Some young children may walk on their toes close to 100% of the time, for no apparent reason. If there is no known cause for your child to be persistently walking on their toes, it is known as Idiopathic Toe Walking. Toe walking is more common in babies born prematurely.
Left untreated, persistent toe-walking often results in shortening of the calf and hamstring muscles at the back of the leg, in addition to leg muscle imbalances and leg fatigue. This muscle shortening can make it hard for your child to stand with a flat foot, squat to play, maintain balance, hop on one foot or skip and often leads to long term abnormalities in foot posture and structure.
Many cases of persistent toe walking require some form of podiatry treatment; however there are still some things you can do at home in order to help minimize the frequency of toe walking. One of these things is the style of shoe you choose for your child.
Below is a list of shoe features to look for to help minimise your child’s persistent toe walking:
1. Stiff-Soled Shoes
it is important to chose a shoe that has the stiffest sole, this will help to provide the child’s foot with some resistance to flexion at the forefoot; your Podiatrist may also suggest adding a shoe-stiffener plate to the sole of your child’s shoes.
2. Fully Enclosed Shoes with Laces
Chose enclosed shoes that feel stable on the feet with laces (rather than slip-ons) so that the shoe is held firmly on the foot;
A well-fitting, supportive shoe can help the child’s sense of balance and stability and may allow them to relax down into the heel of the shoe;
3. Chose shoes a little longer than the measured fit
Some children will do well in a fully enclosed, stable lace-up shoe that is a little longer than the measured fit, providing a slightly longer lever arm and a better sense of balance;
4. Shoes with a deep heel cup or a mid-cut shoe
Shoes with a deep heel cup and good cushioning under the heel and forefoot can also be helpful for comfort and stability;
5. Orthotic-Friendly Footwear
Most children who persistently toe-walk most of the time, will require the assistance of custom foot orthotics that are worn inside their shoes. So, choosing orthotic-friendly footwear is important – these are shoes with a removable inner-sole, deep and firm heel cup, reinforced stable arch area with laces and low heels. Your Podiatrist can help you chose the best shoes for your child.
While the right style of shoe can be helpful in discouraging toe walking, your child may require more than just a shoe change. If your child walks on their toes the majority of the time and is > 2 years old, a paediatric podiatry assessment would be beneficial to determine if further intervention is needed. Remember, children treated at a younger age tend to have more rapid and more effective treatment outcomes.