Toe Walking In Children

Werribee Podiatrist Ifrah Atosh talks about toe walking in children

Toe walking in children can be a scary and confusing issue that parents have to deal with.

It is best to note that this can be a normal developmental stage for children.

There can be a number of underlying issues that can be the cause of the toe walking, some do need to be addressed and others just need to be monitored.

• Structural restriction (bony or muscular block stoping the foot from bending properly)

• Idiopathic/Behavioural Toe Walking-I.e wanting to walk taller like their older sibling

• Developmental Conditions- Such as Autism Spectrum Disorders

Structural restrictions should be addressed when they are first noticed, as this can cause long term issues for the child. Whilst Idiopathic or Developmental causes are far less likely to cause long term issues but should be monitored. There are a number of signs to look for which may be a reason to treat earlier.

• Toe walking more than 50% of the time

• Cant walk at all with their heel flat

• Falls often more often than their peers

• Complaining of pain in their feet or lower legs.

Below is a list of different treatment options that are available:

• Continuous reinforcement (works best to break behaviour)

• Activities and tools to promote heel walking (light up shoes or shoes that make noise when the heels touch the ground)

• Physical therapy & exercises

• Sensory reducing socks (to reduce sensory issues associated with autism)

• Carbon shoe inserts (doesn’t allow the shoe to bend and prevents toe walking)

• Night splints (to gain further movement and promote a normal feeling of the ankle being in the correct position)

• AFO (rigid orthotic device that runs up the back of the leg- mainly used in drop foot but can be used in toe walking)

• Serial casting (used in presentations where there is muscle or bony restrictions)

• Botox (used in cerebral palsy to alow the muscles to relax if the muscles are causing restrictions)

• Surgery (used only if there is major structural bony issues causing his ankle to not bend)

Very rarely is invasive treatment is require. Most often it is just a stage of development.

The main rationale behind the treatment is get the neurolo-muascular pathways use to walking heel - toe, the more that it is done, the more the brain and muscles walk in this pattern, it will soon become a learnt behaviour and will become second nature and the treatment will no longer be required.

If you have any questions or think we may be able to help please let me know!