Wondering how to stop cerebral palsy toe walking?
While toe walking is completely normal as children learn to walk, it should phase out by age 2.
If children have cerebral palsy and continue to walk on their toes past 2 years old, it’s because of spasticity in the calves that pulls the heels up.
This article will go over what causes toe walking in cerebral palsy patients and treatments that can help your child walk normally.
What is Spasticity?
Spasticity is when the muscles contract and get overly tight.
It often occurs in people with cerebral palsy because the brain is unable to tell muscles in the affected area to relax.
If spasticity isn’t properly managed, the muscle will only become tighter and harder to reverse as toe walking becomes a habit.
Generally, spasticity worsens with age and should be taken care of early to prevent chronic pain.
Cerebral Palsy Toe Walking
Cerebral palsy toe walking occurs most commonly in patients with spastic diplegia, which is when the legs are affected.
When a person is constantly walking on their toes, there’s too much pressure on the soles of the feet and ankles. This can also increase the risk of falling due to reduced stability.
Children that walk on their toes often develop abnormal posture due to changing their center of gravity.
Early intervention is crucial to ensuring that spasticity does not harm your child’s growth and development.
The more accustomed your child becomes to toe walking, the more difficult it will be to correct.
Treatments for Cerebral Palsy Toe Walking
So how do you get your child with cerebral palsy to stop walking on their toes?
Well, you have to treat the underlying problem: spasticity.
Here are some of the most popular treatment options for reducing spasticity:
Physical therapy is one of the first treatments your child’s doctor will recommend.
A physical therapist will assess the severity of your child’s toe walking and create an exercise plan.
Stretching will help lengthen spastic muscles.
Your child will also learn how to improve balance when walking, posture, and strengthen the muscles in their legs.
Leg Braces or Casting
Leg braces and casts will help ensure proper form by aligning the joints in the foot.
The reason why form is so important in cerebral palsy patients is that children who learn to walk incorrectly are only further ingraining that bad habit into their brains.
Function follows form.
A leg brace or cast will keep the heel down and stretch the muscles in the calf so that your child can learn to walk correctly.
Botox is injected into overactive, spastic muscles to reduce tone.
It’s a temporary treatment that lasts about a month, but it does help relax your muscles so that people with cerebral palsy can practice walking without spasticity.
However, Botox is only approved for children 2+, so if your child is toe walking before that, other treatments must be used.
Baclofen is a drug that can be taken orally, injected, or pumped into the body to relax spastic muscles.
However, the most popular and effective way is to get it pumped through intrathecal baclofen therapy.
This is when a pump is surgically implanted under the skin of the abdomen. It directly infuses baclofen into the spinal canal, so it can be delivered in smaller doses than if it were to be taken orally.
A baclofen pump is usually not recommended unless the child has severe spasticity because it requires surgery and the pump must be refilled regularly.
Selective dorsal rhizotomy is a surgery that requires cutting specific sensory nerves to permanently reduce spasticity in a certain muscle.
When that nerve is cut off, it can’t grow back, so the muscle can no longer get spastic.
This type of surgery is only performed in cases of severe spasticity and is often considered only when all other treatments fail because it’s very invasive.
Correcting Toe Walking in Cerebral Palsy Patients
Reducing spasticity is only the first step.
Next, your child has to learn how to stand and walk correctly.
It might feel weird or uncomfortable, but that’s because your child is so used to toe walking.
The more your child practices walking correctly, the easier it will get.
Neuroplasticity is the brain’s ability to adapt and recover from brain damage.
The best way to activate neuroplasticity is through lots of repetition.
Children’s brains are especially pliable and can learn to adapt better than adults, so encourage your child to walk as much as possible after spasticity is treated.
The earlier you catch and treat toe walking, the easier it will be to correct.