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elynnmom Forum Rookie
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Posted: Feb 06 2012 at 8:33pm | IP Logged
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I'm wondering if any of you have children who toe-walked and what your experience has been with therapies/diagnosis/etc.
My 5 yo ds has walked on the balls of his feet since he began walking at 17 1/2 months. We recently brought this to the attention of our pediatrician who referred us to an orthopeadic surgeon who referred us to a physical therapist. The PT gave us some inserts for his shoes and 6 stretches that we have been doing diligently for 4 weeks. We had a visit to the PT last week and she told us to keep working for 4 more weeks. My understanding is that if the stretches don't work (which from the PT, it seems like it's going slower than she thought), the surgeon will recommend surgery.
I just want to be sure we're not missing anything.
Thanks so much for any thoughs you may have!
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DominaCaeli Forum All-Star
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Posted: Feb 07 2012 at 11:15am | IP Logged
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Interesting. My 5yo daughter walks on her tiptoes most of the time, and I have never thought much of it. I have heard it's not the best for children's developing legs/muscles, but I have always assumed it would correct itself naturally. Is your son not able to walk otherwise? My daughter can walk normally as well, but prefers not to. She actually was complimented my her ballet teacher for her calf strength. I'm just wondering whether this is something I need to look into.
__________________ Blessings,
Celeste
Joyous Lessons
Mommy to six: three boys (8, 4, newborn) and four girls (7, 5, 2, and 1)
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elynnmom Forum Rookie
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Posted: Feb 07 2012 at 8:45pm | IP Logged
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My son has beautifully defined calves as well . And he can also walk normally if we remind him, but most of the time he's up on his toes. The only reason I asked my ped. about it is because a friend, who is a nurse, pointed it out to me as a concern. From googling it and talking with my ped, I did found out that toe walking after 2 years of age should be checked.
I'm curious, can your daughter balance well on one foot if her foot is flat? My son can't, but he's been able to ride a bike for over a year (so he does have a sense of balance). The PT thinks it is because he is so used to being up on his toes, that his sense of balance is off when his feet are flat.
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SeaStar Forum Moderator
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Posted: Feb 07 2012 at 8:59pm | IP Logged
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I found this article on toewalking from the Mayo Clinic very helpful
Basically it says that most young children toe walk, and that if it persists after 2 years it is mainly just out of habit and is usually not a concern if the child is developing normally otherwise (able to walk normally if he wants, developing normal fine motor skills, etc).
I know from past experience that true toe walking is a neurologic problem, and the best place to go for the right diagnosis is a neurologist. One of the first questions a pediatric neurologist will ask you is: does your child toe walk?
__________________ Melinda, mom to ds ('02) and dd ('04)
SQUILT Music Appreciation
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CatholicMommy Forum All-Star
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Posted: Feb 07 2012 at 9:03pm | IP Logged
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My nephew has this. We thought it was kind of cute - until we learned it can lead to serious problems!
He can walk on flat feet and we always reminded him to - and he would for a little bit. He just always thought it was easier to walk on tip-toes... well, it's letting the muscles atrophy and not forcing them to stretch at the proper places.
He has the at-home stretches, the leg brace (one for sleeping, one for daytime), physical therapy and all. As long as they stay on top of it, he does a lot better; as soon as his mom (my sister) lets up a little bit, he goes right back to tip-toes. His grandfather (my sister is a half-sister of mine - so different dad) had the same problem, so they didn't pay much attention to it at first. He says he outgrew it, but I have a feeling it was "beaten" out of him given his childhood upbringing....
The problem is that the muscles are actually developing wrong by allowing it to continue. If it goes too long, the muscles will continue to strengthen in the wrong spots and as they hit puberty, certain muscles will actually continue to shorten, which will lead to more problems.
Not to be a worry-wart! Just keep up with the therapy, don't skimp on any of it - and do lots of muscle massages to keep things limber. It WILL improve. And if surgery is necessary - you know we'll all be praying him through it!
__________________ Garden of Francis
HS Elementary Montessori Training
Montessori Nuggets
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Kathryn Forum All-Star
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Posted: Feb 07 2012 at 9:14pm | IP Logged
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There is also a casting they can do before surgery but not sure how effective that has proved to be.
__________________ Kathryn in TX
(dd 16, ds 15, dd 8, dd 5)
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Martha Forum All-Star
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Posted: Feb 07 2012 at 11:00pm | IP Logged
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Quote:
One of the first questions a pediatric neurologist will ask you is: does your child toe walk? |
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and if you say 'yes'???????
My dd11 has been doing this for years.
Drives us batty and we correct her on it constantly. usually nicely.
