Tip toe standing - short tendons?

[Scummy0mummy]

Hi, my 18 MO isn't walking yet, she has been pulling to stand only recently. When standing she will only stand on tip toes. I have had a phone appointment with a physio and they have suggested some ways to try to get her to stand on flat feet. She resists this very strongly. At her 10 month review the HV suggested she might be on tip toes because of short tendons and to see how she was going at the 12 month review. The 12 month review never happened. I forgot about this comment and just thought some kids walk late. It has come back into my mind now once I've seen how much she resists flat feet when standing. Has anyone else had experience of this? We have been referred to a paeditrtion by the GP but have been told expect to wait 6 months to hear from them Has anyone seen a paeditrtion privately? How much would this cost roughly? I just want to get some idea of how much it would cost. Thanks X

Hello. Rather than a private paediatrician I would recommend trying to see a private paediatric physio, preferably a neuro physio - unless you are shielding they are still able to come out for face to face appointments.

I think it is abit concerning that she really resists flat feet. Have you tried doing passive stretches, so lieing her down and seeing if you can get her feet at (and beyond) a 90degree angle - if it's hard try bending her leg at the knee to get foot to 90degree and then straightening.

It could be shortened tendons, or it could be mild cerebral palsy - does she have any standing balance on her own? Of course It could also be nothing and just that she's just taking her time - It's not unheard of for children with no problems at all to walk after 18 months.

My daughter has diplegic CP and is up on her toes a lot because the condition causes spasticity in her legs which makes them very tight and therefore it's difficult to get her heels flat. CP is caused by brain injury usually at or around the time of birth - did you have a straight forward labour?

Can't recommend physios enough! They are amazing for my daughter and she's now zooming all around the place with a little walking frame ☺️

Thank you for your reply X I will try flattening her feet when lying down. She was delivered via ventouse so now I am really worried she has cp. We have a physical appointment with the physio in a couple of weeks. I'll see how that goes. She did ask if the birth was straight forward and I said yes because it seemed straight forward at the time of you know what I mean! I have a family member with cp so I do know quite a bit about it.

I'm glad to hear your daughter is doing well X

I know it is only natural to worry, but try not to stress too much, as she is still young I wouldn't jump straight to a conclusion of CP But I think it's good to be aware that it's possible her feet don't go flat because of increased tone. Also if it is CP I imagine it would be relatively mild given she is already trying to pull to stand, which is great! My daughter has moderate CP (level 3 on GMFCS) and she couldn't pull to stand until nearly 3, she couldn't even sit up at 18 months!

If she does have CP or any other kind of condition (which I emphasise is a big IF) Although no one would choose disability for their child, I promise you the reality is far from as bleak as it feels when you first realise something is wrong. Hopefully you know this from your family member too. My daughter is the funniest sassiest little thing ever and although sometimes I wish I could Make life easier for her I'm so happy and proud that I get the privilege of raising such a determined and inspiring little girl.

I hope you get to see a physios and paediatrician soon and they can help give you some answers and suggestions to get those feet nice and flat and walking soon.

Please let me know how you get on, and if your ever worried or want to chat I'm always happy too

Thank you so much for your kind words X they are very helpful

I will let you know how it goes. And I may message you!

We had some good news from the physio. She doesn't have tension in her legs or feet. But apparently she isn't pulling herself correctly. She showed me some exercises for flat feet and correct pulling up. DD screamed the whole time! I have tried doing them at home when she is in a good mood and she still screams. It's so tough. She does occasionally put her feet flat when standing (with her bum out a bit) but it I try and make her do it she really hates it. I will keep trying though!
We have a paeditrtion appointment next month to hopefully rule out any other problems.