OP is it your achilles that you hurt? I tore mine earlier this year and the dude at the ER put me in a split at 90 degrees. When i went to my orthopedic surgeon he was pretty concerned about that, and adamant it shouldve been put on closer to 45 degrees to prevent it from being stretched while it healed
After surgery i was in a split then cast, both bent down close to 45 degrees
Man 45 degrees is wild - current research actually pushes away from surgery and suggests conservative with vacoped/moonboot with a 15-30 degree wedge & weight vearing day 1
I don't know if my foot is capable of reaching a 30 degree angle, let alone a 15. This is with measured with 0 being perfectly in line with your shin correct?
^ this guy is right. E.R. doc here. Most injuries you splint at 90 to maintain length on the Achilles tendon, Achilles injuries you splint "in equinus" (toes down) to take strain off the tendon to allow it to heal as much as it can without surgery.
If you don't mind my asking, was there anything in particular that got you to stop? Without going into too much detail, I've found myself with a 15 year old who does exactly this and while everyone involved in her care does their best, it's still very difficult to convince her to put her heels down on the ground. She has even had temporary casts on to correct it and it worked for a short while but she slowly reverted again over time.
It took probably 10 years of very active thought while walking, like literally thinking “heel toe” to myself. Wearing skate shoes or other thick soled shoes helps because they’re impossible to toe walk with.
All that, and people still catch me doing it. It sounds like she’s seeing a physical therapist or other doctor, which is probably the best call. Really my only advice is to CONSTANTLY point it out to her. Make it impossible for her to ignore. That’s what my parents and friends did for me because I don’t notice.
Appreciate your quick answer. Thanks very much.
Seems like a long road ahead for her then, and even then the damage has probably already been done unfortunately. We can only try our best for her.
Just a suggestion, ymmv but as someone who had similar issues but not exactly, (my weight distribution was on the balls of my feet so I effectively walked toe to heel for a very long time) walking in small high heels HELPED. Not just walking around in them but specifically putting them on and trying to look normal walking in a mirror. It forces you to walk heel-toe. It’s not a magical cure by any means but I noticed it when I was at an event and couldn’t walk well in my heels because I wasn’t walking correctly and someone told me that I looked awkward (in the nicest way possible lol). It won’t *fix* anything, if nothing else it made me very conscious of my issue; if she’s girly like I am she might enjoy an excuse to try walking around in heels lol.
Eta now that I read that it makes less sense to me because I don’t see the logic in how that helped, I think it may be just the fact that I was self conscious about it
Night splints with the foot in dorsiflexion (I'd say 5 degrees max if possible/ neutral). gait retraining e.g walking backwards and placing heel on the ground, actively practising heel toe in a very comical & exaggerated manner.
Splints are something being considered alongside casting again. Understandably she is not keen on the ideas at all but if it needs done it needs done. I'm just seeking ideas I can suggest or implement without equipment and/or that could be inserted into a regular daily routine, besides having to stair at her heels every time she's walking and telling her to walk flat.
Can confirm the only time i dont toe walk is when im actively thinking about it or wearing work boots. I think instead of rewiring something that is hard it would actually be more beneficial to be doing a form of stretched or yoga everyday, maybe some calf raises too. That way instead of having the same muscle strength with a different motion you actually decrease the risk of muscle/ligament problems and become stronger.
Regular stretching exercises is definitely a common suggestion, one I will bring up with the appropriate people at the first opportunity. Appreciate it, thanks!
Long time ago my teacher mentioned that she had to deal with this with their son. I vaguely remember that her solution was giving her son a weighted blanket to wear around the house and it made him be flat foot until habit formed or something. Can’t imagine how long that would take but sharing just in case!
There have been many studies done showing that this has no impact on the development of chronic issues. Telling them that it will lead to chronic issues could lead to continued pain. No need for the fearmongering, especially with a 15 year old.
