Tiptoes, Flat Feet and Funny Steps: Understanding Toddler Foot Development

Once children get past those wobbly first steps, they often develop some quirky walking patterns to get themselves around. They may look funny to you or me — but how can you tell what’s part of normal development and when it’s something to keep an eye on?

Over time the human foot continues to grow and develop well beyond those early steps. It strengthens, adapts, and the bones gradually mature. So naturally, a child’s walking pattern changes over time too. In those first few months of walking, toddlers can move in all sorts of different ways. It often takes around 6 months of being on their feet before they settle into a walking pattern that suits them — after all, walking isn’t as easy as it looks!

Flat Feet and Arches

As your little one becomes more mobile, you may start to notice their foot shape more clearly. One of the biggest concerns parents have is whether their child has flat feet.

All babies are born with flat feet- and this is completely normal. It’s what we expect as their feet are growing, and they have a bit more fatty tissue. That inner arch we see in adults usually begins forming around age 3. A quick way to check? Ask them to stand on tiptoes—if you see an arch, it's there!

Around 90% of children develop arches naturally by age 6. In some cases, flat feet may persist and could be linked to hypermobility or cause discomfort. If your child complains of foot pain or seems to tire quickly, it’s worth checking in with a healthcare professional.

On the other end of the spectrum, some children may have very high arches — a condition known as pes cavus. If your child is walking on feet that appear unusually arched, especially if it causes discomfort or affects the way they walk, it’s a good idea to seek professional advice.

pes planus (flat feet)

pes cavus

Intoeing

A common pattern we see as paediatric physiotherapist’s is intoeing- where a child walks with their feet turned inward. It’s especially common in children aged 4–6 and tends to occur more in girls.

There are a few possible causes:

• Femoral anteversion: The thigh bone (femur) is rotated inwards.

• Tibial torsion: The shin bone (tibia) is twisted inward.

• Metatarsus adductus: The front part of the foot turns inward.

Most of the time, intoeing resolves on its own as children grow, usually by around age 8–10. No special shoes or braces are needed—just time and reassurance. Paediatric Physiotherapists can check what may be causing the intoeing as well as provide guidance to support natural improvement over time.

Outtoeing

Less common than intoeing, outtoeing is when a child walks with their feet pointing outward. It’s sometimes more noticeable in children who are overweight or who have flat feet. Many toddlers initially out toe to widen their base of support and feel more stable while learning to walk.

Like intoeing, outtoeing can also be caused by the rotation of bones like the femur and tibia rotating outwards.

If outtoeing has always been present, it usually improves on its own by age 4. However, if it suddenly appears, especially if it’s only on one side, it’s important to seek medical advice promptly. Sudden asymmetrical outtoeing may indicate an issue at the hip that needs checking.

Toe walking is something that often causes concern and that’s understandable, but it can be a part of normal development. Many toddlers experiment with walking on their toes rather than using their full foot after learning how to walk. After around a year of walking children then develop the heel toe gait that we carry on with as adults.

If your child is under 2, occasional toe walking is usually nothing to worry about. However, if it continues beyond age 2, happens only on one side, and they rarely walk on flat feet it’s worth having them assessed.

Persistent toe walking can sometimes indicate an underlying issue for children, so it’s worth having an assessment. Over time, habitual toe walking may lead to other secondary problems— it’s worth keeping an eye on.

Final thoughts

Every toddler walks in their own unique way — and many unusual walking patterns are part of typical development! If you're unsure or something doesn’t seem quite right, a paediatric physiotherapist can help reassure you and guide the next steps for you and your child.