When a child toe walks, he or she walks on the balls of the feet – the heels do not make contact with the ground. This condition is common with children who are in the learning stages of walking. However, after the age of two, most children transition naturally from toe walking to walking in a normal manner with a heel-to-toe walk pattern. At TEAM 4 Kids, we offer physical therapy services that are able to help resolve the issue of pediatric toe walking.
Solutions for Toe Walking
The type of treatment suggested for toe walking depends on various factors, including the age of the child and whether the child has the ability to walk flat-footed.
Nonsurgical Treatment
For children ages two to five years old having the ability to walk flat-footed, the first treatment option suggested is a non-surgical treatment. Some non-surgical treatment options include:
- Observation. Regularly monitoring your child with routine visits to the doctor over a period of time may resolve the issue, particularly if your child has been toe walking as habit. The child may simply transition to a normal walking pattern on his or her own.
- Physical Therapy. There are many physical therapy exercises that can help children transition away from toe walking to normal heel-to-toe walking. A pediatric specialist can help your child participate in the best exercises and activities, including various stretches, walks, and range of motion exercises, to achieve the desired results over time.
- Casting. A doctor may apply several short leg walking casts to stretch the calf tendons and muscles progressively over time (often several weeks) and break the child’s toe-walking habit.
- Bracing. A doctor may prescribe an ankle-foot orthosis (plastic brace) for the child to wear which can stretch and lengthen the muscles and tendons in the lower leg. This brace keeps the foot at a 90 degree angle and is usually applied for a period of months as opposed to just weeks with walking casts.
- Botox therapy. If the child has a neurological abnormality that causes greater muscle tone, a doctor may inject Botox® to temporarily relax the calf muscles, allow them to stretch better when the child is wearing serial walking casts or bracing.
Surgical Treatment
If a child is over the age of five and still toe walking, the child’s Achilles tendons and calf muscles may be so tight that it is not possible to walk heel-to-toe. In this case, the doctor may suggest lengthening the Achilles tendons through a surgical procedure. The goal of lengthening the tendons is to expand the range of motion and enable the ankle and foot to function better. If your child has been toe walking for some time now, contact our physical therapy team to discuss the issue and we can offer solutions, including exercises that can help your child progress into a normal walking pattern. Call us today at 800.376.3440, send a text to 602.919.1060, or email us at [email protected].