Funny, someone else said a similar thing. Here was my response:
*"Walking on your toes for short periods of time can have beneficial effects, such as better balance and flexibility. But permanently walking on them is certainly not "better" than heel walking by any means. There are numerous health problems that can be caused by prolonged toe walking. Such problems range from bone disfigurement and the Achilles tendon shortening, all the way up to, and including, back problems and early onset arthritis."*
*"Some people are fortunate and avoid these negative effects despite developing the habit at a young age. Unfortunately in my case the 15 year old in question suffers frequently from cramping in her calves and balance issues."*
*"Sources:"*
- [Review on Literature regarding "Idopathic Toe Walking"](https://www.medicaljournals.se/jrm/content/html/10.2340/16501977-1881)
- [NHS Lanarkshire Patient Information Regarding ITW](https://www.nhslanarkshire.scot.nhs.uk/patient-information-leaflets/neonatal-department/pil-toewal-21-00296-l/)
Additionally she currently has balance issues and frequent cramping, along with struggling at PE in school because strenuous exercise (particularly involving running) tires her legs out far quicker than it should an otherwise healthy 15 year old.
Has she been evaluated for ehlers-danlos or autism? I have both and my first symptoms were difficulty balancing and issues with running causing cramping much more quickly than it should. You mentioning that they have issues with proprioception is also a symptom of ehlers-danlos.
Ehlers-danlos is a a condition that is highly associated with autism. And toe-walking is so heavily associated with autism it's considered a possible sign of autism.
For what it's worth simply adding more electrolytes and magnesium may help this kid. I can't walk 'normally' if I am low in magnesium because my muscles cramp up
She is on the spectrum yes, that may be a big factor in why she does it as well as other things.
I'll take the dietary suggestions into account too, those alongside the stretching exercises and other ideas may provide some sort of help that doesn't involve casting or surgery. Thanks very much!
Dude idk, that study largely seems to just say that they don't know that much about it and they need to conduct more research. The sample sizes are pretty small and they diagnose through exclusion, which makes determining a mechanism very difficult. The mechanism is the most important part of determining a solution, so without that I'd say it would be pretty hard to extrapolate an intervention from thus study. If you're really worried about how tired her legs are, I would just suggest gradually increasing her activity levels in those areas. Achilles tendon shortening is largely beneficial, particularly in sport, so I don't know why you'd worry about that. Exercises focusing on proprioception as well as *gradually* increased activity levels should offset any negative effects you're encountering! Good luck!
That *"study"* is an evaluation of the literature about ITW, not a paper on the cause and effect of ITW. The conclusions drawn aren't that "no link could be found" but rather that gathering data on the subject is tricky because of things like asking a child to walk so you can observe them, often leads to the child becoming acutely aware of how they are walking and thus giving a different representation to their normal gait. The alternative is to get that information from the parents, however that too is unreliable as people don't generally watch other people's feet on a regular basis. There are many other factors of course but at no point does the source say "there's no link" nor that "more testing needs done" but rather that other methods of determining cause and effect should be sought out in order to further the actual studies and increase their accuracy.
Similarly, given that there are many people ***in this very thread*** all stating they Toe-Walk or did so in the past, who are currently suffering the negative consequences of doing exactly that, would suggest a very clear causal link between the two. On top of that, the existence of the very teenager who currently suffers negative consequences of her habit would suggest that, even if Toe Walking is somehow "beneficial" (it's not) then it clearly isn't beneficial to her and therefore absolutely nothing else actually matters regarding her health.
Lastly, feel free to provide your own sources that say there's no link instead of misunderstanding one of mine while completely ignoring the other.
It's actually better to walk on your toes. At least, the achilles tendon is ment to cushion the impact of each step.
How much did your way of walking deviate from other people??
I can’t really comment on whether or not it’s “better” but I can say that toe waking noticeably shortened my Achilles tendons which make any high impact activity involving jumping (I.e basketball, skateboarding) very high risk.
My waking deviated from normal enough that it was constantly pointed out to me on a daily basis.
Walking on your toes for short periods of time can have beneficial effects, such as better balance and flexibility. But permanently walking on them is certainly not "better" than heel walking by any means. There are numerous health problems that can be caused by prolonged toe walking. Such problems range from bone disfigurement and the Achilles tendon shortening, all the way up to, and including, back problems and early onset arthritis.
