When you see a toddler walking on his or her toes, you might assume it’s just a strange phase in the path towards learning how to walk. In this case, most of the time, you would be right!
Many toddlers learn to walk and feel comfortable up on the balls of their feet as they learn. It is considered a fairly common part of the learning to walk process, even if not all children do it. While it is most often normal, however, it can also be the symptom of various illnesses that should be addressed. (Normally, toddlers grow out of this habit and walk in the standard heel-toe pattern after a while.)
Some children walk on their toes for longer than the toddler stage, but this is because they’ve developed the habit of doing so. If you are worked about this, consult with a physician, and discuss the matter with them.
Toe-walking can be a symptom of several serious conditions. It could be the sign of cerebral palsy, muscular dystrophy, or autism spectrum disorder, according to the Mayo Clinic.
Toe-walking could also be a symptom of being born with a short Achilles tendon, which runs from the heel of the foot up the back of your lower leg. If the tendon is short, it can be difficult for the child to touch their heels to the floor.
Parents are advised to see a doctor if the toe-walking condition persists past the age of two (2). On the most basic level, toe-walking can increase a child’s risk of falling and sustaining injuries by falling.
A diagnosis of toe-walking involves observation of the toddler. It also entails the use of an EMG, which is a very thin needle equipped with an electrode that is used to measure activities of the affected nerves or muscle. In this case, the EMG device is inserted into the muscle in the leg to measure nerve and muscle activity from a clinical point of view.
Other tests may also be ordered. The tests will likely include different examination options to determine if autism or cerebral palsy is the source of the problem.
Treatment may not be necessary at all. The child may simply be learning how to walk and is stuck in the habit of walking on the balls of his or her feet. They will; normally outgrow this in time.
However, a few other options may be recommended. These include:
— Physical therapy. This generally involves stretching and relaxing of the leg muscles. The child’s role is usually passive, while the therapist manually manipulates the muscles with movement for stretching and massage for relaxing.
— Leg braces or splints are sometimes recommended to train the child to walk in a heel-toe pattern.
— Casts are sometimes used as a form of leg brace. The casts promote normal walking and are replaced periodically as improvement is made, each cast guiding the child’s gait to the next level of success.
— Injections of onabotulinumtoxinA are recommended. This is injected into the calf muscles and can help return a gait to normal.
— Surgery might be recommended to lengthen a child ‘s Achilles tendons if one or both of them are too short to allow for heel-toe walking.
When to seek help
Seek help anytime your child’s gait appears abnormal or if it is causing pain to the child. In Tempe, call FXRX Orthopaedics & Bracing at 480-449-3979 for an appointment.