Children’s bones change with the different mechanical stresses that occur with their growing bodies – they are not little adults.
These changes are common, and are usually a part of typical growth.
Encourage activity and participation with no restrictions.
General warning signs to look out for
- Asymmetry
- Progressive change
- Impact on everyday function
Red flags for urgent care
- Limping
- New, sudden changes
- Associated systemic changes (e.g. inflammation or illness)
Flat Feet
- Limping
- New, sudden changes
- Associated systemic changes (e.g. inflammation or illness)
Intoeing
Feet point inward when walking.
Typical age/resolution
Common 1-6 years, resolves by ~8-10 years.
When to refer
- If severe, asymmetric, or not improving.
**Orthotics will not help.
Toe walking
Walking on tiptoes without heel contact.
Typical age/resolution
Common under 3 years.
When to refer
- If toe walking more often than not.
- If asymmetric.
- If progressing or not improving
Bow legs
Knees apart, ankles together.
Typical age/resolution
Normal up to 18–24 months.
When to refer
- If worsening after 2 years.
- If unilateral (one side only).
Knock Knees
Knees touch, ankles apart.
Typical age/resolution
Peaks at 3–4 years, resolves by
6–8 years.
When to refer
- If worsening after 2 years.
- If unilateral (one side only).
How Unbreakable Physiotherapy can help
Our paediatric physiotherapists at Unbreakable Physiotherapy provide an evidence-based approach to support the assessment and management of these postural variants. If you would like your child to be assessed or you are worried at all – please reach out and book in with one of our friendly and experienced paediatric physiotherapists.