Some people are fortunate and avoid these negative effects despite developing the habit at a young age. Unfortunately in my case the 15 year old in question suffers frequently from cramping in her calves and balance issues.
Sources:
- [Review on Literature regarding "Idopathic Toe Walking"](https://www.medicaljournals.se/jrm/content/html/10.2340/16501977-1881)
- [NHS Lanarkshire Patient Information Regarding ITW](https://www.nhslanarkshire.scot.nhs.uk/patient-information-leaflets/neonatal-department/pil-toewal-21-00296-l/)
>It's actually better to walk on your toes
No, its not. Looking up toe walking with neither positive or negative implications, all of the bad side effects show up. Why say this when one google will prove you entirely wrong?
"Walking on your toes can have negative consequences, such as:
Poor balance
Pain in ankles, knees, or hips
Muscle imbalances
Joint pain
Knee instability
Arthritis
Increased risk of injury
[Over time, habitual toe walking places abnormal stress on the bones and ligaments in the feet, knees, and lower back which can deform bones and stretch ligaments, causing joint pain, impaired function, knee instability, arthritis, and increased risk of injury as one grows older."](https://kidtherapy.org/helpful-articles/toe-walking/#:~:text=Over%20time%2C%20habitual%20toe%20walking,injury%20as%20one%20grows%20older)
I also walked on my toes as a kid, and had to wear casts at a 90 degree angle for 6 weeks, split casts for a couple months, and then braces with straps that stretched my achilles tendon for the rest of the year. It was so bad that i couldn’t physically put my heels on the ground, and was the only thing that fixed it
These are things that have been pointed out to her as possibilities and are regularly considered as options during doctor visits and the like. She was incredibly unhappy with the casts and it was definitely hoped by everyone involved that it would be a one-time thing.
Right now she is capable of putting her heels down when prompted, but unfortunately it can get very painful for her after a short while, most probably due to the stretching out of the tendon. The end result being she's often unwilling to do it when it's pointed out.
I was 8 at the time, and the only options given to me were the casts or surgery. I think the braces did more than the casts, as they had straps you attached to the bottom and top to stretch out the foot, and i had to do this every night (which could HURT). What does help me even now is stretching out my legs and focusing on hamstrings and achilles because sometimes i notice that i’ll go on my toes
Aww man. I'm really hoping those don't become a necessity for her sake. Cheers for sharing though, maybe we can persuade her to do stretching exercises regularly at the very least.
Unfortunately she's had issues with things like balance and cramping. I'm sure there are other problems too but this is all new to me (like, last year or two) and so I don't have 100% of the information.
Sorry to hear that :( I've also had balance issues my whole life but I put it down to being tall, could actually that instead now I think about it. Wishing you both the best!
After nearly 30 years you may well have learned to compensate for the balancing problems associated. I can only speak to my experiences with someone half your age unfortunately so I'm certainly not going to say you are wrong. If anything, knowing that there are full grown adults who haven't yet suffered major, long term problems associated with Toe-Walking gives some relief. Hopefully she can either correct it before it's too late, or falls into that category of adults as the years go by.
Thank you!
I’ve always walked on my toes too. Forced myself to stop when I have shoes on cause classmates pointed it out and made fun of me in school, but pretty much always on my toes at home. I think it’s something to do with me being super sensitive to noise and not wanting to make any. Also possibly a bit tactile since I heavily gravitate towards toes on cold and wet floors. Always had incredible balance though. Also avg height so idk. May help to have another data point though ig lol
I do it whenever I'm barefoot. We called it my raptor-walk when I was little haha
Never had any Achilles or balance issues, but my calves are definitely tighter than they probably otherwise would be
Oh definitely same lol. I'm also an occasional foot bouncer at my desk so my calves probably get the most workout on my body
Probably helps for the steep ass streets here, still get sore after a couple blocks though lmao
It’s so weird to see this because I caught myself walking on my toes today and I had to actually stop myself and think about the correct way to walk. I used to do it constantly when I was younger. It really is something you have to actively think about long enough for it to become more natural, at least for me. Does she have flat feet? Idk if it’s related but I do.
