13 Feb'23

What Is Toe Walking?

Toe walking is when kids walk on the forefoot, with their heels off the ground. It is common in toddlers as they learn to walk. Most children stop toe walking on their own by age 2. Toe walking is a gait abnormality characterized by an absence of normal heel contact (heel strike) by both feet during gait.


Cause

Tightness in the Achilles tendon causes toe walking. Achilles tendon connects the calf muscles to the heel. In some children who toe walk, this muscle-tendon junction may be shorter at birth, or may shorten over time, which prevents the child from touching their heels to the ground and walking flat-footed. Tibialis anterior muscle also become weak due to disuse. Tibialis anterior muscle helps in pulling the foot towards body.


In a smaller number of cases, persistent toe walking can be a sign of an underlying medical condition, such as:
  • Cerebral palsy/li>
  • Muscular dystrophy
  • A spinal cord abnormality
  • Neurological conditions
What are the symptoms of toe walking?

The main and most noticeable symptom of toe walking is your child walks on their toes and balls of their feet. When asked to walk in a regular, flat-footed pattern, most young children can do so. But if your child continues to walk on their toes, you may also notice:

  • Decreased balance and coordination.
  • Frequent falls.
  • Problems wearing shoes.
  • Difficulty participating in sports or other recreational activities.
  • Complaints of pain.
  • Tightness in their heel cords.

What are the long-term effects of toe-walking if left untreated?

If left untreated, toe-walking can put your child at further risk for contractures (i.e., shortened muscles), foot deformities and balance issues. In severe cases, child may need surgical interventions if deformities or contractures are present. Fortunately, physical therapy interventions are often an effective way to treat this condition.


Physiotherapy Management?

Physiotherapy can assist in achieving a heel-toe gait pattern. It may also correct any range of motion restrictions and muscle imbalances.

  • ROM EXERCISE TO ACHIEVE DORSIFLEXION
  • STRETCHING EXERCISE OF CALF MUSCLES
  • STRENGTHENING EXERICSE OF TIBIALIS ANTERIOR MUSCLE AND STIMULATION IF REQUIRED
  • AFO HELPS IN SUSTAINED STRETCHING OF TENDON OF ACHILLES