What is toe walking? Is it normal in children? What causes toe walking? How to stop toe walking? I know all these questions must be popping up in your mind. Don’t stress out!!
Toe walking is all about the form of walking where the child walks on the balls of their feet instead of touching the ground. The children outgrow this habit over the course of time. It is normal in children and is not a matter of worry.
Well, in this article, we will focus on what toe walk entails and what causes it in children. We will also focus on the ways to stop toe walking. So, just scroll down the article and go through it.
[Raed: Terrible Twos]
What Is Toe Walking?
Toe walking is a form of walking where the children walk on the balls of their feet instead of their heels touching the ground. This form is very common in children and it is not something you need to be concerned about.
You will easily see this in the kids younger than 2 years. It is harder to learn with the course of time. This is also referred to as walking on toes or the balls of the feet. This is seen in children when they start to walk.
The children outgrow it in the later phase of life. Once the child starts growing and developing normally, toe walking is unlikely to be a cause for concern.
In very rare cases, if the child is continuing to toe walk after the age of 2, it may be a sign of an underlying medical condition. There will be muscles and tendons in the calves in case of the older children as it gets tighter with the course of time.
[Read: Physical Activities For Toddlers]
The calf is formed by two major muscles. They include:
Gastrocnemius Muscle:
This is regarded as the larger calf muscle. It takes two parts to form the bulge and is visible beneath the skin.
Soleus Muscle:
This is regarded as the smaller, flat muscle that lies underneath the gastrocnemius muscle in children.
Facts About Toe Walking:
- The toe walking occurs when the child continues to walk on their toes beyond 2-3 years of age.
- Toe walking is common in infants and babies when they are first learning to walk.
- The toe walking can lead to tight calf muscles and there will be a huge difference of movements in the ankles.
- The children younger than six years can undergo a form of treatment like calf stretches, Achilles tendon stretches and sit to stand exercises.
[Read: What causes in-toeing and out-toeing]
What Causes Toe Walking in Children?
Toe walking is “idiopathic” in a majority of the cases in children. It is difficult to find out the exact causes of toe walking in children. But still, some of the probable causes are as follows-
Medical Causes
- Cerebral palsy
- Muscular dystrophy
- A spinal cord abnormality
1. Cerebral Palsy
The cerebral palsy is described as a condition that affects muscle tone, coordination, and posture. This could be one of the reasons why the child suffers or may exhibit unsteady walking, including toe walking. Their muscles also may be very stiff.
2. Muscular Dystrophy
Muscular dystrophy (R) is a genetic condition that causes muscle weakness and wasting. In this form of a medical cause, one of the potential side effects is toe walking in children. It all depends upon the child’s walking style including the heel-to-toe pattern before and starts toe walking. The muscular dystrophy could be a potential cause.
3. Spinal Cord Abnormality
Spinal cord abnormalities (R) such as a tethered spinal cord in which the spinal cord attaches to the spinal column or a spinal mass could be a major cause behind toe walking.
4. Short Achilles Tendon:
As per the research and studies, the short Achilles tendon can cause trouble in standing on a flat foot. This could definitely be one of the common reasons behind the condition of the toe walking in children.
5. Premature Birth:
This is another cause that leads to toe walking in children. This is because the child could experience brain bleed. It can damage the brain part that controls movements and manifest that helps in toe walking.
6. Infection
Due to infection, it can also lead to toe walking in children. This infection carries at the time of pregnancy from mother to baby. The brain damage in the baby leads to cerebral palsy and toe walking in children.
7. Periventricular Leukomalacia
The premature baby has the chance of developing a condition called Periventricular Leukomalacia which is one of the probable causes of toe walking in children.
8. Hemiplegia/Hemiparesis
This is also a probable cause behind the condition called hemiplegia/hemiparesis that can also lead to toe walking in children
9. Autism
This is a common symptom for the children walking on their toes. This comes around with a plethora of symptoms. This is found at the beginning of the stage of life and it stops by the age of 2.
Symptom Of Toe Walking In Children:
Sometimes, it is very difficult to figure out the symptoms of toe walking in children, but still, some of them are-
- The child walks on tiptoes on both sides.
- Maintain a balance on their toes constantly.
- Are physically not able to keep up with other children of their age
- The children walk with straight knees
- The kids will often not be able to stand with their feet flat on the ground
- A family history of toe walking is previously present.
Is Toe Walking A Sign Of Autism?
As per the research and studies, there is a higher incidence of toe walking in children suffering from autism spectrum disorders.
This is a common symptom for the children walking on their toes. This is found at the beginning stage of life and it stops by the age of 2.
There is no particular evidence to prove whether autism and toe walking are interconnected or not. What matters here is to know that the toe walking by itself is not a sign of autism.
