why does my child walk on his tippy toes
This is part of our series on kidsв 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 arenвt 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 donвt 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. Itвs 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 isnвt 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 childrenвs 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 вSlapped cheekв syndrome: a common rash in kids, more sinister in pregnant women Teenage pain often dismissed as вgrowing painsв, but it can impact their lives Is hip dysplasia in my newborn something to worry about? Walking on the toes or the balls of the feet, also known as toe walking, is fairly common in children who are just beginning to walk. Most children outgrow it. Kids who continue toe walking beyond the toddler years often do so out of habit.
As long as your child is growing and developing normally, toe walking is unlikely to be a cause for concern. Toe walking sometimes can result from certain conditions, including cerebral palsy, muscular dystrophy and autism spectrum disorder. Toe walking is walking on the toes or the ball of the foot. If your child is still toe walking after age 2, talk to your doctor about it. Make an appointment sooner if your child also has tight leg muscles, stiffness in the Achilles tendon or a lack of muscle coordination. Typically, toe walking is a habit that develops when a child learns to walk. In a few cases, toe walking is caused by an underlying condition, such as: A short Achilles tendon. This tendon links the lower leg muscles to the back of the heel bone. If it's too short, it can prevent the heel from touching the ground. Cerebral palsy. Toe walking can be caused by a disorder of movement, muscle tone or posture caused by injury or abnormal development in the parts of the immature brain that control muscle function. Muscular dystrophy. Toe walking sometimes occurs in this genetic disease in which muscle fibers are unusually prone to damage and weaken over time. This diagnosis might be more likely if your child initially walked normally before starting to toe walk. Autism. Toe walking has been linked to autism spectrum disorders, which affect a child's ability to communicate and interact with others. Toe walking out of habit, also known as idiopathic toe walking, sometimes runs in families. Persistent toe walking can increase a child's risk of falling. It can also result in a social stigma.
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