Toe Walking – Is This Normal?

Toe walking is extremely common in toddlers or children who are beginning to walk. Usually this presentation is a result of a habit learned when learning to walk. When a doctor performs an assessment of the child, they usually test normal with no concerns. If toe walking persists over time, this can indicate another underlying condition:

• Cerebral palsy – injury to the brain, which coordinates muscle function, can lead to this type of gait pattern
• Muscular Dystrophy – due to muscular weakness or damage
• Short Achilles tendon – making it difficult for the heel to touch the ground when ambulating
• Autism

If your child is toe walking out of habit, treatment is not necessary as they will outgrow this gait pattern. If there is an underlying pathology, treatment may be recommended. Some treatment options include:

• Serial casting: a series of walking casts applied over a period of weeks to help progressively stretch and lengthen the muscles and tendons. 
• Botox therapy: For certain patients— those with a neurologic abnormality leading to increased muscle tone—an injection may be given to temporarily weaken the calf muscles, allowing the muscles to stretch easier.
• Surgery: For severe presentations and older children, a surgical procedure to lengthen the Achilles tendon may be recommended to improve range of motion and function of the foot and ankle.

Once these above modalities are performed, physical therapy and orthopedic bracing can help enhance rehabilitation potential and improve success. Physical therapy provides stretching and strengthening exercises while ankle foot orthoses (AFOs) will provide a low grade stretch encouraging proper ankle alignment when walking!

It is important to understand that toe walking does not indicate an underlying problem for most children! After the age of two, if your child is still walking on their toes, reach out to your doctor to discuss if there are any causes of concern that warrant further investigation. Please make an appointment sooner if your child exhibits impaired muscular coordination, or tight leg musculature. If you are concerned with how your child is meeting developmental milestones or walking, please reach out to our office! We are happy to provide a consultation and answer your questions!

 

The Custom Orthotics Team (519) 850-4721 | office@customorthoticsoflondon.com | @cool_bracing