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Toe Walking



Though this may not seem like an issue early on, toe walking can create challenges for a child in their future. In simpler terms, toe walking doesn’t allow the feet to have normal weight progression; instead, it puts all of the pressure on the balls of the feet. All of the joints in our bodies are connected and, because of this, the way a child walks can affect other parts of their body. Toe walking has been shown to accompany excessive pelvic tilt, genu valgum, genu recurvatum, and/or external tibial torsion. Along with these musculoskeletal issues, force production needed in activities, such as running and jumping, can be difficult to generate due to the inadequate development of the ankle joint. Other effects are bony changes in the feet which often create difficulty when fitting into shoes, an altered sensation of legs, chronic leg/hip/back pain, decreased strength in legs and core, and general difficulty when participating in daily activities. In short, our feet and our gait pattern are important to address. Luckily, one of the treatments for toe walking is physical therapy!


To get started, below are some at-home exercises you can do right here, right now!


1. Marble pick up – Grab a handful of marbles, dump them on the floor, and have your child use their toes to pick them up one by one. This is beneficial to the foot intrinsic muscles and for balance practice. If you don’t have marbles, you can also try substituting uncooked pasta or legos!

2. Towel roll up – Grab a towel, roll it up tight, and place it underneath the balls of your child’s feet. This is a great stretch of the Achilles tendon. The bigger the towel, the bigger the stretch. Pro tip: use the distraction of playing with toys on a table or watching TV to get them to stand on it!

3. Duck walks – These are challenging, but fun! Have your child walk in a squatting position, resembling that of a duck. Though they’re having to walk on their toes, being able to do this shows great dorsiflexion through the ankles while also getting an active stretch through the tendon. More importantly, it’s fun!


References

  1. Clark E, Sweeney JK, Yocum A, McCoy SW. . Effects of Motor Control Intervention for Children With Idiopathic Toe Walking. Pediatric Physical Therapy. 2010; 22 (4): 417-426. doi: 10.1097/PEP.0b013e3181f9d5b8.

  2. Harkness-Armstrong C, Debelle HA, Maganaris CN, et al. Effective Mechanical Advantage About the Ankle Joint and the Effect of Achilles Tendon Curvature During Toe-Walking. Frontiers in physiology. 2020;11:407. doi:10.3389/fphys.2020.00407

  3. Bothell Pediatric and Hand Therapy. (2021). Long term effects of Untreated Toe Walking. Youtube. Retrieved July 25, 2022, from https://www.youtube.com/watch?v=22Dw_4UwnNs.

  4. Pomarino D, Ramírez Llamas J, Martin S, Pomarino A. Literature Review of Idiopathic Toe Walking: Etiology, Prevalence, Classification, and Treatment. Foot & ankle specialist. 2017;10(4):337-342. doi:10.1177/1938640016687370

  5. Why is my child walking on their tippy toes? The Mom & Caregiver. (n.d.). Retrieved July 26, 2022, from https://themomandcaregiver.com/toe-walking/


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