When you walk down the street you can often see people who walk in an inside-out gait pass you by. For a severe inside-out gait, you can inadvertently find it very unsightly. Today’s young parents want their children to have a beautiful posture, so more and more parents are coming to the hospital to have their children checked for walking in an inside-out gait. In fact, inside-out gait is more common in children and decreases as they get older. There are three main causes of inside-out gait: forefoot pronation deformity, internal tibial torsion and internal femoral torsion. Most forefoot pronation in most infants and children is mostly due to the position of the foot in the womb, and improves on its own without treatment after birth. The same is true for internal tibial torsion, most of which improve on their own up to the age of 7 years, and it has been studied that there is a 15o range of self-improvement in this process. Internal femoral torsion is associated with anterior tilt of the femur, which is normally about 40o at birth and drops to about 15o by age 12. We know from all of this that most of these gait patterns will improve or get better on their own without the use of insoles, orthopedic shoes, or orthopedic appliances such as wrap-around slings. Is it because of the above reasons that we don’t need to pay attention to children who walk with an inside-out gait? The above is a normal developmental situation. There are also many pathologic reasons why these three deformities may be aggravated or too severe to recover on their own. There is also the fact that these three conditions can produce different alignments that can affect the child. For example, severe internal femoral torsion can lead to hip instability; reverse torsion of the femur and tibia can produce lower limb pain and allow early onset of degenerative knee disease. Therefore, the doctor will make a comprehensive analysis based on the child’s lower limb force line, as well as the child’s age, symptoms, and so on. Some children will need to use some rehabilitation means such as shoe inserts, and those who are particularly severe and have clinical symptoms may also need to undergo surgical treatment. Through the above analysis, I want parents to understand that it is not scary for their children to walk inwardly, most of them will have a good result, do not blindly use orthotics, so as not to cause discomfort to their children’s feet. Seek advice from a specialist if you have problems and try to make sure that your child has a fit and strong foot.