Children often have their own ways of doing things.
When your child is learning how to walk, they may develop walking patterns that would be considered unusual in adults.
Toe walking, for instance, is not an uncommon walking pattern in young children, but is still not typical or ideal.
There are certain medical conditions that are associated with toe walking, but sometimes there is no known cause which we refer to as idiopathic toe walking. In either case, if you notice your child toe walking, seeking out a physical therapy evaluation can be helpful in determining the cause and plan of treatment.
Here at Little Feet Therapy, one of the pediatric therapy specialist services we offer is physical therapy for toe walking.
Let’s take a look at toe walking, its causes, and how pediatric physical therapy can help.
What Is Toe Walking?
Toe walking refers to a walking pattern where someone walks on the balls of their feet instead of touching their heels to the ground.
While toe walking is common amongst children under 2 years of age, children over 2 years old are expected to be walking with a typical heel toe gait pattern.
Is Toe Walking A Problem?
If your child is meeting other developmental milestones, toe walking in young children younger than two years old is not usually a cause of concern.
However, persistent toe walking in older children may lead to lasting walking difficulties.
For instance, toe walking may cause your child’s calf muscles to tighten, making a typical heel to toe
walking pattern harder to learn as your child ages. This muscle tightness may also impair their balance, and ability to run, jump, and squat.
Furthermore, if the muscle tightness resulting from toe walking is not addressed, it may result in leg or back pain due to improper body mechanics as your child ages.
If your child isn’t outgrowing their toe walking, a pediatric physical therapist can help.
Your child’s physical therapist will examine them in order to rule out conditions that are known to cause toe walking.
Causes Of Toe Walking
Several medical conditions are known to cause toe walking, including:
Idiopathic Toe Walking
Idiopathic toe walking refers to the presence of toe walking without an identifiable medical reason.
Children with idiopathic toe walking are typically capable of walking in a typical heel to toe walk, but just prefer to walk on their toes.
This diagnosis is given once all other medical conditions are ruled out.
For instance, if your child’s toe walking is idiopathic, they will present with normal neurological exams.
Toe Walking From Cerebral Palsy
Cerebral palsy is a condition that affects muscle tone, coordination, and posture.
It can also lead to stiff muscles.
If your child’s toe walking is caused by cerebral palsy, you may notice that their walking seems unsteady, and their muscles may be stiff.
Pediatric physical therapy treatments for cerebral palsy will address your child’s toe walking if it’s an issue.
Toe Walking From Muscular Dystrophy
Muscular dystrophy is a genetic condition that leads to muscle weakness and wasting.
Due to this muscle weaking, people with muscular dystrophy will sometimes exhibit toe walking.
If your child has always walked in a heel to toe pattern and suddenly develops toe walking, muscular dystrophy could be a potential cause.
Toe Walking From Spinal Cord Issues
Certain spinal cord abnormalities may cause toe walking.
For instance, tethered spinal cord, a condition where the spinal cord attaches itself to the spinal column, may cause your child to toe walk.
A spinal mass may be another potential cause of toe walking.
Toe Walking From Autism
Autism spectrum disorder is a condition that may affect a person’s communication, social skills, and behaviors.
Toe walking has a higher incidence rate in individuals with autism spectrum disorder.
However, doctors have not been able to pinpoint the exact reason for this.
One of the potential causes for toe walking in children on the autism spectrum may be sensory aversion, where the child does not like the feeling of the floor on their heels.
Another potential cause for toe walking in children with autism spectrum disorder is sensory seeking. Often children will toe walk when they are excited or in a heighted state of arousal.
It is important to note that toe walking in and of itself is not a symptom of autism since it could be occurring due to vision or balance related issues.
Physical therapy treatments for autism spectrum disorder will address toe walking if that’s a concern.
Pediatric Physical Therapy Treatments For Toe Walking
Physical therapy is an excellent option for toe walking in children.
Your pediatric physical therapist will work with you and your child to help encourage typical heel to toe walking.
There are several physical therapy techniques that your child’s physical therapist may utilize, including passive and active range of motion exercises, strength training, weight bearing activities, and sensory integration strategies.
In passive range of motion exercises, your child’s physical therapist will conduct gentle stretches on your child’s calf and hamstring muscles in order to encourage better range of motion for walking.
Similarly, active range of motion exercises encourage better range of motion for walking through the use of aids such as incline wedges and balance boards.
Animal walks, such as crab walking, can also encourage active range of motion in a way that is fun for your child.
Strength training helps develop your child’s muscles so that typical heel to toe walking becomes easier.
Some strength training exercises that your child’s physical therapist may use include:
- Getting your child to lift their foot with a soft bean bag on it
- Getting your child to use a scooter board to provide weight support while walking
- Getting your child to step or jump over hurdles
- Getting your child to walk on pillow or soft/unstable surfaces
Weight bearing activities are also a fun way to encourage heel to toe walking in your child.
Weight bearing activities usually involve the use of an aid, such as a dyna disc or a foam balance pad.
For instance, a physical therapist may get your child to stand on a dyna disc while squatting to drop toys in their correct boxes.
Additionally, a physical therapist may utilize sensory integration strategies to help eliminate sensory aversion in children on the autism spectrum.
Some sensory integration strategies your child’s physical therapist may use include:
- Joint compressions
- Encouragement of barefoot exploration on different surfaces
- Use of a vibrating massager on your child’s feet
- Use of tactile material inserts in your child’s shoes
- Use of heavier shoes and/or high tops to control foot alignment
- Grippy socks
Finally, a physical therapist may recommend braces or orthotics for you d to decrease their toe walking and improve their mobility.
Your child’s physical therapist will be able to assist with setting up an appointment with an orthotist and will work with the orthotist to find the brace or orthotic that will provide the best support for your child’s feet.
Correcting toe walking can be a frustrating experience for both you and your child.
At Little Feet Therapy, we can help.
Book your appointment with Little Feet Therapy today.