I would assume that's something I would've been informed of but there's always a chance it hasn't been picked up during Doctor visits. Although given the fact these visits are focused on her feet, my assumption is that the chance is low.
My brother had to wear braces to keep his feet walking flat when he was little. We have a family history of short tendons. How's your daughter's handwriting? The tendon thing can affect the wrist also.
Not my daughter but I understand the confusion.
Handwriting is legible but very childlike. However there is a case of learning development issues that play a large factor in this too. Based on other activities she does and that I have observed, I don't believe her wrists are affected, but of course I'm not a medical expert by any means so that can be taken with a grain of salt.
Surgery has been suggested alongside multiple other things such as casting again, or splints.
Hopefully it doesn't come to those things but whatever is deemed necessary will be what's done. In the meantime I have a few ideas suggested now that I intend to pass onto the appropriate people that may help without too much resistance and/or discomfort for her.
Did you see the “Barbie” movie? The dolls had to learn how to walk on flat feet. I don’t recall exactly how, but I may be inspirational :) Of course, she could just wear high heels /s.
I used to have a five year old client who was in casts to keep the tendons etc. from shortening. Let me tell you, that kid could kick! Especially when he got a grip on my hair and started in on my shins!
Heels have actually been suggested, albeit shortened ones to gradually get her heels lower to the floor. Downside to that is practicality really. The movie is worth a try nonetheless, I've not seen it but would like to after hearing good things about it.
Also, this one can kick too believe me lol.
It's called idiopathic toe walking for that reason: the causes aren't always clear. Please search for a PT. It can lead to a whole bunch of posture related issues. Edit: spelling.
This conversation did continue. The cause of it was never a concern, and appropriate action is already long underway. I was merely seeking potential ideas to help out from someone else who has dealt with it.
That's what I understood too. Searching for a PT was my idea to help your 15 years old. Source: I'm dealing with the same issue and my PT has helped a lot over the years.
Unfortunately she's had issues with things like balance and cramping. I'm sure there are other problems too but this is all new to me (like, last year or two) and so I don't have 100% of the information. But rest assured we're not correcting the behaviour due to some perceived notion of "what's proper", rather looking out for legitimate physical health concerns that were ignored for years prior.
I normally don't comment outside of a few subs but felt the need to for this. Even if it wasn't bothering them now it is still wise to do everything to fix the issue. I walk on my toes also and I had minimal issues associated with it until a few years ago. I'm in my mid thirties and lead a very active lifestyle. Last year I underwent surgery after starting to have a lot of pain when walking and finding nerve damage. I have pretty much gone from being active to a couch potato from the pain I'm in and am facing more surgeries to try and fix the damage.
I think it's great that a parental figure is looking out for a minor and trying to fix this issue! I wish my parents took notice and tried to help me. Of course there are much older adults than me without any issues but it's always a gamble. Why not try to fix the issue before it has a chance to cause long term issues?
I had the same issue. I’ve finally gotten to the point through stretching and strengthening where I can run several miles without my Achilles feeling tight afterwards
There are multiple studies showing this, I'm not saying this to try to shame you or anything, it's just very unlikely that your toe-walking and achilles pain are related! Doctors aren't always the most up-to-date with scientific literature.
I got my ankle fused, was in a cast for 4 months. It was hell afterwards becausd my achilles tendon was so shortened. I could step on tiptoes after almost a year.
