As a parent, noticing your child consistently walking on their toes can naturally raise some questions—and maybe a bit of anxiety. While it’s true that toe walking can be a normal phase for many young children, in some cases, it might point to something more serious.
Dr. Mikkel Jarman explains more in this video:
Key Factors in Determining the Need for Surgery
When we’re deciding whether surgery is the best path forward, we typically consider these three key things:
1) How Effective Non-Surgical (Conservative) Treatments Have Been
2) Your Child’s Age
3) Results from the Silfverskiold Test
Your Child’s Age Matters
Age is a big factor here. Most young kids under 7 years old naturally outgrow toe walking without any treatment at all. However, if your child is older—around 7 or 8—and still toe walking, it’s less likely to resolve on its own. At this stage, continuous toe walking can start causing body posture changes and other physical complications, potentially making surgery necessary.
Of course, every child is unique. Some younger kids might require intervention if their toe walking is particularly severe. These situations are considered individually by your specialist.
What’s the Silfverskiold Test?
The Silfverskiold Test is a simple yet critical evaluation that foot and ankle specialists use to pinpoint what’s causing your child’s toe walking. Sometimes toe walking happens due to tight calf muscles or a tight Achilles tendon—a condition known as equinus—which keeps the heel from reaching the ground comfortably.
This test helps identify whether the gastrocnemius muscle or soleus muscle is causing the tightness. Knowing exactly what’s behind your child’s toe walking is key to choosing the best treatment. Although there are online resources describing this test, always have a professional conduct it for accurate results.
Conservative Care—Did It Really Get a Chance?
Before recommending surgery, we first explore non-surgical options like physical therapy or orthotic devices. Unfortunately, conservative care can vary widely, and not every child receives adequate guidance or support.
One effective non-surgical treatment is the Pediatric Toe Walking Brace. These nighttime orthotic devices are designed to gently stretch the calf muscles and Achilles tendon, promoting a natural heel-to-toe walking pattern. Consistent use over several months can lead to significant improvements, helping to correct the gait without the need for surgery.
The Pediatric Toe Walking Brace (shown above) is a specialized orthotic device designed to address persistent toe walking in children over the age of three.
Considerations for Use
Before introducing the Pediatric Toe Walking Brace, it’s essential to consult with a healthcare professional to determine the underlying cause of toe walking. Conditions such as neurological disorders, muscular diseases, or structural abnormalities may require additional interventions. The Silfverskiöld Test is often utilized to assess the flexibility of the ankle and identify the specific muscles contributing to toe walking.
When Is Surgery the Right Choice?
Surgery is typically considered when:
- The child is over 7 or 8 years old.
- The Silfverskiold Test indicates a structural issue.
- Conservative treatments have failed to improve the condition.
Next Steps for Parents
If you’re concerned about your child’s toe walking, the best thing you can do is schedule a thorough evaluation with an experienced specialist. Whether you’re nearby or from another state, our team is ready to provide compassionate, personalized care.
Whether you’re local or out of state, our team is here to help. If you’d like to explore treatment options for your child, please reach out to our office today. Together, we can create a plan to help your child walk confidently and comfortably.
