Toe Walking

I am a physical therapist working with a child with CdLS who walks on his toes all the time. The doctor has informed the mother that if we can’t correct this with bracing he will recommend surgery. He is able to walk, run, and go up and down the stairs independently. Do you have any suggestions on the best way to address this and what type of bracing may work best?

In an almost nine year old if the Achilles tendons are tight, they will probably need to be lengthened. If they are not tight, a trial of solid ankle AFOs in a few degrees of dorsiflexion may be helpful. Treatments such as stretching exercises, serial casting, and Botox injections are rarely if ever successful (I’ve never seen them work).

TR/TK 7-13-10

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