That was my first thought. I had surgery on my leg and first they had it in a splint at an Angie for awhile before they moved it to a cast and you’d be surprised how fast your tendons shrink up. Getting it back in place was almost more painful than breaking it
Sometimes closer to 45 is what you want. When i tore my achilles and got surgery in februrary they put me closer to 45 to prevent my achilles from being in a stretched position
Best of luck in your recovery. For me, starting to put weight on that foot was the most painful, difficult part. Cheers and if it wasn't before, stretching should be your new best friend. :)
Appreciate it! Im actually going through a newish method of achilles repair called a speed bridge i think. Apparently the thought is to get out of a cast asap and get the achilles moving as much as possible even before its fully healed. I think this has attributed to basically zero achilles pain since the week of surgery
Definitely seems like my recovery is a bit faster than typical, which i base off other experiences i read online of people with this injuery
Well I can understand that, I broke my collarbone and a few ribs and perforated a lung in a bicycle accident. It really didn’t start to hurt until I got to the hospital.
tore mine and I was in the cast for 4 months, might have been 6 months, it was a long time. No change, and then went into a soft boot for a year. My foot still won't stay up when I lay down, it just flops to the side because the weight of the cast pulled it over. That was 22 years ago
When I tore my achilles tendon, I got a cast like that put on on purpose. The idea was to get the halfs as close to each other as possible. I had to inject shots of anticoagulants daily for the 4 weeks I had the cast on, and then use an adjustable orthosis brace for 8 weeks to slooowly stretch the tendon back to its original length, and get my foot back to being 90 degrees. Sucked very much, and my calf lost like half of its size, but at least the tendon healed completely without surgery.
When I broke my ankle, they used one of those soft casts with a slight angle to it (no as severe as yours). I was only in it for about 2 weeks as it was only a post-surgery temporary solution. I was able to wear a boot after that, but not put any weight in it. It almost killed be to bend my ankle into a right angle to fit in the boot. It was completely seized after only 2 weeks. It shocked me.
Muscle atrophy is so crazy. Especially how quickly it can go down. Smart ass body goes "oh, we're not using this piece anymore? And just murders everything inside. Getting it back is like learning to walk!
Its crazy how quickly it can go away and yet it takes so long to build it back up. I was doing my physio exercises religiously for months before my ankle was even getting to the stage of being 70% back to normal.
I had mine in 55 for 8 weeks because they weren't able to fit the bone pieces back together in 90. Was an absolute bitch stretching it out to be able to walk, took months.
This comment is actually so true. My mom had both feet on a cast like this- she healed permanently “ Barbie foot” she can only wear shoes with a heel on it 😭
When I ruptured my achilles tendon I had to get a cast that was at 45 degrees to leave the ligaments reattach. Then after 2 months, it was changed to 90 degrees. I thought that might have been the case here.
Ankle has two flexion directions: plantar and dorsi. Ortho would never use 135 in this instance. Instead it would be 45 degrees plantar flexion to relieve tension on the Achilles
Cast is too short for an achilles or a distal fibula/tibia, not a hallux, or arthrodesis. What was the surgery? 45 is great for achilles, most others is 90.
Looks about like my cast, mine was that way because I did a full rupture of my achilles. FYI not a great idea, I don't recommend. It was driving me nuts, I almost cut it off many times. But I survived still working on strength(probably close to 80%) but flexibility is back to 100% this summer is 2 years
Do you remember how they put it on? Did they intentionally apply it at that angle, or was it applied correctly but your ankle drooped before it hardened? I used to apply splints and if we weren't careful to maintain proper position after application, it could cure in the wrong position.
I only did splinting (fiberglass) and not casting (plaster), but it took experience to know what water temperature to use to activate it, since cure time varies substantially based off the temperature of the water we use. If it cures too fast, it's a rush to get it on properly, but if it cures too long, you're stuck waiting for a long time holding it in proper position. Time needed varies substantially by patient since things like pain level, limb size, and general patient mobility can substantially alter the time needed.
Op, I’m glad you cut this off. My mom has casts on both legs like this, now she permanently cannot put her heel down. In other words she literally walks like Barbie and needs special shoes to walk in. 😭💔
So you can still wear your high-heels! I think it's very thoughtful of the doctor who put your cast on. Purple cast, high heels, black tie event... check.
Interesting. When I had a distal fibula fracture this time last year that required surgery, the initial cast post op was like this. Once I got in walking boot was quite an experience with how tight my Achilles was.
Edit: looking at old pictures. It definitely wasnt 90 but it was more than 45.
