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Pes Equinus

 Pes Equinus,  that is the medical term for a toe walker.  I am doing this post as a way to get help.  If you are a toe walker, have a toe walker, know a toe walker or work with toe walkers,  I want your thoughts.  Your experience with any of what I am writing about:  orthodics, casts, night splints.
 Sarah Kate has seen several pediatricians about her toe walking.  She will turn 4 on June 14th.  She is able to put her feet down, but they go right back up.  She does not present with clonus.  We took her a few weeks ago to a pediatric orthopedist in Tulsa.  He said that her toe walking is not neurological.  He suggested physical therapy if we wanted and then he wanted to evaluate her in a year.  This Dr. wants to do casts for six weeks if she is still a toe walker next Feb.  He also said her best fix would be to do a recession at age 7 or 8.  WE DON"T WANT HER TO HAVE SURGERY.  We are trying to avoid that.  We have also heard that orthodics can cause problems in the long run.  The Dr in Tulsa said that orthodics would not be good for her.
We have learned that drs. and physical therapists have very strong opinions about the subject.  Some think she will grow out of it.  Some think Cascade orthodics are the answer.  Some think casts are the answer.  Some think night orthodics are the answer.  She started physical therapy this month and she loves it so far.

We want to do what is best for Sarah Kate.  It is just hard to know the best.
Thank you!

Comments

Nancy said…
My niece did the same thing, outgrew at about 6 years old. But you know your sweet girl better than anyone else! Wish I could give you comforting words!!!
Praying for a great outcome.
2:07 PM
Karen said…
I have no words of advice or ideas, but just wanted you to know that you'll be in our thoughts and prayers. I love your approach to parenting, though...and know that whatever you decide will be what is best for Sarah Kate.
2:11 PM
laina said…
I work at a preschool and most of the toe walkers there have been treated with casts, some several times. They have all done great and had no problems. We just had them go with the flow and ithas worked out for all of them.
2:24 PM
denise said…
As a pediatric OT I dont deal directly with toe walking in my practice but some of the kiddos I have seen have benefitted from sensory bases OT. Your PT may have some insight into this. My 6 year old daughter is a toe walker. We have her involved in dance, yoga and soccer to keep muscles loose and wretched. We also do toe touches often as in I cue her to walk flat then we touch toes to stretch. It has been helpful.
2:24 PM
Tiffany said…
Have her PTs mentioned a type of brace called SureStep? I went to an inservice recently where they were shown to really improve toe walkers that don't have any other neurological signs or tone. It is nonsurgical and something that is easily removed. I am sure there are other types of these braces but thought I would mention it. Good luck!!
2:25 PM
Tiffany said…
This comment has been removed by the author.
2:25 PM
rae said…
My foster son is 21 months old and he is a toe walker. It sounds like his situation is totally different than SK though. He was a late walker (18 months) because of the tone in his feet which also causes his toe walking. He wears AFO's to train his feet to stay in the correct position as he grows, but I'm not sure that would benefit SK. He also goes to outpatient PT and loves it! His PT is who I truly trust to tell me what is best for his feet. I'll be praying for you guys! I'm sure you will find what is best for her.
2:42 PM
J. Johnson said…
My daughter was a toe walker for several years. Unfortunately, when I initially expressed concern, I was told she would grow out of it and not to worry. She wasn't treated for toe walking until she was 7. What worked for her was a combination of braces and physical therapy. She wore braces for a year (they went up to her knee and strapped over her whole foot, both feet), and underwent physical therapy at the same time. There were also exercises she had to do at home. After a little over a year of the combination braces/exercises/pt, she was able to stop using braces, but continued with the physical therapy/exercises. After another year, she was able to stop all of that. Now she doesn't have a problem, and never goes up on her toes (she is now 14).
2:57 PM
Kelly said…
I have a good friend in the Tulsa area whose son is a toe walker and they did Botox shots to help. It has made a huge difference. Don't know if you know anything about that, but would br happy to get you her contact info if you are interested.

