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5 yo toe walker

Hello all! I have a 5 year old that is still toe walking. He has since the time he learned to walk. We have been to the pediatrician, orthopedics, and neurology. He’s been cleared in all areas that there is nothing physical or neurologically causing the toe walking. We’ve been to physical therapy for the past year. He’s been in DAFO9 leg braces at night for about 6 months. They seemed to be working but he hit a growth spurt and the braces have been causing him a lot of pain and skin breakdown. He was fitted for new braces and we are waiting for them now. I’m just feeling discouraged that they seemed to be working and now that he’s not in them all night every night he’s right back on his toes the majority of the day. Will he ever stop?? Any advice or other moms out there dealing with older toe walkers??

Growth spurts can be so frustrating. I am dealing with a similar issue with my little one’s torticollis. The good news is that it was working prior to the growth spurt! Are you still seeing the PT? Have the worked on any motor relearning? Sometimes when we get the new range we still have to teach the muscle and brain what to do so it can unlearn the old habits. Happy to try to answer more questions.

I think this growth spurt is the first time I’m realizing how much they can be impacted! I hope your little one doesn’t regress too much! We are seeing PT but very limited. Maybe once a month at this point because she feels like there’s not much more she can do. And she’s great, we love her. I trust her opinion. She just thinks it’s a lot of habit at this point and doesn’t have much on how to help that. She’s also mentioned there being some sensory aspect to it, which I work with him on at home exposing him to different textures and all. She also feels like it’s very emotionally driven. If he’s very excited, happy, mad, frustrated, he tends to do it more and also be up higher on his toes. I don’t know how to help these aspects and how we can correct them. I should have mentioned, when the therapist first started with him she discovered it seemed to be due to a weak vestibular system. She worked a lot with strengthening that. I haven’t ever heard her mention motor relearning though. What is that?? Should I get him into any additional therapies?? Thanks so much on your thoughts and feedback!

Hi! Growth spurts can absolutely have an effect. Also, older toe walkers who tend to do it more when concentrating or getting excited are using it as a way to help regulate themselves/gain deep sensory input through their feet.

If you are giving that sensory input, make sure it’s through the heel and the whole foot. Also have you tried an AFO during the daytime to prevent toe walking then?

Also, how does he respond to verbal cues? If cognitively aware, he can practice and work to control it more often.

I agree with @tots-allison. In terms of the motor relearning I was talking about it was that when we walk our calf muscle slowly lengthens when we hit with the heel first so that we can bring our leg forward over our foot. For kids who toe walk a lot of time their calf muscle doesn’t know to slowly lengthen and it automatically corrects. Using a brace for walking may help him especially while he is growing!

Thank you both so much! He does great with verbal cues. The second I tell him “heels down” he goes down and stays there for a couple steps but then he is back up once he stops thinking about it. Before the growth spurt, he was staying down for a decent amount of time after a verbal cue which is how I knew the DAFO9 braces were working. He also seemed more comfortable walking flat before this growth spurt. I will mention day time braces next time we see his PT. I think she’s trying to avoid them for fear of him feeling uncomfortable with others looking or asking about them because he’s a neurotypical kiddo, but I just want him to stop being on his toes at this point. I feel so defeated. I really appreciate your feedback!

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