In-toe Walking

What is it?

A youngster is “toe walking” when he or she favours walking on the tips of their toes or the ball of their foot over using the heel or other parts of the foot. Having an underlying issue is possible but not always present in a child who walks on their tips.

Tiptoeing is a common movement for infants just starting out on their feet. Most children will naturally outgrow toe walking. Treatment for toe walking often consists of physical therapy, bracing, and casting. However, surgery may be considered if these noninvasive methods fail.

 

In-toe Walking

Causes

Kids who walk idiopathically on their toes may be doing so for reasons that aren’t clear. Some of the most common underlying causes are neurological disorders like cerebral palsy, autism, and muscular dystrophy. First, the doctor will do a full history and physical to rule out any underlying issues.

 

A child’s birth history, as well as their family’s and the child’s own, will be topics of discussion between the doctor and parents (ITW may run in families).

Occasionally, toe walking is the outcome of a more serious condition, such as:

  1. A brief Achilles tendon: This tendon joins the calf muscles to the back of the heel bone. The heel may not be able to reach the floor if the shoe is too short.
  2. Neural palsy: Abnormalities in movement, muscle tone, and posture, such as toe walking, can result from damage to or improper development of the areas of the developing brain that regulate muscular activity.
  3. Dystrophy of the muscles: There is genetic evidence linking toe walking to a disease in which muscle fibres are more prone to injury and degeneration. If your child walked normally at first but subsequently started walking on their toes, this could lend credence to the diagnosis.

Symptoms

Autism spectrum disorder patients are more likely to walk on their toes, a behaviour that has been seen by medical professionals. Collectively, these problems can hinder an individual’s decision-making, interaction with others, and expression of emotion.

However, doctors still don’t know why autistic persons may be more likely to walk on their toes. Toe walking is not a hallmark of autism. Potential causes of toe walking in autistic persons include sensory difficulties, such as a dislike of the way one’s heels feel when one touches the ground. Problems with vision or the vestibular system could potentially be at play.

Clinicians usually only think of toddlers when addressing toe walking, but the condition can affect adults as well. An adult who had a history of often tripping over their own feet might not have benefited from corrective measures. Even adults can develop a case of toe walking every once in a while. This could be due to a variety of different foot conditions or idiopathic factors. Symptoms such as loss of sensation in the feet, calluses, corns, and peripheral neuropathy are all possible results of nerve damage in the feet.

 

Diagnosis

If you or your child is still walking on your toes, you should see a doctor who can examine you or them and investigate for possible explanations. In most cases, this is the stage at which a patient’s medical history is gathered. For instance, a doctor may question about the following:

  • A mother’s pregnancy was considered healthy if her baby was born at 37 weeks or later, and vice versa.
  • Whether or not a child’s toe walks on both feet, if there is a history of toe walking in the family, depends on whether or not the youngster has mastered developmental milestones like sitting and walking.
  • If they have other symptoms relating to their feet or legs, such as discomfort or weakness in their legs.

Further, your doctor will do a physical examination. A common example of this is being asked to demonstrate that you or your child can walk. We’ll also take a close look at how your feet and legs are growing and how much you can move them.

 

If you or your child continues toe walking, you’ll want to see your doctor who will evaluate for potential causes.

Treatment

While most people with idiopathic toe-walking outgrow their toe-walking by age 5, those who do so may be at risk for complications. It can be challenging to find shoes that are both comfortable and supportive if you walk mostly on the tips of your toes, and activities like roller skating requires specific footwear. You can also become clumsier and have more accidents.

Non-surgical treatment is preferred if a youngster between the ages of two and five is able to walk flat-footed without assistance. When teaching children to walk with their feet together and flat, a gentle reminder is often all that is needed. In children with idiopathic toe walking, flat-footed walking typically develops as the child gets older.

Bracing or casting may not be successful in lengthening muscles and tendons in a person who continues to toe-walk after the age of five and is unable to walk flat-footed when directed. Therefore, your physician may recommend a surgical procedure to extend your Achilles tendon. You won’t have to spend the night at the hospital because this is an outpatient procedure.

Other in-toe walking treatments include:

  1. Wearing leg casts designed to stretch the calf muscles and tendons may be recommended if tightness is detected there. Your child will likely need several more casts as his or her range of motion improves.
  2. Stretching the tendons and muscles in the ankles is made easier with the use of an ankle-foot orthosis (AFO). This form of brace requires much longer usage than a leg cast would.
  3. If tight, overactive muscles in your legs are the root of your toe walking problem, then Botox injections may be able to help. These injections can help your child’s muscles adjust faster if they need to wear a cast or brace.

Paediatric care is very strong in Saqsham Ortho. Our team of orthopaedic experts is ready to help you recover from everything from a minor fracture to a congenital anomaly, and we offer a comprehensive set of services.

To provide your child with the best possible care, our hospital features a number of paediatric subspecialties. Our state-of-the-art facilities and knowledgeable staff will assist you in finding the best physicians to handle your medical needs. Our team of highly trained experts is here to provide you with the best possible medical attention.

 

At Saqsham, we care for your well-being and strive to bring you the best orthopaedic care and solutions. If your child is experiencing any such issues and would like to get a medical opinion,
we’d suggest you book an appointment.