This is part of our series on kidsБ health. Read the other articles in our series. When toddlers are learning to walk, many spend some time walking up on their tip toes, which is known as toe walking. Commonly this is to get into things they arenБt meant to, but as they perfect their walking, they walk more with their whole foot on the ground. The majority of toddlers will walk with their whole foot by the time they are three. Some toddlers are unable to walk with their whole foot, and this is something that should be checked out by a health professional. Toe walking can be into four groups. Some neurological conditions such as cerebral palsy or muscular dystrophy cause the calf muscle to be tighter or change the way it works. This makes it hard or impossible for the child to get their heels onto the ground to walk with their whole foot. There are also orthopaedic conditions such as congenital talipes equinovarus (also known as club foot) or (inflammation of the growth plate in the heel) which cause toe walking. The structural change in the foot or leg makes getting the heel to the ground impossible or painful. However, some children who can get their heels to the ground prefer to walk up on their tip toes. This group of children also has other behavioural characteristics, such as delays in achieving milestones or ritualistic behaviours. Here toe walking is associated with autism spectrum disorders or. Then there are healthy children with no medical conditions who still persist in walking on their toes. This is known as
toe walking and is diagnosed through exclusion of all other medical conditions known to cause toe walking. Idiopathic toe walking has historically been called with the presumption that the child has formed a habit of walking on their tip toes.
It has also been called, as some studies report family members sharing the trait. Idiopathic toe walking affects between and of healthy children and researchers donБt know its causes. There may be a genetic cause as it is often seen in multiple family members. There are also other features often observed in children with this gait type. In some small studies, children with idiopathic toe walking have also shown and challenges with such as difficulty with balance and seeking out movement. The most common observation in idiopathic toe walkers is tight calf muscles. This can make getting the heel to the ground even harder and can cause pain when children are trying to play sport. As you can imagine, children may be teased for walking differently. What can be done? No single treatment permanently fixes idiopathic toe walking. Often time is the greatest fixer as the children get heavier and the toe walking gets harder to maintain. However, as many children with idiopathic toe walking also have tight calf muscles, many health professionals recommend treatment primarily focused on making these muscles longer. Tightness in calf muscles in adults has been known to cause trips, falls and foot and leg pain. Treatment for idiopathic toe walking can be broken into two types: conservative and surgical. Conservative treatment includes verbal reminders, stretching, heavy footwear, full-length orthotics, ankle foot orthotics, plaster casts to stretch the calf muscles, and injections of Botox into the calf muscles. Surgical intervention has primarily focused on lengthening the Achilles tendon. Many of these treatments have limited evidence supporting their use.
At present, the supports plaster casts or surgery. Both of these treatments have shown the greatest improvement in the length of the calf muscles. Yet found that many children who had been treated with serial casts or surgery still continued to toe-walk for up to 13 years after treatment. Having multiple treatment options with varied success makes it hard for parents to choose the best treatment option. ItБs also a challenge for doctors in knowing what treatment to recommend. Researchers agree that keeping calf muscles long enough to easily make heel contact with the ground is important for children who are diagnosed with idiopathic toe walking. If this isnБt able to happen, a health professional will commonly then encourage treatment. There is also agreement that any child who is unable to get their heels to the ground at any time or continues to toe walk after three, should be assessed by a health professional. Further reading: Do kids grow out of childhood asthma? A snapshot of childrenБs health in Australia Bed-wetting in older children and young adults is common and treatable Migraines in childhood and adolescence: more than just a headache БSlapped cheekБ syndrome: a common rash in kids, more sinister in pregnant women Teenage pain often dismissed as Бgrowing painsБ, but it can impact their lives Is hip dysplasia in my newborn something to worry about? July 23, 2012 — More than half of young children who toe walk will stop doing so on their own by about age 5. And most children who are toe walkers will not have any developmental or neuropsychiatric problems, a new study finds. \”Walking is such a notable milestone, and if it is not typical, it is often a concern for parents and physicians,\” says pediatrician Lee Beers, MD, who practices at Children\’s National Medical Center in Washington, D. C. , and who reviewed the study for WebMD. It appears in the journal Pediatrics. \”This study certainly makes me feel more comfortable when I see toe walking in children who are otherwise developing well. \” Toe walking can accompany disorders such as and, but it also occurs among children who have no such underlying conditions.
In such cases, children are said to be idiopathic toe walkers. The cause is unknown, lead author Pahr Engstrom, MD, of the Karolinska Institutet in Stockholm, says in an email. It could be related to nerves, muscles, a mixture of both, or another unknown factor, he says. Prior to this study, the number of children who were idiopathic toe walkers was also unknown. The parents of more than 1,400 children participated in the study, which was conducted in Blekinge County in southeast Sweden. At their child\’s routine 5. 5-year checkup, parents were asked questions about their child and toe walking. Here\’s what the researchers found: Nearly 5% of all young children had toe walked at some time. However, by age 5 1/2, fewer than half of them were still doing so. Toe walkers typically begin doing so when they first walk independently, though some walk normally during the first year and beyond. Former toe walkers did so for one to two years before walking normally. Children still toe walking at age 5 1/2 do so about 25% of the time. Children with a diagnosed cognitive or neuropsychiatric disorder such as were more likely to toe walk; in the study, 41% of such children were current or past toe walkers.