I ask about this every year in hopes that one of you physiologists/kinesiologists or other PT medical training people can answer this. I’ve googled this to death.
How do you fix excessive toeing out during running. Toe is angled out at the side during leg swing and somewhat on landing? I see this moreso in women than men, but I have it.
I have it worse on the right than the left, but on both legs. Several PTs have said that this is from a weak gluteus muscle. And I’ve done one legged squats to death, I can do them now, I do crab crawls all of the hip flexor, abductor muscles (TFL, medius) still this appears to do no good. I think its simply anatomical doing with Q angle and you can do nothing about it. I blame this for a history of ITBS and PF. On the other hand if I stand stationary, lift up the heel, and straighten it NORMAL, heel in line up the leg, no outtoeing, I’m using my hamstring to do this, and some muscle down on the top of my foot, to turn my foot inward. There’s no way that can be a solution during long runs.
Not quite as qualified as you’d like for a response (just 6 years of working specialty running retail), but here goes with my own bit on it:
It usually is related to strength deficiency related to the glute and the hamstring. This doesn’t allow your hips to open up naturally, and so the compensatory mechanism is to toe out a little bit. The fix I’ve seen most often is to hold the pelvis steady during your gait cycle. This will naturally fire the hamstring and glute through the propulsive phase of the gait cycle. I’ve found it has quieted my ITB right on down.
It sounds a LOT more complicated than it is. Dumb exercise I do: when my IT starts hurting, I hold my hands on my hips, and try to get things level again. Once I do that, the hamstring starts to fire off correctly, and I’m back on my way again.
am not qualified at all except for 30 years of running 
i sort of do the same thing as you do. both my feet do the toe-outward thing, but my right leg and foot also swing a little wide. the faster i run, then the less swing/toe-out i do. slow running is pretty ugly - coach says i run like a duck.
this didn’t bother me for the first 10 years of running, but once i started doing long bike rides, my right ITB started giving problems. that may be purely co-incidental.
anyway, when the ITB hurts, i do a strengthening exercise -
- cut an old tube so that it is one long piece. stand up straight. hold an end of the tube in each hand and loop the tube under your feet. hold it so the tube is stretched a bit. bend at the knees while keeping the back straight, straighten the knees to come back to standing. the tube provides a little extra resistance. something like three sets of 20-25.
after a week or two of the exercises, my ITB is usually problem-free. and then i stop doing the exercises until the next problem. i didn’t say i was smart.
Booth,
You definitely touched on it as did the others. Toed out running is frequently also called having a heel whip. Heel whip b/c when you swing through, that guilty leg’s heel often scrapes your other shin.
This type of running or deficiency has been attributed to several anatomical causes. It can by caused be the person being genu valgus (knock kneed). This is really determined by their anatomical Q angle as you mentioned. That Q angle is taken from your greater trochanter to your femoral epicondyle to your lateral malleolus. Basically the angle formed between your thigh and shin. Women tend to have greater Q angle due to wider hips for child bearing. With that said, they tend to have more ITB injuries and other lower leg injuries.
What really screws things up is a female that has a large Q angle but yet runs “normally” or a male that has a mild Q angle and yet has that bad toe out/heel whip swing through. WHy do people have/get it? I’ve done lit reviews and there are many theories. It has definitely been attributed to muscle fatigue. I believe it is mainly your TFL as someone mentioned. I’ve also read about leg length discrepancies. Frequent running on a crowned roads too. The best remedy my PT and AT friends found was cross training with lateral movements like basketball, ultimate frisbee, soccer, etc. The trap we, as triathletes, fall into, is tons of 2 dimensional motion (i.e. running) and tend to not use certain muscle and over use others.
Hopefully this helps some. Did my doctoral research on running and had several classmates do their master’s theses on similar topics.
I agree with everything that has been said to this point. One additional question I would have for you is what position is the foot in during the swing? Toe up, Toe down, Flat, etc…
The reason I ask is that it could simply be a weakness in the dorse flexor of the ankle in combination with a weak knee drive. The brain can solve that problem by externally rotating the leg to ‘clear’ the toe from catching and tripping you.
I know it sounds simple but sometimes simple is the answer.
Good luck and keep us posted.
Best,