Kelly
3:21 PM
Leigh Anne Hedges said…
My daughter is 5. She was always a toe walker, and we were concerned, but when she started pre K, she began to just stop. She rarely does it anymore.
3:27 PM
Debbie said…
My cousins daughter did this, I'm not sure of the technicle term, but the string on the back of her foot, from the heel to the ankle was not long enough, which caused her pain to put her foot down. You haven't said anything about pain, so hopefully that's not the case. She had to have surgery to correct that. Thought I would let you know, just in case it might help. Blessings, Debbie
3:35 PM
shelley said…
My daughter is 3 & started toe walking at about 2. She can walk flat footed, but prefers her toes. I took her to her pediatrician & she wasn't horribly concerned. I talked to the occupational therapist at the school I work at & she thinks it's a sensory issue which is what I think. The OT suggested high top tennis shoes or heavy shoes which would possibly force her foot down. I'm going to order her some hot-pink converse tennis shoes & I try to buy slip on shoes so she has to walk flat footed or her shoe falls off. I do get a little tired of everyone pointing it out as if I don't know.
3:42 PM
Jill said…
This comment has been removed by the author.
4:14 PM
mm said…
have they mentioned anything about her achilles heel being too tight?
4:42 PM
sandy said…
My niece was a toe walker and outgrew it about age 6 or 7.
4:51 PM
Jennifer, Eric, Isaiah, and Noah Heuer said…
You may want to look into a chiropractor who works with children. They could maybe do some adjustments to loosen things up a bit! I don't have any toe walkers but I have huge success with chiropractic care!
6:16 PM
Sarah Bryant said…
Try some heavy shoes, like Dansko clogs. They make the cutest ones for children and you can get some great used ones for less on ebay. I can't imagine being able to walk on my toes in those and carry their weight. This might be the dumbest comment on here, but was my first thought. I have no experience, so take this with a grain of salt. I know it is heavy on your heart and mind. Will pray for clarity and direction as you seek help.
6:20 PM
Ruth Ann said…
My son is a constant toe walker and our pediatrician isn't concerned. For us he said if he can stand flat on his feet without pain we shouldn't be concerned. They think he'll grow out of it. Should I begin to worry?
8:17 PM
Ruth Ann said…
My son is a constant toe walker and our pediatrician isn't concerned. For us he said if he can stand flat on his feet without pain we shouldn't be concerned. They think he'll grow out of it. Should I begin to worry?
8:18 PM
Jessica said…
I too have a toe walker and have been talking to his dr. about it. He is 3. The doctor told me to not worry and he would outgrow it, but it's so hard to know what to do so we are seeking multiple opinions. My son will walk on his toes in flip flops, so I'm trying that as much as possible while more opinions roll in. Hard to know what to do as the parent!
8:22 PM
Jessica said…
I too have a toe walker and have been talking to his dr. about it. He is 3. The doctor told me to not worry and he would outgrow it, but it's so hard to know what to do so we are seeking multiple opinions. My son will walk on his toes in flip flops, so I'm trying that as much as possible while more opinions roll in. Hard to know what to do as the parent!
8:23 PM
kristinainaustin said…
My husband was a "toe walker" as a child and had surgery to fix it. Of course, that was almost 30 years ago, so I'm sure you'll be able to find an alternative solution for your little one!
9:35 PM
Sara Campbell said…
I dont' have a clue, but just wanted you to know I am praying for you, friend. We all have different issues as moms don't we? I had one that could not hear and I finally clued in she had chronic ear infections!!! But God will direct you as you commit it to him. I did like Sarah Bryant's suggestion...get her some clogs and have her wear them all day every day. Tell her she can wear her princess shoes if she'll walk on her flat feet??? just a thought to start. Love you, looking forward to you turning 40 as an April fuella!!!
12:45 AM
Jamie said…
My 10 year old cousin is a toe walker and this year she has started wearing braces at night and going to PT - mainly walking on a treadmill. It has helped alot. She stills does it but not constantly like she was. Her muscles/tendons are really tight and needed help loosing to help her be able to walk flat. Hope that helps!!
3:30 AM
Erin said…
Hi Laurie....

I am not a doctor but I am a toe walker :)

I have walked on my toes since I learned to walk and I did not receive any treatment of any kind for it other than my parents telling me to not walk on them (and now when my husband catches me - he tells me).

For the most part I did grow out of it (I only occasionally find myself on my toes). I participated in sports when I was school aged such as softball, ice skating, and cheering. I do believe that playing sports and running with other kids cause me to outgrow this bad habit.

