many children outgrow in-toeing naturally, persistent inward turning can affect balance, coordination, and walking patterns. Pediatric physical therapy can help identify the cause and support proper alignment, strength, and functional movement. Who Does In-Toeing Affect? In-toeing is fairly common in young children and can affect both boys and girls equally. It often becomes noticeable when children begin walking independently. There are three main types: Metatarsus Adductus: The front of the foot curves inward. Most common in infants and often improves without intervention; Often a positional issue in the womb, leading to a curve in the front of the foot. Tibial Torsion: A twist in the shinbone (tibia) that causes the feet to point inward. Common in toddlers and usually resolves with growth; Frequently develops in toddlers due to natural growth patterns. Children may sit in the “W” position, which can reinforce inward rotation. Femoral Anteversion: An inward rotation of the thigh bone (femur). Often seen in preschoolers and may persist longer than other types; Commonly develops as a child grows, usually peaking around age 3–5.  When to Seek Evaluation Most cases of in-toeing are harmless and improve naturally. However, it’s important to consult a pediatric physical therapist if your child:
How Pediatric Physical Therapy Can Help Pediatric PT can: ● Assess the Cause of In-Toeing Determine whether the inward turning is coming from the feet, shins, or hips. ● Improve Strength and Alignment Strengthening leg, hip, and core muscles supports proper walking and running patterns. ● Enhance Balance and Coordination Activities such as hopping, balancing, and obstacle courses improve motor skills. ● Teach Proper Foot Positioning Exercises encourage the feet to point forward naturally. ● Provide Home Exercise Programs Parents learn fun and safe exercises to reinforce PT goals at home. Examples of PT Activities for In-Toeing ● Balance Games: Walking along lines or curbs, standing on one foot, or hopping through an obstacle course. ● Stretching Exercises: Gentle stretches for the hips, legs, and feet. ● Strengthening Activities: Squats, bridges, or resistance-band exercises designed for children. ● Gait Practice: Encouraging proper foot placement through playful activities like “follow the leader” or running games.  Why Early Evaluation Matters
Early assessment and intervention help: ● Prevent persistent gait abnormalities ● Improve coordination and confidence ● Avoid discomfort or pain in the feet, knees, or hips ● Support age-appropriate motor skill development With timely evaluation and guidance from a pediatric physical therapist, many children with in-toeing achieve improved alignment and movement patterns, often without the need for braces or surgery. If you have concerns about your child’s walking pattern, please call either of our offices or fill out the contact form on our website. Our team is here to provide a personalized evaluation and help your child move confidently! Obstacle courses are a fun and effective way to help kids develop strength, coordination, and confidence. By incorporating different challenges, children can improve their balance, agility, and overall physical fitness while engaging in play. Whether at home, in a classroom, or during therapy sessions, obstacle courses can be customized to suit various skill levels and abilities. Benefits of Obstacle Courses Obstacle courses offer a range of developmental benefits, including:
 Creative Obstacle Course Ideas Here are some engaging obstacle course setups that can be adjusted for different age groups and abilities: Indoor Obstacle Course Ideas
 Tips for a Successful Obstacle Course
Conclusion Obstacle courses are a fantastic way to promote strength, coordination, and active play. Whether indoors or outdoors, structured or freeform, these courses provide a dynamic way for kids to build essential physical skills while having fun. Try setting up an obstacle course today and watch your little ones develop confidence, resilience, and a love for movement! Autism Spectrum Disorder (ASD) is a complex developmental condition that affects how a person communicates, moves, interacts socially, and experiences the world. Because it’s a spectrum, every child with ASD presents differently. Some children may struggle with language and social cues, others may show repetitive behaviors or intense sensory sensitivities. Many also face physical challenges that aren’t always immediately obvious—but this is where pediatric physical therapy can make a real difference. Children with ASD often present with low muscle tone (hypotonia), which can affect their posture, coordination, and overall strength. They may also walk on their toes, have delayed gross motor development, or seem unaware of their surroundings, leading to safety concerns. Physical therapy addresses these concerns head-on through movement-based interventions that build foundational skills for everyday life.
For example, toe walking is a common pattern seen in kids on the spectrum. PTs work to gently improve range of motion and calf flexibility while building strength and motor control to encourage a more typical walking pattern. Similarly, kids with low tone may have trouble with balance, fatigue quickly, or have difficulty sitting upright during school or play. A pediatric PT can implement a program that targets core strength, postural stability, and endurance in fun, engaging ways, often using play-based strategies that feel like games to the child. Motor planning, knowing how to move the body to complete a task, is another area where kids with ASD may struggle. Things like jumping, skipping, or even getting dressed can be difficult. Physical therapists break down these tasks into manageable steps and help children build the confidence and ability to perform them independently. Safety is another major concern, many children on the spectrum have reduced body awareness (also called proprioception), which means they might not realize where their body is in space. This can lead to clumsiness, bumping into things, or even bolting without awareness of danger. Through targeted activities, therapists can help children improve spatial awareness and reaction time, making everyday environments like playgrounds, classrooms, and even parking lots safer and more manageable. Pediatric PT also addresses sensory needs. Some children seek out intense movement to feel grounded, like crashing into furniture or constantly jumping. Others may avoid movement altogether. Physical therapists design sensory-motor activities that help regulate these responses, offering safe and structured ways to meet sensory needs. A child might use swings, obstacle courses, or balance tools to help their nervous system process input more effectively. Beyond the physical, physical therapy sessions often provide a natural setting to support emerging social skills. Whether it’s taking turns on equipment, following directions in a game, or learning how to navigate group activities, PT can help support interactions in a structured, low-pressure environment. Every child with autism is different, and physical therapy is never one-size-fits-all. At Leaps and Bounds, by considering each child’s physical limitations, but also sensory preferences, emotional regulation, and communication style, the goal is always the same: to help each child move, explore, and engage with the world more confidently. Backpacks are an essential part of a child’s daily routine, but carrying a heavy or improperly worn backpack can lead to pain, poor posture, and long-term musculoskeletal issues. As parents and caregivers, ensuring proper backpack use is key to supporting spinal health and overall well-being. The Impact of Heavy Backpacks A backpack that is too heavy or incorrectly worn can cause strain on a child’s neck, shoulders, and back. Over time, this can contribute to:
Choosing the Right Backpack Selecting an appropriate backpack can significantly reduce strain on a child’s body. Consider the following features:
Proper Backpack Wearing Tips Even the best backpack won’t prevent strain if it’s worn incorrectly. Teach children to:
Encouraging Healthy Habits To further prevent backpack-related issues, encourage kids to:
When to Seek Professional Help If a child complains of persistent back, neck, or shoulder pain, it may be time to consult a pediatric physical therapist. They can assess posture, strength, and mobility to address any underlying concerns and provide personalized strategies to prevent discomfort.  Backpack safety plays a crucial role in preventing pain and poor posture in school-age kids. By choosing the right backpack, wearing it properly, and encouraging healthy habits, parents and caregivers can support their child's physical well-being and academic success. If pain persists, seeking professional guidance can make a world of difference in keeping kids active and pain-free. At Leaps and Bounds Pediatric Physical Therapy, we often work with families who are concerned about their child’s walking pattern—particularly when a child walks on their toes instead of using a typical heel-to-toe gait. Toe walking is common in toddlers who are just learning to walk. Between the ages of 10 to 18 months, it's not unusual for children to walk on the balls of their feet as they explore their mobility. Most children naturally grow out of this phase by around age two-three. However, if your child continues to toe walk beyond that age, it could be a sign that further evaluation and support are needed. In this blog, |
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