Does My Baby Need to See an Orthopedist?
The short answer
A pediatric orthopedist specializes in bone, joint, and muscle conditions in children. Your pediatrician may recommend an orthopedic referral if your baby or toddler has a hip click or asymmetry, persistent foot deformity, abnormal leg alignment, limping, joint swelling, or a bone/skeletal concern. Many childhood orthopedic conditions are normal variations that resolve on their own, but some require treatment that works best when started early.
This is one of the most common questions parents ask. Searching for answers means you care.
By Age
What to expect by age
Common reasons for orthopedic referral at this age include hip dysplasia (detected by hip click or ultrasound), clubfoot, metatarsus adductus (curved foot), and torticollis with associated skull asymmetry. Early treatment for these conditions is highly effective.
Referral may be needed for hip asymmetry (uneven leg creases or limited movement), persistent foot turning, or unusual posture when sitting or standing. If your baby is not bearing weight appropriately, an orthopedic evaluation can help determine whether there is a structural cause.
Common referral reasons include persistent toe walking, significant bowed legs beyond 18 months, leg length discrepancy, limping, or refusal to walk due to pain. Mild bow legs are normal in early walkers but should be improving by this age.
Referral may be appropriate for severe knock knees, flat feet with pain, in-toeing that causes frequent tripping, limping, or joint swelling. Most alignment issues in this age group are normal variations, but an orthopedist can confirm this and provide reassurance.
What Should You Do?
When to take action
- Mild bow legs in a child under 2 years.
- Flat feet in a toddler who just started walking.
- Occasional in-toeing that does not cause functional problems.
- Flexible feet that can be gently moved to a normal position.
- One leg looks different from the other.
- Your child's leg alignment is not improving with age.
- Persistent foot turning in or out.
- Your child complains of bone or joint pain.
- Your baby has a hip click or leg length difference.
- Joint swelling, redness, or warmth.
- Your child limps or refuses to bear weight.
- Progressive deformity of legs, feet, or spine.
Sources
Related Resources
Trust your instincts. If something feels wrong, reach out to your pediatrician.
Worrying about your baby means you care. That is a good thing.
Related Physical Concerns
Does My Baby Need Physical Therapy?
Pediatric physical therapy (PT) helps babies and toddlers who have delays or difficulties with gross motor skills like rolling, sitting, crawling, standing, and walking. PT is recommended when a child is significantly behind on motor milestones, has muscle tone issues (too stiff or too floppy), shows asymmetric movement, or has a diagnosed condition affecting movement. Early intervention PT is free or low-cost in most states for children under 3.
My Baby's Foot Turns Inward
Metatarsus adductus (foot that curves inward) is common, affecting about 1 in 1,000 babies. Most cases are positional from womb positioning and resolve on their own by age 1 without treatment. More rigid cases may benefit from stretching exercises or, rarely, casting. Your pediatrician can assess the flexibility of the foot.
My Baby's Bowed Legs Are Not Straightening
Physiological bowing (normal bowed legs) should begin straightening after age 18-24 months. If bowing persists beyond age 2, worsens, or is asymmetric (more on one side), it may indicate Blount disease, rickets, or other conditions that benefit from treatment. Most persistent bowing is treatable when caught early.
My Toddler Limps After Resting
Limping after rest that improves with movement is a hallmark sign of juvenile idiopathic arthritis (JIA). This "gelling" phenomenon occurs because inflamed joints stiffen during inactivity. If your toddler consistently limps after naps or in the morning but walks better after moving around, contact your pediatrician for evaluation.
My Baby Seems to Use One Side More Than the Other
Babies should use both sides of their body fairly equally during the first 18 months of life. While slight preferences can be normal, a consistent pattern of favoring one side - using one arm much more than the other, crawling with one leg dragging, or turning the head predominantly one way - should always be discussed with your pediatrician. Early identification of asymmetry leads to the best outcomes.
My Baby Only Army Crawls
Army crawling (also called commando crawling) is a completely valid and normal way for babies to move. Many babies army crawl for weeks or even months before transitioning to hands-and-knees crawling, and some skip hands-and-knees crawling entirely. What matters is that your baby is independently mobile and exploring their environment.