Tip toe gait

[Choclatespread]

Hello, I haven't been on Mumsnet for ages. So here I am looking for some advice. Please if anyone could direct me in the right direction. Most appreciated.
I'm not sure if anyone remembers, but I wrote a whole ago regarding my son walking on tip toe, anyway here we are 6 months later, still no progress. Well we've managed to get OP appointment to see a orthopaedic, however the physio can't deal with our son as we are not in the borough. So why did the consultant refer us there? Anyway now we are still waiting for a appointment with the physio at our local.
My son has tight tendons, and tight calf muscles. One registrar wanted to refer him to neurology department, orthopaedic consultant didn't agree. So here we are 6months later with no results.

"I would like to know from all you other parents, does your child complain of pain in their legs? "

Ds has complained of pain in his legs when he has gone through a growth spurt. Its generally sorted itself out in a few weeks. My son's toewalk is the same on both legs.

"His tip toe walking & limping have gotten worse since last year October."

That is something different to my son. It must be a serious worry if the toewalking and limp are actually getting worse. It sounds like that your son really could do with seeing a paediatrian at a child development centre to rule out anything serious.

What is the rest of your son's development like? How is he getting on at school. It sounds like he could really benefit from the holistic approach of a child development centre.

Reallytired yes very worrying & frustrating.
He is being seen by a paediatrician at St Mary's Hospital, our first appointment was on 25 April, and despite being referred to the orthopaedic team, he hasn't yet had any treatment started, due to the physio mix up issue.

Anyway some news this morning: our local has wrote to us to say they have received the referral, & he will be seen within 3-6 weeks due to the waiting list.

The rest of his development are fine
Even though he has had some gut issues since he's been born, his immune system reacts to certain foods.
Although his condition is under control, he does not have a very balanced diet, & therefore is taking vitamin supplements.
He is under the Gastroenterology @ GOSH for this.

Generally he is a confident & happy child, loves talking & very interested in learning & very independent.

I think I might need to persist for a neurology referral as well, just to rule out anything there.

Thanks for everyone's feed back, & good luck with your child/s.

"Anyway some news this morning: our local has wrote to us to say they have received the referral, & he will be seen within 3-6 weeks due to the waiting list. "

I'm glad that you aren't waiting too long for an appointment. Is it an intial assessment? We had to wait four months for treatment after our intial assessment. You will find that an hour will go very quickly and its worth asking the physio to show you some stretches.

"Generally he is a confident & happy child, loves talking & very interested in learning & very independent. "

That's brilliant. Its good news that your child has no learning difficulties or problems with social interaction. Does your son have good balance?

A child physio will be able to tell you if your son has any symptoms of cerabral palsy. It suppose the difficulty is that even if your son has mild cerabral palsy its impossible to repair the brain. All these theraphies do is maximise your child's chances in life. All a physio can do is treat the symptoms.

Oh I do hope it's NOT an initial assessment. Really the orthopaedic has done a initial assessment, and now the physio should recommend the exercises plus the night splints & insoles.

Does he have good balance

No, he doesn't, I am assuming this is because of the tip toe walking.

Can anyone answer this:

Is it the tip toe that's causing the tight tendons, or the tight tendons which are caused by something else that is causing the tip toe?

it ist the tip toe that causes the tight tendons, or the tight tendons which are caused by something else that is causing the tip toe?

This is a very hard question to answer without actually examining your DS, the thing is that the reason its called idiopathic toe walking is because the pathology isn't actually that clear. Add to that the fact that the anatomy and bio mechanics adapt to cope with the stresses put on the body and any possible underlying conditions and you get a very complex picture.

Also remember that its often a bit more complicated that just tight tendons; you have to consider all of the muscles and fascia of the lower limb all the way up to the pelvis and even the lowback as well as the joints and even the psychology behind it.

To answer an earlier question about DS complaining of pain in his legs - yes he did for a couple of years he had sore knees - especially behind his knees - this eased with stretching exercises and he doesn't complain of pain any longer. I must say though that he does have very flat feet for a boy of 12 and really wonky toes, but that is probably just him :) I was interested that someone upthread said that toe walking is linked to dipraxia, I can't find the reference, now but DS does have quite severe dyslexia.

"Is it the tip toe that's causing the tight tendons, or the tight tendons which are caused by something else that is causing the tip toe?"

That is a million dollar question. Everyone has told me that my son's toe walking is orthopedic, however no one has ever said why my son toe walks.

However I was 33 hours in labour with my son and his fine motor skills are weak. My son also had unexplained jitteryness at 16 hours old. I sometimes wonder if my son has very mild brain damage. However he is a bright and socialable little boy.

My son was delayed with his gross motor skills. My personal belief is that there is fundermentally different between my son and my daughter when it comes to gross motor skills.

mollified now that has got me thinking. If dyspraxia is linked with toe walking, just researching a little about that. This is probably why the orthopaedic registrar wanted to refer him to neurology, I would be interested to see if there is a link, the only problem is the consultant has not put the neurology referral in the plan ATM.

Although my son is happy & confident, he does get over excited & is always moving about. He used to be slightly clumsy, knocking things over (Bless him). But
He's got a lot better now.

What do you want neurology to do? Even if your son has mild brain damage there is nothing that a brain surgeon can do about it. I can see sense in neurology if you feel the toe walking is getting worse.

There are links between toe walking and autism and many people believe that dyspraxia is a condition on the autistic spectrum.

The links between toe walking and autism scared the hell out of my DP when DS2 started doing it as DS1 has ASD, but you'd be hard pressed to find a flatter-footed child than DS1.

The Neurologist can check for nerve problems, weakness of muscle strength, co- ordination problems, & I would like to rule out everything.

If he has dyspraxia, it is very mild.
As I said on one of my previos post , I feel it is getting worse, & maybe there is no answers to why he toe walks, but being his mum, & seeing the complications everyday & considering hes had a history of other medical issues as well, I want to make sure I do my best to check every possibility.

I will try The physio first, but we have a outpatient appointment with the consultant in August which I would like to be prepared for.

If you want to do stretching exercises, which I would recommend definitely, I would get this book from amazon 'teaching motor skills to children with cerebral palsy and similar motor disorders'. It gives clear step by step instructions with photos on how to stretch tight tendons and muscles. I am NOT REPEAT NOT saying your child has cerebral palsy but the stretches are exactly the same for what you are needing with the toe walking. Was your DS prem by any chance?

Not premature, 10 days over.
Thanks for the stretching exercise advice.
I wonder if I can get that book from the library.

Possibly but only around £13.00 on amazon and delivered free. Really worth having as it gives all the reasons for stretching and it done well helps avoid further treatments. Not to mention making the child more comfortable as tight tendons can be very uncomfortable.

ReallyTired received a appointment letter this afternoon, it is a initial assessment first & then treatment if needed will start from there. They have fully explained the procedure.

Good luck. I hope the physio appointment goes well.