Verified By Apollo Pediatrician June 17, 2023
5160Toe walking refers to the abnormality commonly seen in the walking patterns of infants, characterized by the use of balls of their feet instead of their heels during the gait cycle (repetitive events of walking). The absence of proper heel-to-floor contact may cause deformities in the toes of the feet.
In most cases, toe walking in children does not cause any concern, and it is considered a normal part of their development and learning during the early walking stages. Most children usually start walking normally on their own without intervention. However, persistent toe walking needs to be evaluated .
Idiopathic toe-walking refers to toe walking in healthy children due to unknown reasons. This may include older children who continue to toe walk out of habit, behavioral reasons, or tightened tendon muscles due to prolonged toe walking. Many children develop the habit of toe walking due to unknown causes. This condition is called idiopathic toe-walking.
Some underlying conditions too may be associated with toe-walking in children which include:
Birth defects like congenital spinal abnormalities make it difficult to maintain the body’s balance, leading to toe walking in children.
Muscular dystrophy is an inherent genetic disorder that causes progressive weakening of muscles. As a result of muscle loss, weakening of muscle fibers, and posture changes, the affected child may start to toe walk to keep the body stable while walking.
Achilles’ tendons are muscles connecting the calf muscle to the heel bone. Children with congenital abnormal foot structure or with short Achilles tendon muscles may toe walk.
The most common noticeable symptom of toe walking is the inability to walk with feet planted on the ground . The affected child may experience difficulty wearing shoes, participating in sports activities, and stabilizing the body while walking. Other symptoms include:
Fortunately, toe walking does not cause any life-threatening illness. It is considered a common learning stage of early walking in infants. In most cases, children begin to walk flat-footed with their heels touching the ground without any medical interventions.
However, if your child experiences chronic conditions of toe walking (beyond age 2 ) or a walking difficulty, or if toe walking recurs after a period of normal walking, it is advisable to seek immediate medical help.
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Your doctor or pediatrician will perform a general physical examination of your foot muscles, tendons, and skeletal structure to rule out any major medical issues. These physical examinations are usually enough to diagnose most toe-walking conditions. However, if the doctor suspects any other underlying condition, he/she may recommend further evaluation by specialized orthopedic surgeons or neurologists.
The treatment for toe walking largely depends on the foot condition and the affected person’s age. In mild and moderate cases, non-surgical options are followed. For severely deformed toe structures, surgical options are recommended.
1. Non-Surgical Methods to Treat Toe Walking:
2. Surgical Methods to Treat Toe Walking:
Surgical treatment of toe walking is considered as the final option if other conservative treatments prove inefficient. Surgery for toe walking involves surgical lengthening of the Achilles tendon in the foot muscle. This lengthening of tendons promotes a greater range of motion and allows proper foot and ankle function.
Toe walking puts excess stress on the toe muscle. This prolonged pressure of body weight on the toe may cause Achilles tendons and calf muscles to tighten over time. This limits the normal range of the toe muscle, leading to difficulty in walking.
There is no standard prevention of toe walking as the child usually adopts normal walking over a period. Certain physical exercises and muscle stretching in children below six years of age may prevent the likelihood of adopting or practicing toe walking later.
Conclusion – Outlook and Prognosis:
The outlook largely depends on the extent of abnormality in walk patterns, foot deformities, and habitual causes. But most children with abnormal walking patterns (toe walking) improve over a period with medical assistance and lead a normal life with no walking difficulties. However, in some cases, toe-walking recurs after a period of normal walking.
If your child is experiencing any signs and symptoms of toe walking, the following practices may promote a heel-to-floor connection:
Children with Attention Deficit Hyperactivity Disorder (ADHD) are highly susceptible to toe walking and Achilles shortening.
Generally, toe walking in children stops on its own by the age of 5.
Your doctor may suggest one of the following treatment methods,
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October 25, 2024