Some of the people with autism show sensory concern. This is a symptom where the child may not like the way their heels feel when they hit the ground. There is another reason behind the sign and symptoms that are related to vision and vestibular balance.
How To Stop Toe Walking?
Toe walking is a concern when it continues for a longer period of time, that too beyond 2 years of the toddler’s life. This can result in a lot of health problems over time.
There are two ways to stop toe walking in children – one is the surgical treatment and the others include the non-surgical methods.
1. Non Surgical Treatment:
This is a form of treatment that is recommended for the children who are of to 2- 5 years of age. Sometimes, simple steps or ways helps the child to walk on the flat feet. Over the course of time, it gets better and okay to walk on flat feet.
The Treatment Include-
- The children should wear special leg casts as it helps in stretching the muscles and tendons in calves. The child will get new casts a couple of times as the flexibility increases with the course of time.
- The ankle-foot orthosis (AFO), which is a special brace that has significant effects on stretching the muscles and tendons in the ankles, helps as well. This extends up the back of the lower leg and holds the foot at a 90-degree angle.
- There is another form of non-surgical treatment which is called botox (R) injection. This injection helps the legs to weaken overactive and tight leg muscles. These injections help stretch the muscles more easily than any other form of treatment. This also increases muscle tone.
- Observation is also another way to fix toe walking. Simply monitor the child regularly over the course of time. If it is out of habit, then it will stop on its own.
- The doctor will ask to wear short leg walking casts to help stretching and lengthen the legs of the muscles and tendons in the calf. It has significant effects on breaking the toe walking habits. This is performed over a period of several weeks.
Exercise For The Children Under 2-5 Years Old of Age:
These exercises help a lot to fix the toe walking pattern. They vary with the age of the children. Some of the exercises are as follows-
Calf Stretch:
- In this form of exercise, you have to lie the child on their back on a comfortable surface such as bed, mats, ground, etc.
- Keep their knee straight and leg supported on the bed. After that, bring the child’s foot in upwards direction, facing toward their head, and bend their ankle.
- After that, hold the leg and stretch at the end of the movement for about for 15 to 30 seconds.
- Make sure it should not be painful to your child as it can stay for a longer period of time.
- Then after, bring the child’s foot back to the normal position.
- Repeat the exercise for about 10 -15 times on each leg daily.
Achilles Tendon Stretch:
- In this form of exercise, you have to lie the child on their back on a comfortable surface such as bed, mats, ground as I mentioned in the above form of exercise.
- Keep their knees bent and bring the child’s foot in upwards direction, toward their head, and bending their ankle.
- Now hold and stretch the muscles of your child’s legs at the end of the movement for about 15 to 30 seconds.
- Make sure it should not be painful for your child.
- Then, you can bring your child’s foot back to a normal position.
- Repeat the exercise 10 times on each leg daily. (R)
Sit To Stand:
- In this form of exercise, make your child sit on a children’s sized chair or stool.
- Then place hands below their knees as it will provide a constant pressure downwards and will keep their heels on the floor for the children while doing exercise.
- Hence after, the child can practice standing up while keeping their heels on the ground for the support.
- You can also do this exercise with fun by using some creative activity.
Other Exercise Include:
- Marching on the spot
- Walking uphill
- Walking uneven surface as in a surface on playground or sand.
- Walking on the heels only
- Practicing squats
[Read: Excercise For Kids]
2. Surgical Treatments:
If the child continues to have toe walking even after 5 years and is unable to walk flat foot, then the doctor may refer to have surgery to lengthen a portion of the Achilles tendon. This is the way that can correct toe walking in children.
This is a process that takes a few hours of time, it doesn’t need an overnight hospital stay. After the surgery is done, the child is asked to wear walking casts for four to six weeks. You can go for physical therapy too.
The doctor will not recommend the surgical method immediately. If he/she comes to show no signs of improvement over 12 months’ time, then the doctor will go for surgery.
Long Term Effects Of Toe Walking:
If the toe walking continues for longer periods of time in case of children above 5 years, then it can lead to long terms effects, such as-
- Tighten muscles and tendon
- It will lead to abnormal stress on the bones and ligaments of the knees, hips, and lower back.
- It can lead to pain over time
- Increase the risk of falling and inducing injury
- It can affect self-esteem
When To Worry About Toe Walking?
As I said above, toe walking is common in children and it is not a matter of worry. But, if you see certain signs and symptoms in the child, then you can take an appointment of the doctor for further diagnosis.
Some of those symptoms include:
- The child walks most of the time on his toe
- Got stiff muscles
- Uncoordinated
- Stumbling most of the time
- Motor skills are delayed
- Can’t bear weight on her foot
- Losses motor skills.
Toe walking is common in children and needs special care and attention. I hope this article has given you good information about toe walking in children.
