Course Summary

$79 • 2.75 hours

PREREQUISITE: Posture & Torso Alignment (CTF Level I). Already completed this course? Click here for CTF-2 signup link.

The first segment in a four-part training program that comprises two didactic sessions and two lab sessions, this didactic course builds upon the foundation laid in CTF Level I - Posture & Torso Alignment. The content features a review of typical and pathologic aspects of orthopedic development of the pelvis, hip joint and femur that influence the foot progression angle (FPA), i.e., in-toeing and out-toeing in gait. The principles support the safe use of TheraTogs pelvic and hip rotation strapping. 

Topics include:  

  • Transverse-plane (TP) modeling processes and events in the developing pelvis, hip, and femur. 
  • A review of development of the pelvis, hip joint and femur in the TP. 
  • A discussion of the difference between femoral anteversion and femoral antetorsion with implications for safe management of the developing femur and hip in the transverse plane. 
  • A review of musculoskeletal assessment procedures used to identify sources of deviations in FPA in the hip joint and femur, and to document changes in a replicable manner.
  •  A review of TheraTogs strapping strategies for improving functioning alignment at the pelvis and hip in the transverse plane. 
  • A discussion of the potential for hip lateral rotation strapping to disrupt hip joint stability. Attendees who successfully complete this didactic program qualify to attend the associated lab course to obtain certification as a TheraTogs Fitter (CTF) Level 2.


In addition to offering a substantial investment in your professional development, the Pediatric In-toeing/Out-toeing Management for Neuromotor Training online course delivers 2.8 contact hours of Cusick-level content.

Certificates will be emailed within 2 weeks to those who complete all sessions, record 90% or better on all quizzes, and submit their online evaluation. 

For Physical Therapists: The Pediatric In-toeing and Out-toeing Management for Neuromotor Training course has been approved for 2.75 contact hours and CEUs in multiple states (40 + as of this date) by Redefine Health Education, Inc. For a list of approved states, visit their website. If you are in a state not listed, Redefine Health Education will assist you in applying for individual approval. You will receive two certificates — one recognizing your course completion, and one documenting the CEU approval.

For Orthotists: The Pediatric In-toeing and Out-toeing Management for Neuromotor Training course has been approved for 2.8 scientific contact hours by ABC. 

Course Objectives

Your learning objectives for this course include the following....

  • Discuss the skeletal modeling process that influences long bone torsion and explain the modeling “window of opportunity.

  • Describe the ideal changes in growing bone design that occur in the transverse plane in the pelvis and femur in children born at full-term gestation.

  • Relate foot position – pronation and supination - to body weight distribution on the feet in standing and walking.

  • Relate toeing in and toeing out to body weight distribution on the feet in standing and walking, and to muscle recruitment strategies needed to maintain the upright position.

  • Explain the role of the Iliotibial band (ITB) and the “deltoid of the hip” in maintaining pelvic alignment and postural control in gait.

  • Describe the influence of a medially-rotated knee axis on ipsilateral iliotibial band alignment and competence.

Course Curriculum

    1. Welcome to the Pediatric In-toeing / Out-toeing course!

    2. Introduction

    3. Section 1: Skeletal Modeling Mechanisms in the Transverse Plane (TP)

    4. Section 2: Nomenclature Review

    5. Section 3: Development of the Pelvis, Hip Joint & Femur in the Transverse Plane

    6. Section 4: Pathomechanics of Excess and Diminished Femoral Antetorsion

    7. Section 5: Review of Assessments: Hip Rotation ROM in Extension, Femoral Torsion Test

    8. Section 6: Pelvis, Hip & Femur - TP Management Strategies using TheraTogs

    9. Section 7: TheraTogs Research

    1. What's Next...

    2. Review Quiz

    3. Course Evaluation: Pediatric In-toeing and Out-toeing Management for Neuromotor Training

About this course

  • 12 lessons


President / Senior Instructor Beverly (Billi) Cusick

Beverly (Billi) Cusick PT, MS, NDT, COF/BOC is an internationally known pediatric physical therapist whose specialty is the orthopedic development and orthotic management of children with cerebral palsy and other neuromotor deficits.

She has been teaching these and related topics since 1978 - including presentations by invitation for the APTA, AACPDM, AOPA, and AAOP and more than 460 full programs and workshops worldwide.

Ms. Cusick received her BS in PT from Bouve College at Northeastern University in Boston, MA in 1972, and her MS in Clinical and College Teaching for Allied Health Professionals from the University of Kentucky in Lexington in 1988. She is an Associate Professor for the Rocky Mountain University of Health Professions – Pediatrics Program – Provo, Utah (2006-present) and is NDT basic- and baby-trained.