My 10 year old son is a habitual toe walker. He can walk on his feet when concentrating on it, but when not, he's back on his toes. He does not have CP. 3 years ago he wore casts for 6 weeks - no success. His doctor has now suggested Botox shots, then casts for 2 weeks, then braces for 6 months. I would like to hear from other parents who have children with this problem and your experiences with Botox, casts and braces. I am unsure about the Botox shots - any experiences you can share would be greatly appreciated. Thanks!!!!

hello--my daughter is almost 8 and she does the same thing. i have to constantly remind her to walk flat and i have never understood why she does this and have been curious. what is the ds or dn or whatever it was u said?? and is this something i need to worry about?? thank you!!

ok sorry cp lol!!

Some of the causes of toe walking, according to the doctors we have seen, are Cerebral Palsy, Tight Heel Cords and Habitual Toe walking. Habitual toe walkers have no physical cause, they just persist in walking on their tiptoes. They can stand flat when you ask. Sometimes the problem resolves by itself. My concern is that my son's heel cords could become tight if he doesn't walk normally. The doctor said if we do nothing now the problem will become less noticeable as he becomes an adult. I would like to avoid the casts again - I just want to know that I am doing what's right for my child. The problem is not stopping him from normal activities but it does affect his balance during times when he needs to stand still.

Hi my son is a toe walker, he is only 2.5 yrs old, but I can almost guarentee that he will still be doing it at 10! He is autistic, and although your son is not autistic (I assume), he may do it for the same reason as mine, and that is simply because it alters the perspective on the world, they simply enjoy the different feeling that it gives. I am not really concerned about my son toe walking, so long as it doesnt damage his muscles, I view it as "each to thier own", there is so much in life that we have to do no matter whether we want to or not, so its nice to have an escape, something that may relieve stress, or anxiety? or what ever each child does it for. Good luck with your child, if you find a way around it I will certainly be interested in know (if my little one is still doing it when he about 15 I think Ill really be panicking then!!! http://www.healthboards.com/ubb/smile.gif Take care Cindy

My son is 10. He Toewalks and has his entire life. Ideopathic or Congenitally short heel cords. We have heard both and seen 5 pediatric orthopedic surgeons. The choice now is Botox, Gastocnemus Recession, or Lenthen the Heel Cords. What is the worst case senario if we do the heel cord surgery? Has anyone done any of these with a 10 year old? We can not find a Dr that has treated a 10 yr old, always younger? Does this mean it is too late? Thanks for the help.

Yet another possible explanation is anterior pelvic tilt, also known as anterior rotation, antroversion or pelvic flexion, depending on the practitioner. They all seem to have their own lingo.

When the pelvic tips forward this causes body weight to be shifted to the toes, the knees lock back and the calf muscles (heel cord)tighten up for balance. It's usually the quadriceps (anterior thigh muscles) doing it but nobody ever checks the upper thigh because the symptoms are everywhere else (the toe walking and heel cord).

Normal angle of the pelvis for boys is 0-5 degrees and for girls 5-10 degrees. It's measured with a goniometer which is like a protractor that you used to measure angles in geometry class. The measurement is taken between two bony landmarks on the pelvis called the ASIS and the PSIS.

Any physical therapist should know how to do this.

Massage therapists trained in neuromuscular therapy and other similar structural bodyworkers may also know how to take this measurement.

The treatment is massage to release the quadriceps followed by stretching.

[This message has been edited by plymouth (edited 09-10-2003).]

my2eyes - another message forum you might find helpful is www.orthoseek.com. (http://www.orthoseek.com.) Go to the message forum under children's foot problems - then toe-walking. I hope you find some answers to your son's toe-walking.

My son was also a toe walker. He could stand flat when prompted but for only one or two steps then he was right back up. His orthopedic surgeon wanted to put him in casts but one of my friends suggested skate boarding shoes. I spent $20.00 at sketchers and bought a pair with a sole that would not bend at all. They look like regular tennis shoes and my son wears them every moment he is on his feet. He can go up on his toes, in the shoes, about one inch but goes right back down because it is uncomfortable. Hope this helps.

