Walking on the balls of your feet or your toes is referred to as toe walking. If a child continues to toe walk after 3 years of age she probably will continue to do so for many years. A congenital short Achilles tendon could be the cause (you are born with a short tendon that joins your calf to your heel) or, more often, the cause is learning to walk wrong. Learning to walk wrong is known as “Idiopathic Toe Walking.” Idiopathic Toe Walking can lead to a heel cord contracture. There are other serious causes for toe walking that require a full physical examination by a physician to diagnose. We also treat toe walking that is caused by cerebral palsy.
Toe walking can cause the front part of your child’s foot to become disproportionately wider than the heel. This can make finding shoes that fit hard to find. Sometimes they will walk on the backs of their shoes. There is no evidence that toe walking can cause problems into adulthood. However, in a childhood setting, toe walking can be a cosmetic problem that can lead to social problems.
What is the Treatment?
Pediatric Orthopedics of Brandon and Riverview offers a serial casting program to treat children who are Toe Walkers. Your child’s first visit will include an evaluation to see if she has a serious cause for toe walking or if she has Idiopathic Toe Walking. Most children we evaluate do not have one of the more serious causes for the problem. We usually recommend serial casting as the treatment for Idiopathic Toe Walking. The casting process usually takes 4 weeks. Every week you will come to the office to be placed into a walking cast that your child can walk in for a week until the new one is placed. The casts stretch the Achilles tendon and also teach the child to walk heel to toe. After the casting is complete, your child will need to wear ankle foot orthoses (AFO’s) during day time and night time for 6 months and then night time only for another 6 months. The daytime AFO’s fit into shoes. We make every effort for the process to be enjoyable for your family and as convenient as it can be.
Tips and Frequent Questions
- Serial casting involves placing a fiberglass cast from just below the knees to the toes.
- We offer waterproof casts that can fully submerge in the bathtub and the pool
- We have a lot of fun color options for the casts that usually gets the children excited about picking out themselves.
- Every week when you come back we take off the casts to check the skin and ankle motion.
- The second or third casting session we will remove the casts and send you over to the orthotist (the specialist who makes the AFO’s) to fit your child for the braces. You will then come right back over to our office so we can place your next casts.
- Your child is able to get around fairly easy with the casts on, however, she may need assistance if you have a day full of walking planned.
- Sometimes the AFO’s break or cause redness. If this happens, you will need to call the orthotist right away to fix the problem.
- You can take off the AFO’s for bath time and certain activities.
How do we get started?
You schedule an appointment at POBAR with Dr. Bradley. The evaluation will be done at that appointment. If serial casting is indicated we can start you in the program that day or any other day that is convenient for your family.
What is Toe Walking? If a child continues to toe walk after 3 years of age she probably will continue to do so for many years.
Dr. Timothy M. Bradley
Raising the Bar in Pediatric Orthopedics