Equinus gait, or “toe-walking” is a type of gait pattern where a child only walks on their toes and balls of their feet. It generally becomes a concern if it does not resolve before or at the age of 2 years old. Some complications of toe-walking can include shortened calf muscles and a loss of balance. Others include the inability to put your heel down lifting your toes, shortening of the Achilles’ tendons, and calloused forefeet. This type of walking can change the kinematics, or motions of walking and running gait. Also, it can potentially impact other joints such as the knees and hips in time as well. Often times, this can be linked to autism, muscular dystrophy, or birthing complications. These can result in developmental delay or neuromuscular impairments, such as toe-walking.
When toe-walking does not resolve in a child, common treatments can include surgery, an injection of botulinum toxin A to relax the calf muscles and allow the heel to go down, aggressive stretching, or splinting with a brace. Physical therapy is also a more conservative, or safe option that can benefit your child. Physical therapy allows longer lasting effects towards eliminating toe-walking and correcting their gait pattern.
How can PT help? Physical therapists can create a program for your child that involves the examination of their feet and leg muscles. The examination will help to understand the level of impairment and how to address it. This can include gentle stretching of the calf muscles, strengthening of muscles around the shins, and in the feet. Also, having the child engage in games and activities that promote a “heel down” position. Additionally, PT’s can help increase tactile stimulation on the patient’s heels. By doing this, their neural system can start to recognize touch and have an increase of sensory information that will prepare them to walk with heel contact to the ground.
If this article raises your concerns for your child’s walking and running gait, contact your physician and come see how we can help you at Hohman Rehab!