Idiopathic Toe Walking: Its Meaning and Frequency in the Population
**Addressing Idiopathic Toe Walking in Children: A Comprehensive Guide**
Idiopathic toe walking (ITW) is a common paediatric condition, affecting approximately 5-10% of children during their childhood. This condition, characterised by a child walking on their toes without placing their heels on the floor, is typically observed when a child continues to walk on their toes beyond the usual age when heel-toe walking develops (after age 3).
The exact cause of ITW remains unknown, although it is often attributed to a combination of factors such as weakness in the calves, sensory issues, family history, habit, and undiagnosed conditions. In some cases, the Achilles tendon in the leg can shorten due to ITW, making it even more difficult for the child to walk normally.
Diagnosis of ITW involves a series of tests, including neurological tests, musculoskeletal examinations, gait analysis, and in some cases, imaging like MRI scans. It is crucial to monitor ITW and consider treatment if it does not improve over time.
Treatment options for ITW can include stretching and strengthening exercises, encouragement to go on long walks in stiff shoes, wearing supportive footwear or orthotics, and serial casting. Serial casting is a treatment for ITW that involves placing a child's foot into plaster casts, which are changed weekly, to slowly stretch out the muscles and improve the flexibility of the foot joints.
In most cases, children respond well to conservative treatments like physiotherapy and home exercises. Targeted exercises to improve muscle length (especially calf muscles), strength, and motor planning can help increase heel contact during walking. In some cases, braces such as SureStep SMOs can provide support to correct gait patterns, improve foot alignment, and enhance mobility and confidence.
It is important to note that for most children, ITW is a temporary phase rather than a long-term concern. However, early assessment is essential to prevent muscle shortening and gait abnormalities that might require more invasive treatment later.
Children with autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) are more likely to experience ITW. Moreover, ITW is more common in boys than girls, although the reason for this remains unknown.
If your child continues toe walking for a long period of time or experiences any discomfort, it is advisable to seek advice from a healthcare professional to explore potential treatments. Other symptoms include pain or tightness in the feet, losing balance easily, slower running or walking, poor endurance, and a shorter Achilles tendon.
In conclusion, ITW is a treatable condition that can be managed effectively with a combination of physiotherapy, home exercises, and supportive footwear or orthotics. Early intervention is key to prevent complications and ensure optimal lower limb range of motion for the child.
Mental health is crucial in the treatment and management of idiopathic toe walking (ITW) in children. For instance, addressing any underlying conditions such as autism spectrum disorder (ASD) or attention deficit hyperactivity disorder (ADHD) may help improve the child's willingness and ability to participate in treatment exercises. Furthermore, maintaining good health-and-wellness practices, including regular exercise and a balanced diet, can support the overall wellbeing of the child and aid in their recovery.
