Toe Walking Causes in Infants & Kids
How toe walking occurs is a question that many parents of children and infants have. While toe walking may not be an incredibly serious condition, it can become a nuisance and is a less efficient way to walk than a normal gait. Because toe walking is something that concerns both children and their parents, learning about how toe walking occurs, can help you better understand what you should do to make sure your child walk better.
If your child has begun toe walking recently or if they have been toe walking for many months without causing any pain or problems, then consider asking their doctor whether it's something you should worry about.
Main Causes of Toe Walking
Most children who toe walk do not have a serious condition that cause them to toe walk, but simply learned to walk wrong. Toe walking can also be the result of a medical problem in some children. It's possible that one or more of the following are contributing to your child's toe walking:
Cerebral Palsy (A problem in the brain)
A muscle or nerve disorder, such as Duchenne’s muscular dystrophy
Autism spectrum disorder
Cerebral Palsy in Infants
In some cases, infants toe walk because they have a neurologic disorder such as cerebral palsy. Infants with cerebral palsy often have a hard time controlling the muscles in their legs and therefore tend to toe walk more often than other children on average. While toe walking in children with cerebral palsy is common, toe walking isn't always connected to the condition. Children who have cerebral palsy almost always have significant development delay and do not begin walking until after age eighteen months.
Duchenne’s and Becker’s Muscular Dystrophy
DMD is a rare, inherited form of muscular dystrophy that causes progressive muscle loss and weakness due to the impairment of a protein called dystrophin, which helps maintain muscle cells intact. DMD is one of four diseases known as dystrophinopathies. Other dystrophinopathies are Becker muscular dystrophy, limb-girdle muscular dystrophy, and myotonic dystrophy.
Children with Duchenne’s muscular dystrophy walk heel to toe when they first walk. They began to toe walk later. The kids with Duchenne’s usually change to toe walking when they are 3 to 5 years old. Children with Becker’s Muscular Dystrophy change from heel-to-toe to toe walking when they are a few years older than the age children with Duchenne’s make the change.
Autism Spectrum Disorder & Toe Walking
In persons with autism spectrum disorders, physicians have noted a higher rate of toe walking. This is a group of conditions that affects a person's communication, social skills, and behavior. Most toe walking cases occur in children who do not have autism.
Other causes of Toe Walking/Heel Walking
There are several hypotheses about toe walking that have been suggested by experts. These include:
Low muscle tone or motor skills
Tight heel cords (Achilles tendons)
Sensory issues and toe misplacement
Issues relating to balance and gait
Most of the kids we treat for toe walking are normal except they toe walk.
Diagnose & Treatment of Toe Walking/Heel Walking
When taking a medical history from parents, it is important to ask about the child’s developmental milestones in addition to performing a neurologic exam and examining their gait. We should ask questions to help determine if an underlying cause for toe walking such as autism spectrum disorder, cerebral palsy or spina bifida is present. If toe walking has been present since infancy, there could potentially be musculoskeletal causes such as tight plantar flexor muscles (in the bottom of your foot). Examples of questions a doctor may ask include:
whether a child was born prematurely or if there were pregnancy complications
when a child reached developmental milestones, such as sitting and walking
if they toe walk on both feet or one
if there is a family history of toe walking
if there are any signs of muscle tone weakness
Schedule an appointment at POBAR with Dr. Bradley and our Merche, our pet therapy dog. We aim to make your child’s first visit as comfortable and safe as possible. This would also include an evaluation to see if the child has a serious cause for toe walking or if they have Idiopathic Toe Walking.