Best of luck in making your decision.

erin
7:12 AM
Kim said…
You know I have no advice but I'm praying for guidance for you and Steve. Also praying this problem fixes itself very soon! God has a plan. :)
If u decide you want to visit with my aunt, I'll be happy to give you her number. She'd be happy to visit.
7:55 AM
Angie said…
I really have no experience so can't offer any advice. What I do have to offer is my prayers though & will be praying for you and yours!
10:11 AM
Dawn said…
My daughter is 9 and we did the surgery to lengthen the muscles 2 years ago. It was our last resort. We did PT, shoe inserts, braces, surgery, and then she had to do casts after the surgery. My daughter's is a neurological issue so I do feel like that prevented the therapy from being as successful as it should have been. I do think you are doing the right thing having SK in PT. What I was told is if a child is a chronic toe walker that the muscles eventually tighten up to the point that he/she physically cannot put their foot down. So you definitely want to keep her muscles stretched to prevent that. Our pt had us doing stretches daily and had inserts made for my daughter. Then my daughter was to keep her shoes on at all times except for sleeping and bathing. It was no fun for her because it really did keep up from lifting up so high on her toes.
10:30 AM
Shelley said…
My daughter was a toe walker, as well. She outgrew it by Kindergarten/6 years. People always told me she would be a fast runner :) She is pretty sporty now at age 12! Will be praying for you and sweet Sarah Kate. I believe PT can only help.
10:47 AM
MaryBeth said…
I have two boys, 6 and 2.5, and they are both toe walkers. It does seem like medical professionals have very differing opinions on this matter. Our older son was treated with braces at age 2.5. He wore them for half a year. It broke the "habit" which we also think was a sensory issue. Since then he has worn orthopedic inserts in his shoes to help support his arches (another reason that our physical therapist believed he was toe walking). Our 2.5 year old has not been treated at all yet. We are hesitant to do braces again, at least until the winter months when the cooler weather is much easier for them to adjust to hot braces.

While our youngest child hasn't been to a physical therapist yet, I will say that it seems that the physical therapists all know much more about toe walking and treatments than any other doctor we have seen. (It sounds like you have seen a specialist though, so that may not be true in your case.)

I'm curious now about what problems orthodics can cause in the long run. I've never heard that. Guess I'll google it. It's been a real frustration for our family. Good luck, and hopefully someone out there will have some great advice/encouragement for you!
5:54 PM
Lisa said…
My daughter is a toe walker as well. She will be three in June. She has no physical pain when walking flat. The orthopedist said it's a habit...but it's a hard one to break. We just got AFO's (leg braces) for her...which she hates. It's very hard to get them on her...without her helping...which she usually isn''t willing to do. Our orthopedist also said that toe walking can eventually cause problems. The bones continue to grow...but the muscles won't (as they will be too tight). :( We don't want our daughter to go through surgery either...so we're hoping the braces will help...if we can get her to wear them!
8:23 AM
Jennifer said…
My daughter has been on her toes since she could stand. The PT that was seeing my other daughter said that she wouldn't be able to walk until she got her feet flat. She helped us with exercises and she was walking at a year.
She is 6, almost 7, and we still find her on her toes. I really see it when she isn't wearing shoes or thin flipflops. We haven't seen a doctor about it because I didn't think it was that big of a problem. Now I'm wondering if we should address it with a Dr.
We keep her active in sports and she loves to run. (and is very fast) I also make her wear shoes, which she doesn't mind to do.
Sorry that I don't have that much insight. My thought is don't let it stress you and continue with the PT.
8:42 AM
Kate said…
Laurie:

I am 35 years old and I have been a toe walker since I learned to walk. I never had any sort of PT and grew up playing all kinds of sports, etc. To this day, I still walk on my toes a good 50-75% of the time. I even do it in flip flops. People point it out to me, or else I wouldn't even notice it. I hope that you are able to find an answer for SK, and that whatever it is, it is a simple fix. I almost wish that someone had done something for me when I was younger simply because people pick on me about it even as an adult!
7:09 PM
Jenny said…
I think PT is the best route!
7:21 PM
Unknown said…
My daughter was a toe walker and had casts at age 3 for 6 weeks. She hasn't walked on her toes since! The casts were no fun but really not as bad as I thought they'd be. She's 7 now and doesn't even remember it. The put one set on for 3 weeks then took them off and put another set on for the last 3 weeks.
3:14 AM
Andrea said…
My daughter walked on her toes from the time she learned to walk. She would even sometimes curl her toes under and walk on the tops of her toes. She is almost 5 and has seemed to outgrow it. I hope everything works out well whatever you choose to do.
6:15 AM
MikeandLynette said…
I use to work in a Chiropractic office and the Dr often saw toe walkers. Might be worth a phone call to check. I know each case can be different but he did help a lot of children. Good luck!
8:31 AM
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