Toe Walking in Children

As parents, we are very concerned about how our children develop.  One thing that seems to push parents to seek a medical profession is how their child walks.  Is toe walking bad?  Does it mean that they will walk like that forever?  Is it a sign that something else may be wrong?  Let’s discuss.

Toe walking in and of its self is harmless and in most cases is simply how your child has decided to walk.  Many children simply have chosen to toe walk because it is comfortable for them at this stage.  If the child has been walking on their toes since their first step, there is additional assurance that nothing is wrong.  If the child is old enough to respond to verbal commands, ask them to stand on their heels and to walk with their heels touching the ground.  The far majority of children will be able to do this easily and painfree.  This is a sign that there is no underlying problem or surgical issue that needs to be addressed. 

Toe walking is only a sign of an underlying disorder when it is accompanied by other signs of slow development, or if the child was walking on their heels and then suddenly begins to walk on their toes.  If the child is missing other milestones of growth, cognitive development, or other benchmarks, a pediatric physician should be consulted.  If the child was walking normally and then begins to toe walk, or if they begin to toe walk only on one foot, this should also prompt evaluation.  Pinching of the spinal cord from a myriad of possible sources could be the reason and can be addressed and reversed.  It is possible, however,  that the abrupt toe walking is a sign of a muscle or nerve development problem that may not be so easy to reverse.  This represents a very small percentage of cases which your child most likely does not fit into.

In most cases, toe walking is not a sign of an underlying problem, and parents can be assured that their child will walk normally eventually.  We’ll discuss some other common worries parents have for their young children in future posts.

Treatment for Heel Pain in Kids

Last week we discussed Sever’s Disease, or calcaneal apophysitis, which is the major cause of heel pain in children.  Let’s now discuss how to help.

The most immediate relief can be gained by taking an anti-inflammatory medication like ibuprofen.  This will help take the edge off the pain and allow them to continue to participate in athletic events.  A higher dose of ibuprofen needs to be taken in order to have the pain relief.  Pediatric doses depend on the weight of the child and their ability to swallow pills.  This can have an very beneficial effect in a very short time.

Another easy thing that can be done it for the child to wear heel lifts.  A major component to the pain is the pull of the Achilles tendon on the growth plate.  Especially taut Achilles tendons must be relaxed in order to decrease their pull.  Heel lifts can take the tension off of the Achilles and allow the inflammatory process at the heel bone to calm down.

Achilles tendon stretching is the treatment which takes longer to have an effect, but will result in long term relief.  Stand facing a wall with feet facing forward and shoulder width apart.  Take two steps backward.  With one foot, take one step toward the wall, while keeping the other foot 2 steps from the wall.  Lean forward and place both hands against the wall while keeping both keep pointing forward.  This should cause the Achilles tendon in the foot furthest from the wall to be stretched.  This should not be painful, but should stretch the tight tendon.  Hold this position for 30 seconds then switch feet.  Do this at least 5 times a day, more if possible.  This will help to eventually eliminate this problem so that heel lifts and medication are no longer needed.

The combination of the previous treatments should help to resolve the heel pain in a matter of weeks, so that children can maintain their active lifestyles.