TOE WALKING IN TODDLERS & PHYSIO TREATMENT

TOE WALKING IN TODDLERS

It means walking on toes or on the balls of the feet, it is common in who are just beginning to walk, but it can be a sign of a physical problem if it continuous. It can accompany some disorders like cerebral palsy, muscular dystrophy autism spectrum disorder and in some children who have short Achilles tendon and sensory problems. Toe Walkers develops tight calf muscle or back leg muscle and decreased movement of their ankles. Also the muscle on the front their legs become weak and wasting of the muscle of the leg.

Sometimes it occurs in children who have no such underlying disorders and those children are called Idiopathic Toe walkers. It is not a serious condition which often resolves spontaneously and does not cause the child significant problems apart from cosmetic appearance. It is seen more commonly in males than females and in hypo or hypersensitivity condition children don’t like the feeling of different surfaces on their feet, which causes them to raise the heels and walking on Toes.

      Treatment:

• Surgical procedure – Releasing or lengthening the tight Achilles tendon and gastrocnemius muscle.
• No need of surgery for Idiopathic Toe walkers.
• Recently Injection of Botulinum Toxin A (Botox) has been used to weaken the calf muscle thus preventing toe walking.
• Repeated bracing and casting of feet and ankles

Physiotherapy Treatment - Exercise program should be fun so that children enjoy the challenges of achieving goals. The following are the some of the exercises which you can make the child do easily but before starting the exercise programme please consult your doctor and physiotherapist.

• Marching on the spot. Make the child bring their knees up high and then land with a flat foot 
• Walking uphill
• Walking on an uneven surface such as Sand
• Sit to stand exercises
• Encourage them barefoot standing using a variety of Textures.
• Make the child do squats on a foam balance pad, Squatting also helps in transmitting the body weight evenly on both the feet which helps in improving sensation also.
• Tell the child to walk on the heels only, Keep the Toes off the ground at all times.
• Balance Exercises
• Strengthening Exercises,
• Tell the child to pick up small objects with their Toes.
• Climbing stairs and
• Stepping over obstacles    
• Gently Stretching of the leg and foot muscles
• Leg braces and splints 
• Wearing proper shoes – Before taking shoes to your child please check these once. Select a high cut shoe with a wide sole which provides good foot support. The Shoe should not be flexible in the middle section. The back heel should be firm.
• Make the child stand without shoes on a dynamic surface, like incline wedge or wobble board. So, that they shift their weight to maintain balance and will experience an active stretch of the affected muscle. 
• Stretching – In a lying position, hold their foot in your hand. Apply light pressure by bending the foot upwards, once you feel tightness or resistance hold for 10 to 15 sec and release. Repeat to alternate foot and stretch.