Among the transitory modalities of walking in the very first years of life there is also the one on the tips, which in the absence of other clinical signs is completely physiological. However, if it continues over 3 years, the situation must be attacked and evaluated together with the pediatrician
It is a common mistake to think that a child who has recently learned to walk is already able to do it just like us adults. The conquest of autonomy in walking is a certainly crucial stage in the motor growth of children, but the way in which this occurs, for the first two to three years of life, sees the alternation of different phases, in most cases transitional. Such as that of walking on the tips (the so -called Toe walking), a rather frequent trend especially in the initial phase of autonomous walking. But if the parents see their own child walking on the tips And this phase is prolonged over time, should they worry? Let’s try to understand it in this article.
Why does my son walk on the tips?
“Why does my baby walk on the tips?”. Let’s do (it is appropriate to say it) a few steps back …
It is necessary to imagine the novice little one with walking like a very young and immature athlete to the continuous and incessant search to improve their performance in terms of balance and motor scheme. This is why, just like an athlete who spends time to train, he will broaden his legs, then his support base, to feel more stable, or maybe he will alternate very quick steps with slow steps. Another child, on the other hand, could maintain a slow and staggering incede for a long time, or rather he often stumbles or will carry the tips in the feet inside.
Among the transitory methods of walking in the very first years of life we also find the action of walk on the tips, Probably put in place by the child with the aim of moving his center of gravity forward and optimizing energy in his first steps.
Each modality just described, including that of walking on the tips, is however to be considered physiological in the early stages of motor autonomy since, in fact, it is part of that constant and progressive training that will slowly lead the baby to improve his balance, safety in walking and his own posture.
Walking on the tips, in particular, is a mode that concerns a large number of even older children (5%), so much so that these deserve the name of Toe Walkerthat is, those who deploy in a prevalent, or persistent way, on the forefoot with both lower limbs.
The pace on the tips, therefore, if present in children under the age of 3 and in the absence of further clinical elements, must not arouse concern in parents.
What to do if a child walks on the tips
Let’s see some now Tips for Toe Walking. It is first of all important to observe the child during all the phases of his day. In most cases, the action of walking on the tips is, as mentioned, only a transitory habit and the little one will show that it is still able to walk by leaning the whole foot, if it is expressly asked to do it.
Particular should not be put in the field “Remedies” if the child walks on the tips. In these cases, just invite him to frequent all his foot to the ground, perhaps creating different sensorial stimulation games. For example: stimulate it to walk on carpets of different consistency, on the grass, on the sand, on the mattresses, on the cushions, etc. But more generally it will be sufficient to let the “small athlete” continue to freely experience his walking and also any falls, which represent a fundamental part of its overall motor development.
The tendency to walk on the tips seems to be more frequent in children who used the swivel. This is probably linked to the fact that the use of this tool does not allow a correct acquisition of the control of your body in the upright position and rather leads to the use of the push on the tips to obtain the autonomous movement (we talk about it more in -depthly in this article). This is certainly one of the reasons why it would be avoided
When to worry if the child walks on the tips
Do you need to worry if the child walks on the tips for a long time? If it is true that in the very first years of life this trend is considered transitory and not alarming, it is however important to underline that there are conditions within which it must be attentive (it will be your pediatrician who evaluates the situation and possibly direct to a specialist visit).
In case of fetal or perinatal suffering, for example, or if there is a conclaimed family history of neurological diseases of muscle weakness or in the suspicion of diseases of the spinal cord (spina bifida) will be placed indicating a neurological or neurosurgical visit.
In the event of coexisting communication disorders, learning deficits, severe language disorders, the possibility of carrying out a neuropsychiatric visit To evaluate any early signs of diseases of the psycho-behavioral sphere, so the pace on the forefoot can be one of the presentation elements. About 60% of the subjects suffering from autism, for example, have a walking walking, although international literature has not yet agreed in identifying the reason for connection. A probable interpretation is that the autistic subject, walking on the tips, reduces as much as possible the sensory inputs from the ground, perceived by him as unpleasant.
Even in the absence of one of the aforementioned causes, or other clinical signs, there are children who continue to walk preferentially over the tips over 3 years of age. They are not few, they represent almost 5% and are defined Toe idiopathic (or habitual) walkers. In these cases it may be appropriate to carry out a pediatric orthopedic visit that will evaluate the correct morphology of the foot and ankle and its joint excursion (the physiological dorsiflexion of the ankle is about 15-20 °), and will allow to identify a possible retraction of the Achille tendon or the presence of compensation postural mechanisms (reactive hyperlordosis).
In cases of conclato -short diagnosis of the shortening of the Achille tendon, which therefore involves a mechanical obstacle to achieve the physiological movement of dorsal flexion (i.e. does not allow the foot to rest the heel on the ground), the treatment can include physiotherapy aimed at the stretching of the rear muscles of the legs or sometimes requires the use of guardian/chalks or, still, injects of botulinum toxin in the muscle.
In the most severe cases, however, surgical intervention is used. There are different Achille tendon stretching techniques, generally they are carried out percutaneously, without therefore needing to resort to real surgical engravings, and are always accompanied by the use of a plaster device that allows the tendon to cicatrite.
