Idiopathic Toe Walking
What could be the reasons for toe walking?
For someone who does not walk on their toes, this walking will seem more difficult than walking on the whole foot.
Part of the understanding that there are children who walk on their toes, should include the assumption that any way the body chooses to perform a motor action is the most efficient for it.
This understanding allows us to search for the reason for this.
My professional experience as a physiotherapist, which focuses on movement analysis through the "eyes" of gravity, has led me to far-reaching insights.
If we agree that the body strives to maximize its abilities with minimal effort, as explained in the following publications: Motor control and Motor range, which explain how the nervous system adapts to a number of variables and strives for the most efficient movement, even in terms of energy. And after we have internalized this, we will try to understand the issue of toe walking whose background is not related to the diagnosis of cerebral palsy (CP), in which, as a result of the brain damage, there is also a damage to the muscular ability to produce quality movement and sometimes in early age, the expression will be a rise on the toes for walking and also in standing.
When it comes to toe walking whose background is not clear, and on the face of it there should be no difficulty in producing quality movement within the normal range, we need to try to understand the biomechanics of the standing and walking pattern. And for that, we need to understand the motor and sensory milestones from birth onwards.
Motor development, which has a clear connection to the form of walking, and each person will develop the characteristic and unique walking for him, just like a fingerprint. The walking pattern will be influenced by a number of factors: genetics, abilities to cope with gravity, exposure to motor experiences, sensory components, and more.
A child who walks on his toes and is not treated in time, because there is an expectation that the phenomenon will disappear, will develop secondary motor and sensory difficulties, that is, their source is secondary to the source of the disability, and among them we can mention, for example: muscle development that is directed to the walking pattern and various sensory difficulties due to improper weight bearing, poor spatial perception and also lacking stability abilities with difficulty in the quality and controlled motor range.
Toe walking as the main means of walking is due to a combination of difficulty in two areas, the sensory plane and the motor plane. There are interactions between these two planes.
There is a very great importance to treat this condition from the moment it is clear that there is a difficulty in proper weight bearing on the feet and we recommend not to wait to start treatment in order not to aggravate the motor difficulty assuming that the sensory difficulty is not worsening.
The treatment focuses on the acquisition of proper weight bearing and weight transfer capabilities, taking into account the sensory ability to contain touch on the feet, and the synergistic activation of the muscles in the lower legs and feet.
The age of the patient will dictate the desired motor requirements in the treatment.
Unequivocally, according to our approach, it is possible to treat and improve the abilities of acquiring control over toe walking and not through various medical interventions.
An important point to understand - if a child walks or stands on his toes, a sure sign that this is the preferred option for him, and it is necessary to look for the reason for this choice of the body. And there is also the possibility that the source of the difficulty is not in the feet, as is perceived today.
We are required to take a broader look at this topic.
The author of the text argues that toe walking is a way for the body to achieve the most efficient movement. This is because it allows the child to take shorter steps and use less energy. The author also argues that toe walking can be caused by a combination of sensory and motor difficulties. Sensory difficulties can make it difficult for the child to feel the ground under their feet, while motor difficulties can make it difficult for the child to control their muscles.
The author concludes that toe walking can be treated through physical therapy. Treatment focuses on improving the child's ability to bear weight on their feet and to control their muscles. The author also argues that it is important to look for the underlying cause of toe walking, as this can help to identify the best treatment approach.
