Toe walking in children

Description

Walking on the toes or the balls of the feet, also known as toe walking, is fairly common in children who are beginning to walk. Most children will outgrow it.

Children who are still toe walking beyond the toddler years often do so out of habit. While your child is growing and developing normally, toe walking is unlikely to be a cause of concern.

Toe walking sometimes can result from certain conditions, including cerebral palsy, muscular dystrophy and autism spectrum disorders.

Symptoms

The finger of the foot is walking on the toes or the ball of the foot.

When to see a doctor

If your child is still standing, and walking after 2 years of age, talk to your doctor about it. Make an appointment before if your child also has tightened the muscles of the legs, stiffness in the Achilles tendon or a lack of muscle coordination.

Causes

Normally, toe walking is a habit that develops when a child learns to walk. In some cases, toe walking is caused by an underlying condition, such as:

  • A short Achilles tendon. This tendon links the lower leg muscles of the back of the heel bone. If it is too short, it can avoid that the heel touches the ground.
  • The Cerebral palsy. The toe can be caused by a disorder of movement, muscle tone or posture that is caused by injury or abnormal development in the parts of the immature brain that control muscle function.
  • Duchenne Muscular dystrophy. Toe walking sometimes occurs in this genetic disease in which the muscle fibers are very prone to damage and weaken with time. This diagnosis may be more likely if your child initially walked normally before you start to toe.
  • Autism. The toe has been linked to autism spectrum disorders, which affect a child's ability to communicate and interact with others.

Risk factors

The toe of the custom, also known as idiopathic toe, sometimes it runs in families.

Complications

Persistent toe walking can increase a child's risk of falling. It can also result in social stigma.

Toe walking in children

Diagnosis

The toe can be observed during a physical examination. In some cases, the doctor may do a gait analysis or a test known as electromyography (EMG).

During an electromyography (EMG), a thin needle with an electrode is inserted into a muscle of the leg. The electrode measures the electrical activity in the affected area of the nerves or muscles.

If the doctor suspects a condition, such as cerebral palsy or autism, he or she may recommend a neurological exam or test to detect developmental delays.

Treatment

If your child is toe walking out of habit, no treatment is needed. He or she is likely to outgrow the habit. Your doctor may simply monitor your child's progress during office visits.

If a physical problem is contributing to walk on tiptoe, the treatment options may include:

  • The physical therapy. Gentle stretching of the leg and the foot, the muscles that could improve your child's gait.
  • Braces or splints. Sometimes, these help to promote a normal gait.
  • Serial casting. If physical therapy or leg braces are not helpful, your doctor may suggest a series of below-the-knee check to progressively improve the ability to carry the toes towards the shin.
  • OnabotulinumtoxinA. Injections into the calf muscles are sometimes used to help promote a normal gait.
  • Surgery. If conservative treatments fail, your doctor may recommend surgery to lengthen the muscles or the tendons on the back of the lower leg.

If the toe is associated with cerebral palsy, autism, or other problems, the treatment focuses on the underlying condition.

Preparing for your appointment

Probably your first concern to the attention of your primary care provider, family doctor, nurse practitioner, physician assistant, or doctor. He or she may refer you to a doctor who specializes in nerve function (neurologist) or orthopedic surgery.

What you can do

Before your appointment, you might want to write a list of questions to ask your doctor, including:

  • What could be the cause of the toe walking in my child?
  • What tests are needed?
  • What treatments are recommended?

What to expect from your doctor

Your doctor may ask some of the following questions:

  • Does your child have any other medical problems?
  • Do you have a family history of muscular dystrophy, or autism?
  • Was your child born prematurely?
  • There were complications with the birth of the child or for the children's room of the hospital stay?
  • He made his first child to walk flat-footed, then you start to walk on tiptoe?
  • Your child can walk on their heels, if you ask for?
  • Does your child avoid contact with the eyes or the display of repetitive behaviors such as rocking or spinning?
Symptoms and treatment of Toe walking in children