Toe Walking – Not Just For Ballerinas Anymore

I know nothing about dancing. I’ve never been fond of dancing myself. Aside from some occasional thrashing about in nightclubs back in my early twenties, I am generally standing on the sidelines, or more likely, near the food/bar. From what I understand however, dancers, particular those in the ballet, work long and hard to build the strength and flexibility in their calves to allow for dancing on their toes. Apparently this makes movements more graceful and beautiful.

In children, toe walking takes on a completely different meaning. Many children walk on their tip-toes as they learn to walk, and will generally abandon that for a more typical heel-first walking style early on. Sometimes, children do not shake the habit, however, and despite its cuteness, can be pretty damaging both physically and emotionally. We have just begun officially dealing with this in our own little toe-walking son.

A neighbor of ours brought it to our attention over a year ago now. She told us about her own son’s toe-walking, and his need for a serial brace work for portions of every day in order to stretch out the tendons in the Achilles area to allow for a heel-first strike. Xavier advanced through most of his physical milestones early than average, and began walking just as he turned 10 months. Very shortly thereafter, he began running and kicking (I proudly share that he already has “mad” soccer skills). I must admit, it was tough to hear that my budding athlete might have an issue with his legs, but our neighbor’s warning was accurate, and after Xavier failed to shake the habit after more than a year and a half of walking, we decided to have a consultation with a physical therapist at Children’s Memorial Hospital.

The session was held in a typical doctor’s office, but the staff was a bit different. Instead of stethoscopes and tongue depressors, they came equipped with what appeared to be some sort of protractor, some toy cars, and a basketball. As far as Xavier was concerned, there couldn’t be a more entertaining doctor’s office to visit! They asked Xavier to do a series of things like squat down, lay on his stomach (so they could measure the angles his stretched tendons would allow), and walk like a duck. He behaved wonderfully, following every request and suggestion perfectly. Eventually, we made our way to a more gym-like room where other exercises followed.

The result is that while bracing is not necessary right now, we do have some exercises to perform daily with Xavier at home, and will be heading to therapy weekly for the next 4-6 weeks. The exercises are fairly entertaining, so Xavier doesn’t put up a fuss (for now), but it does take even more discipline and diligence in all of us to make sure we are doing them regularly and correctly. I have a high degree of confidence that we are taking care of this early enough that we will be able to correct his walking through exercise alone, but time will tell. Either way, it takes nothing away from his abilities or coordination (remember…MAD SKILLS), so I am not worried.

A word of warning, however, for other parents out there. We were told that though this could just be something natural that he was predisposed to do, some things can exacerbate the problem. Among those things are the family of “exer-saucers” and “walking aids” that seem pretty ubiquitous in children’s playtime rota. Before Xavier was walking, we would frequently let him play in his Rainforest Jumperoo by Fisher-Price. It seemed like an excellent toy to us – he loved it, it appeared to strengthen his legs, and it kept him occupied without crawling all over the condo like some drunken marine doing basic training drills. Come to find out that these toys encourage the child to brace their weight on their toes early on until they graduate to walking. Then, in an evil follow-up, the “walking toys” that seem to help the child walk actually force the child out of control, and that is exactly their problem. When used, the child is encouraged to walk with their weight forward on their toes in order to keep up with the rolling toy. Again, Xavier LOVED his “walker”, though due to frequent collisions with objects both inanimate (the wall or a pile of toys) and animate (my foot or the cat), we were less in love with this one, and will happily forgo its use with Hayden.

Xavier in his Rainforest Jumperoo, a.k.a. Tendon Compactor

In place of these toys, the therapists suggest loads of “tummy time”. If you are a parent, you know what “tummy time” is, and if your not a parent…well, you can guess. Another problem that comes with toe-walking (or is it a cause – I can’t remember) is weak abdominal muscles. Strong abdominal muscles are developed during tummy time, and in turn encourage the weight to fall back on the heels when walking, standing, etc. You can actually see it on Xavier when he tries to perform a sit-up of sorts. A ridge running vertically down the middle of the stomach pushes up as he tenses his abdominals. This ridge, along with a noticeable flaring of the ribcage is the result of the two sides not yet “coming together” (again, I don’t know the scientific terminology). This too should be corrected with these exercises we are performing.

So, if you child, or soon to be child displays the toe-walking and abdominal ridge after 18 months of age, I suggest a visit to a good physical therapist to catch the problem before it becomes an impairment that needs correcting during school years. Kids can be cruel. We’ve all been there – probably on both sides of the teasing battlefield – and whether the child is forced to wear orthopedic shoes, or walk like a ballerina, chances are some taunts will be uttered in their direction.

If you have a very young child who hasn’t yet gotten into a Jumperoo-type or walking-assistance product, heed my advice, and stick with “tummy time”. Not only is it better for your child, but it will save you a few bucks as well.

Be well!