Why Do Children Walk on Their Toes?
Toe walking is common in young children. Some children walk on their toes out of habit, however you should have your child evaluated if they continue to walk on their toes. Toe walking can be associated with several conditions, which include:
- A Short Achilles Tendon/Tight Heel Cord
- Cerebral Palsy
- Muscular Dystrophy
Tight Heel Cord In Children
The tight heel cord is one of the root causes of many mechanically related foot and ankle conditions. Many children may seem to “grow out of it” when really they are compensating and causing incredible stress on the foot causing eventual breakdown of joints that can lead to acquired flatfeet and rupture or stretching of soft tissue supports in the arch later on in life.
In mild to moderate cases the tight heel cord can be monitored and controlled with conservative treatments. Heel cord stretching and orthotics and supportive shoes are often recommended to control the associated symptoms. Casting may be attempted to stretch out the tight Achilles tendon.
In more severe cases, the tight heel cord often requires some form of a Surgical Heelcord Lengthening .
There are several techniques for lengthening along the heel cord:
- Achilles Lengthening: Performed just above tendon insertion.
- Gastrocnemius Recession: Performed near tendon/muscle interface.
In young children, these procedures can be performed on both sides at the same time. Children are typically placed in weight-bearing casts for 1 month. Rehabilitation afterward is important to ensure the tight heel cord does not return.
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