My son Paul has Autism and was toe walking as soon as he started walking . I to was very concerned about his cords getting to tight or short. What saved us was we lived on the beach and my Dr. suggest we let him walk on sand everytime we got the chance. the summer he was 18 months and then 2 &1/2 we let him walk on the sand every chance we got. it was impossible for him to toe walk in the sand. He eventually stoped toe walking, Don't know if he just outgrew it, the sand helped. or he just got to heavy to do it anymore. but he stopped with out needing any treatment with cords.

This is very common with Autistic kids as well as kids with Aspegers. You can have your child screen, sometimes even through the schools Or Dr.s.

Toe walking is common for lots of kids. I have 3 daughters who toe walk--one has CP, one has PDD-NOS, and one is develoiping typically.

My daughter who has CP has had braces and Botox treatments before. The safety of Botox is nothing that concerns me anymore; however, my daughter needs to go under GA to recieve it which is something I'd rather avoid if possible. Of course she receives several injections in several different muscle groups, guided by an EMG needle, and tends to be easily frightened so going under GA is much more humane for her. OTOH if she only needed a couple of injections, without EMG guidance, some sleepy juice (Versed) and local numbing cream (Emla) would probably be sufficient. We have not done any casting because it is a major PITB and I don't expect my daughter would tolerate it well. Braces are no big deal, although the casting experience can be frightening for young children.

With regards to your situation, I would definitely try braces, and maybe Botox which could make the braces more comfortable for your son depending on how tight he is. I would not cast him unless he is very tight and cannot get to his end ranges. Even then, I would try Botox, braces, and exercises first. My daughter has been able to gain range of motion with Botox and keep it over the long term. Your son can always sleep with the braces on, which will give him a good, long stretch, and practice using his new range during the day. Extended use of braces and/or casts leads to muscle atrophy; on the other hand weakening targeted muscles may be part of the treatment goals. Oh, and you may also want to work with an OT or PT during this time who can give your son exercises to practice to maximize learning wlaking with a heel-toe gait.

A previous poster asked what is the risk of orthopedic suregry...over lengthening is the answer. In the instance when someone is over lengthened new problems arise. However, if lengthening is needed check out Dr. Roy Nuzzo in New Jersey. He has developed a lengthening procedure for the fascia which carries no chance of over lengthening.

HTH!

My daughter is 4 and has been toe walking for 3 years. She doesn't have Autism or Cp but is really high on her toes and always is. She has been working with a PT weekly and wears braces (ankle foot orthotics). Her flexibility has improved but still has a major habit. We are starting to see some deformity in her toes and was wondering if anyone else has seen that. Instead of being straight - they are starting to point outwards. Thanks for your thoughts!

I am a toe-walker. Have been my entire life, though I'll admit that my parents never paid it any mind. I do have Asperger's, but truthfully... I couldn't say that was the reason for it. I was born with no arches in my feet whatsoever and it's incredibly uncomfortable for me to walk with my feet flat. I've stopped bothering with trying to walk flat, even while at work. Hurts too much and, let's be frank, nobody really cares in the end... so, so long as it doesn't cause a problem then I'd say it's of little to no concern.

My daughter is 4 and has been toe walking for 3 years. She doesn't have Autism or Cp but is really high on her toes and always is. She has been working with a PT weekly and wears braces (ankle foot orthotics). Her flexibility has improved but still has a major habit. We are starting to see some deformity in her toes and was wondering if anyone else has seen that. Instead of being straight - they are starting to point outwards. Thanks for your thoughts!
My son is turning 3 and has always walked his toes. . .his tippy tip toes! He will walk flat when asked now and we ask about 100 times a day. He's started to stand flat when concentrating or when stopped. . .most of the time but as soon as he's on his way its back up. We've been to P/T and O/T and braces, nothing stops it for long. His toes are splayed out a bit as well I think due to the grip they need of the ground. I am hoping that with time and more walking flat they will rotate back in. He is fast but a little more unstable so there are a few extra bumps and bruises. How is the therapy working?

