What is toe walking?
Toe walking is a style of walking in which a child walks on balls of his or her feet, with no contact between the heels and ground.
It's an abnormal gait pattern that can be seen in children during development. In majority such an abnormal walking will naturally regress within six months or after two years of age. If the child still continues beyond two years of age, then they are diagnosed with persistent toe-walking.
Reasons Why Children on spectrum Toe Walk:
Toe walking is a very common characteristic found in children on spectrum. Some of the reasons behind toe walking are as follows:
High Oxalates: Oxalates are found to be much higher in these children as compared to others. Oxalate and its acidic form oxalic acid are basically from three sources: these are our diet, fungus like Aspergillus, Penicillium, and Candida. These crystals are deposited in the joints which can lead to toe walking.
Constipation: If your child's bowel movements are not regular or hard or simply if they are constipated then they may be uncomfortable or in pain. To alleviate or deal with the tightness they usually feel in their tummy, many kids prefer toe walking.
Vitamin or nutrient deficiencies: Deficiencies in magnesium, zinc, or thiamine (a B vitamin) levels can be a reason for toe-walking. Vitamin B12 deficiency for instance can affect the nervous system and affect the way of walking.
Food sensitivities and allergies: Food sensitivities or allergies can leave your child feeling anxious, irritable or under stress. This can result in toe-walking as well.
Sensory processing difficulty or disorder: Incase of a child facing a problem with a sensory processing disorder they may be seeking additional input in their feet, toes, and lower legs. To achieve this they may begin toe-walking as it provides extra sensory input.
Eye development issues: A child on spectrum, may toe-walk because of depth perception issues or a visual processing disorder, which in turn can affect the cycle of messages being sent from their eyes to their brain and back to their body. These perception issues can be a reason for a variety of problems including toe-walking.
How to Prevent Your Child From Toe Walking?
Stretches and ankle weights: Toddlers lack flexible muscles. Stretching exercises helps loosen stiff muscles enabling them with a better range of movement. A proper ankle weight
can help strengthen your child’s tendon and help them walk correctly on the ground.
Shoes: The correct pair of shoes with right ankle support will prevent toe walking. Encourage your child to wear shoes often to help him walk on his feet.
Tactile training: Making your child walk barefoot on different surfaces like grass, sand, some stones, etc. This will give him a perception of what it feels to walk with his whole feet pressed against the ground. You can even try a similar activity with a multi texture path at home by using carpets, pillows, cardboards, blankets etc.
Some other activities for kids which can help with correct walking
You should consult a doctor if you find any of the following:
Your child is constantly walking on his toes even beyond 2 years of age.
If you feel that your child has stiff muscles in leg and foot region.
If your child is unable to maintain a balance or lacks coordination while walking eg: if he/she stumbles very often.
Has delayed motor skills. He/she is unable to walk or crawl beyond his/her ideal developmental milestone
He/she has regressed the motor skills that he/she already had.
Has trouble bearing weight on his/her feet.
Role of Functional medicine in dealing with toe walking
Functional medicine is an individualized, patient-centered, science-based approach that empowers parents and practitioners to work together to address the underlying causes of disease and promote optimal wellness. We do a root cause analysis to find out the reasons behind your child’s toe walking and design a personalized treatment plan to correct the same.
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References
Wilder, D. A., Ingram, G., & Hodges, A. C. (2021). Evaluation of shoe inserts to reduce toe walking in young children with autism. Behavioral Interventions. https://doi.org/10.1002/bin.1860
Leyden, J., Fung, L., & Frick, S. (2019). Autism and toe-walking: Are they related? Trends and treatment patterns between 2005 and 2016. Journal of Children’s Orthopaedics, 13(4), 340–345. https://doi.org/10.1302/1863-2548.13.180160
Ruzbarsky, J. J., Scher, D., & Dodwell, E. (2016). Toe walking. Current Opinion in Pediatrics, 28(1), 40–46. https://doi.org/10.1097/mop.0000000000000302
Barrow, W. J., Jaworski, M., & Accardo, P. J. (2011). Persistent Toe Walking in Autism. Journal of Child Neurology, 26(5), 619–621. https://doi.org/10.1177/0883073810385344