I distinctly rmember my 5th grade gym teacher at public school screaming at me to stop it from across the track. So I didn't think much of my dd doing it other than to tell her to stop it. It has become a terrible habit for her. (My ped says it's bc she doesn't have the grand experience of having a gym teacher scream at her in front of the entire 5th grade to stop it before it became a habit. )
__________________ Martha
mama to 7 boys & 4 girls
Yes, they're all ours!
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SeaStar Forum Moderator
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Posted: Feb 08 2012 at 6:08am | IP Logged
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If you say yes, the doctor will pay very close attention to gait on physical exam and have the child do a number of things to help rule out neurologic diseases.
True toe walking can indicate cerebral palsy, autism or other brain diseases.
__________________ Melinda, mom to ds ('02) and dd ('04)
SQUILT Music Appreciation
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JennGM Forum Moderator
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Posted: Feb 08 2012 at 7:46am | IP Logged
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My grandmother was a toe walker. It was funny to watch her tiptoe. She rarely went barefoot, couldn't wear flat shoes. It was funny to see her in high heels or wedges EVERYWHERE. Even camping.
But the toe walking started when she was a child, and by the time she was an adult her muscles and tendons were too far into that position to make it comfortable for her to flatten it out.
I'm just giving an anecdotal story, not a scare store. We never knew if there was a problem at the beginning, just that she toe-walked and always wore heels.
__________________ Jennifer G. Miller
Wife to & ds1 '03 & ds2 '07
Family in Feast and Feria
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elynnmom Forum Rookie
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Posted: Feb 08 2012 at 9:43am | IP Logged
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SeaStar wrote:
True toe walking can indicate cerebral palsy, autism or other brain diseases. |
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Do you know if the treatment for the toe-walking itself is the same (ie. stretches, orthotics, possible casting and as last resort, surgery) whether it's neurological or habitual?
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Kathryn Forum All-Star
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Posted: Feb 08 2012 at 10:04am | IP Logged
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I would imagine the treatments are for it being a habit. If there were a true neurological/brain reason, my guess is those issues would have to be addressed since the toe walking was a "brain function" and any attempt to orthotically correct it would just make it go back to the way the brain has taught it. ?!!?
__________________ Kathryn in TX
(dd 16, ds 15, dd 8, dd 5)
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SeaStar Forum Moderator
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Posted: Feb 08 2012 at 11:34am | IP Logged
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Kathryn wrote:
I would imagine the treatments are for it being a habit. If there were a true neurological/brain reason, my guess is those issues would have to be addressed since the toe walking was a "brain function" and any attempt to orthotically correct it would just make it go back to the way the brain has taught it. ?!!? |
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Yes, an underlying condition would first have to be addressed. Specific treatment for the underlying condition would come first, and that alone might resolve the problem.
But you would most likely be seeing other red flag signs if there was a brain condition causing the problem. Some kids just like to walk on their toes the way some like to twirl their bangs or bite their nails. It's just a quirk that can become a habit that is very hard to break.
__________________ Melinda, mom to ds ('02) and dd ('04)
SQUILT Music Appreciation
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leanne maree Forum All-Star
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Posted: Feb 08 2012 at 7:50pm | IP Logged
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Your son is doing well to put his heal to the ground on request.
I would continue with these exercises, and include hanging the back of his heal over a step to lengthen the tendons and muscles.
The condition you decribe is much like ladies who wear high stilleto shoes and shorten there long muscles in there calves.
Surgery is the next step, but I think with phsio., and persistance from you and dh encouraging him, it will be resolved.
Let us know how he gets on.
Leanne
__________________ God is Love
Leanne
Loving wife to Dermot and Adoring mother to Louise, Kristie, Kieran & Brid
http://leannemaree.blogspot.com/
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elynnmom Forum Rookie
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Posted: Feb 09 2012 at 10:59am | IP Logged
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I put a call into the ped.s office this morning to check why she referred us to the orthopeadic surgeon vs. a neurologist. That is really my concern - that everyone is looking at him in isolation (the surgeon through her lense, the PT from her lense, etc). The surgeon asked if he had ever been evaluated for Cerebral Palsy (he hasn't), which is what go me thinking - if she's not checking him for this, then who will? She is the specialist we were sent to to figure this out! While my dear son doesn't have big red flags, he has a lot of little yellow ones, if that makes sense... we've always wondered about him - just different than the other three kids in many little ways. Anyway, thank you all for the input, I'll keep you updated about the response from the doc.
I also appreciate the antecdotal stories!
Catholicmommy wrote about her nephew's stretching regimine. Ours takes 1 to 1 1/2 hours a day. ds is such a trooper and works so hard.
Thanks for all the support!
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