If your child's pediatrician has expressed concerns about toe walking, you may need to talk with an orthopedic surgeon about an evaluation. Toe walking, as indicated by the name, refers to a gait in which the child steps, stands and walks on his or her toes instead of a traditional heel-to-toe movement. Although it can be a brief phase in the learning period, if toe walking persists beyond two to three years old, it may necessitate a consultation to see if there are any underlying issues. Here are some things you should know about toe walking and its potential treatments.
Isn't Toe Walking Normal for Young Kids?
When young kids are first learning to walk, toe walking can be quite common. Many children start on their toes when learning to walk, and then gradually shift to a traditional heel-to-toe gait before late toddlerhood. Toe walking that persists beyond this stage is an indication of a possible physical or developmental concern.
What Can Cause Toe Walking?
There are many conditions that can cause toe walking, and the treatment recommendations will depend on the root cause of the problem.
Developmental and Neurological Problems
Toe walking is a key indication of the existence of an autism spectrum disorder in children. For kids with no other signs of autism, other neurological conditions such as cerebral palsy and muscular dystrophy can also cause it.
If there are no underlying neurological conditions, your doctor may recommend an orthopedic surgeon to evaluate the length and condition of the Achilles tendon. If the tendon and muscular structure of the back of the leg are too short, it can cause discomfort for children to stand flat on both feet or to walk with a normal gait.
When it comes to treating toe walkers, the first step is often to sit back and watch. In many cases, kids will outgrow it in the first few years of life. Since this brief toe walking doesn't typically have any lasting ill effects, it's not usually a serious concern. If it doesn't resolve itself in the first couple of years and your child is still toe walking by preschool age, there are a few options.
Non-Surgical Treatment Options
For kids who toe walk due to autism spectrum disorders or other neurological conditions, physical therapy is the first place to start. You'll need to retrain your child's muscular memory to encourage a proper gait. In addition to physical therapy appointments, you may be advised to do exercises or routine stretches and may have to use a splint at night to keep your child's feet positioned to stretch the tendon and encourage proper positioning.
If your child's toe walking is a physical condition due to a short Achilles tendon, you'll likely have to work with an orthopedic surgeon to lengthen it. This process takes time, but the longer tendon will allow the heel to comfortably land before the toes, encouraging a proper gait. In most cases, a cast will be fitted to the feet during the recovery period to protect the tissue from tightening up while it heals.
The casts will start with ones that keep your child off his or her feet for several weeks. After this first part of the recovery period, the surgeon will replace these casts with walking casts. The walking casts remain in place for a few weeks, with the duration varying based on your child's individual recovery. When the walking casts come off, you'll be given braces much like the overnight braces, but your child's shoes should fit with these. Physical therapy may also be included in the recovery period to help your child learn how to walk properly.
As you can see, there are several options to treat toe walking if it has reached a problematic or concerning stage. Talk with your doctor about your concerns and see if a visit to an orthopedic surgeon could benefit your child.
You can also visit http://www.towncenterorthopaedics.com to learn more.