[QUOTE=DolceMom;3202083]My son is turning 3 and has always walked his toes. . .his tippy tip toes! He will walk flat when asked now and we ask about 100 times a day. He's started to stand flat when concentrating or when stopped. . .most of the time but as soon as he's on his way its back up. We've been to P/T and O/T and braces, nothing stops it for long. His toes are splayed out a bit as well I think due to the grip they need of the ground. I am hoping that with time and more walking flat they will rotate back in. He is fast but a little more unstable so there are a few extra bumps and bruises.

my daughter is almost 4 and she always walks on her toes. everyone points it out and tells me how cute it is that she does this, but i've never been told it's a problem before. how do you determine if your child needs PT for this, or if it is just a cute thing she does? my 21 month old is starting to do it as well, but we always thought she was just copying her sister.

I have a child with CP and his is constantly on his toes unless he is wearing his braces. Has your ped mentioned anything about testing your child for Muscular Dystrophy? Toe walking can be one of the first indications. If your child does not see a neurologist, I would ask your ped for a referral to one or at least mention this possibility to him/her.

Good luck.

Amy

My 7 yr. old son has been walking on his tip toes since he started walking. Everyone said he would out grow it, but he is almost 8 and is still doing it. I wasn't to worried about it at first but I noticed he tended to trip a lot, he couldn't run real fast and he can't stand up straight with his feet together. I started thinking about what walking in stelleto shoes from sun up till sun down for 7 years would do to my back & my ankles, that is what made me decide we needed to help him get off his toes. The best thing we have done for him is stretch his legs out 3 times a day and have him do 20 laps heel to toe walking a day.
It makes it easier for him to walk flat footed when his muscle aren't so tight.
As far as trying shoes to help, the only ones that keep him on his flat feet are his motorcycle boots.

My Niece was a toe-walker right from the day she started walking. As she got older I felt sorry for her because she couldn't keep up with the other children as much. My sister tried everything from therapy to acupunture but in she ended up having surgery at 4, it was a simple surgery to correct her tendons in her legs and she is on her flat feet now. She does wear casts but not all the time and she is doing great.

Mammalovejoy. Hey! I am just in the process of doing some research and I stumbled across this post. So far, it seems you are the most knowledgable and informed average joe I have come across. Our 9 yr.old son (nearly 10) is a pronounced toe walker and also has very flat feet. We have seen so many Dr.s and are in the process of getting him a new pair of orthotics, we do regular stretching as well, but we just aren't really seeing results. I am looking for a Dr. who knows more than all the ones I have seen! And I am looking for people who have walked this road before and have some experience to offer.

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I'm sorry, I didn't mean to go outside the bounds there, I acutally hadn't really gotten aquainted with the page yet. My point was, I have a desperate need for more than the Dr.s are offering! We had one Dr. tell us that the only other option besides surgery was to get him a pair of high heels! I almost slapped the guy! Needless to say we haven't been back. We have seen probably 10 different Dr.s and haven't had much hope. I saw your post with all the right acronyms and language and it sounded like what you have already gone through, the steps you have already taken, are the things we haven't even been offered. I am just looking for more information, maybe a Dr. in our area. We live near West Palm Beach and are close enough to Miami (I hope I am aloud to say that) and I just know there has to be someone here who can help us. I have called countless Dr. offices asking questions and seeking the right person. If you, or anyone, could give me any advice, names of Dr.s (local or not!) any kind of guidance from a perspective of experience, I am in desperate need! Thank you so much!

Hi my son is 5 now and they wanted to do cord lenghting on him but I wanted further testing before the went ahead with it, only to find out that it is a neurlological problem and the sergery probley would have done nothing but put him through unnesesery pain. The MRI reveled that he had a charie malformation, wich is when the skull dose not fully form and the brain slips down and puts pressure on the spinal collum. Causing poor motor development and his toe walking. All I am trying to say is you need to be your childs advocit and if you think its somthing elce don't take no for an answer there is always another opinion. Best of luck.