Walking on toes is common among children for first few years of their milestone. However, after 2 years most of them begin to walk with their foot resting on the ground. Sometimes the toddler walks on toes out of sheer habit or just for fun. As far as the growth and development of the child is normal, toe walking is not a cause of worry.
But it should be a cause of concern for the parents when the toddler walks with an abnormal gait or has uncoordinated movement once the child crosses the toddler age.Because, persistently walking on toes can be a sign of muscle or nerve disorder.
What Causes A Child To Walk On Toes?
As said earlier in beginning few years walking on toes is considered normal. However, if the child does not outgrow toe walking after the age of 2 to3 years, the child needs physical assessment as there are several related causes for walking on toes. Early detection and correction will allow the child to walk without disability as he grows into adulthood.
- Shortened Achilles tendon: This tendon attaches the muscles of lower leg to the heel bone. It is a major tendon which allows free range of motion of foot and ankle. A short Achilles tendon prevents the heel from touching the bare floor. As a result the child has to walk on tiptoes.
- Cerebral palsy: Toe walking can occur due to spasticity of muscles. It means the muscles are stiff. Spasticity is a form of cerebral palsy. Children born prematurely are more at risk of developing cerebral palsy. Damage to the brain during the time of birth can affect the foot movement. An infection in the baby or mother during pregnancy can damage the brain leading to a condition called cerebral palsy.
- Muscular weakness: Toe walking can occur due to abnormality in muscles. It may be associated with genetic muscular disorder. The condition is gradual and it should be suspected in a child who used to walk normally before beginning to walk on his toes.
- Autism: Toe walking is also common in a child suffering from autism. It is a disorder in which the child lacks communication skills.
Once if all the above causes are ruled out, and even than the child walks on tiptoes, the cause is considered to be idiopathic. It means the cause is not known and toe walking is just a habit.
How To Stop Toddler Walking On Toes?
In most cases the child outgrows toe walking after the age of 2 to 3 without any outside corrective measures. The best thing that needs to be done during this period is to observe the child on how the condition progresses. There are few simple corrective measures which are helpful.
- Children with short Achilles tendon are advised to wear ankle foot splint or braces during daytime. The purpose is to stretch the tendon to facilitate smooth walking. Ankle foot orthosis helps the foot to remain at 90 degree angle.
- In severe cases cast is recommended to stretch the tendon. The cast has to be changed weekly to maximize the pull of tendon.
- Sometimes when the calf muscles are stretched as in muscular dystrophy, botox is injected as it relaxes the muscle. Due to its effect the stretch on Achilles tendon is reduced.
- Lastly if all the measures fail, surgical correction may be recommended.