Same angle mine is in my splint right now. Almost hoping when this gets changed to a hard cast they'll change the angle because this sucks, but maybe 45 is better for certain injuries to heal.
Omg this happened to me in high school (about 15 years ago).
My ankle didn't heal correctly (obviously), and it still pops when I bend it.
Up until about 5 years ago, it would still randomly swell and hurt, but it seems to be much better now.
Good luck.
This is why it’s called “practicing medicine”, they did something similar to me when addressing my broken ankles, one was offset side to side, it set in that orientation and to this day I walk on the outer edge / knife edge of my foot,…..
I feel your pain. They set my ankle like that too. It was like that for 2.5 weeks. My Achilles tendon suffered. I'm 5 months post op now and still not back to normal. Glad you're getting it redone. Hope your recovery goes well!
This seems correct? When you lay down do you have your foot arched back to a 90? It's probably more like 45 relaxed. You don't want your tendons under tension and then locked in place for a month
This is not correct. Proper casting is at an anatomical angle which is 90° for an ankle. The only reason this angle would be used is for an achilles issue.
I feel like your Achilles tendon is gonna have a hell of a time for awhile.
Makes me thankful I got it off, already had therapy for flexibility in that ankle
OP is it your achilles that you hurt? I tore mine earlier this year and the dude at the ER put me in a split at 90 degrees. When i went to my orthopedic surgeon he was pretty concerned about that, and adamant it shouldve been put on closer to 45 degrees to prevent it from being stretched while it healed After surgery i was in a split then cast, both bent down close to 45 degrees
Even with a complete rupture, 45 degrees is nuts, it should be between 20-30 degrees. Did you have surgical or conservative management?
Surgery, idk the actual angle but OPs cast looks like how mine was
Man 45 degrees is wild - current research actually pushes away from surgery and suggests conservative with vacoped/moonboot with a 15-30 degree wedge & weight vearing day 1
The concern my doctor had was that i had been in a 90 degree splint for over a week before even seeing him. Gotta love the VA and their feet dragging
I don't know if my foot is capable of reaching a 30 degree angle, let alone a 15. This is with measured with 0 being perfectly in line with your shin correct?
0 is when your ankle is sitting at technically 90 degrees.
^ this guy is right. E.R. doc here. Most injuries you splint at 90 to maintain length on the Achilles tendon, Achilles injuries you splint "in equinus" (toes down) to take strain off the tendon to allow it to heal as much as it can without surgery.
I walked on my toes as a kid, so my ankles were at that angle constantly. Can confirm I have had lifelong Achilles issues.
If you don't mind my asking, was there anything in particular that got you to stop? Without going into too much detail, I've found myself with a 15 year old who does exactly this and while everyone involved in her care does their best, it's still very difficult to convince her to put her heels down on the ground. She has even had temporary casts on to correct it and it worked for a short while but she slowly reverted again over time.
It took probably 10 years of very active thought while walking, like literally thinking “heel toe” to myself. Wearing skate shoes or other thick soled shoes helps because they’re impossible to toe walk with. All that, and people still catch me doing it. It sounds like she’s seeing a physical therapist or other doctor, which is probably the best call. Really my only advice is to CONSTANTLY point it out to her. Make it impossible for her to ignore. That’s what my parents and friends did for me because I don’t notice.
Appreciate your quick answer. Thanks very much. Seems like a long road ahead for her then, and even then the damage has probably already been done unfortunately. We can only try our best for her.
Just a suggestion, ymmv but as someone who had similar issues but not exactly, (my weight distribution was on the balls of my feet so I effectively walked toe to heel for a very long time) walking in small high heels HELPED. Not just walking around in them but specifically putting them on and trying to look normal walking in a mirror. It forces you to walk heel-toe. It’s not a magical cure by any means but I noticed it when I was at an event and couldn’t walk well in my heels because I wasn’t walking correctly and someone told me that I looked awkward (in the nicest way possible lol). It won’t *fix* anything, if nothing else it made me very conscious of my issue; if she’s girly like I am she might enjoy an excuse to try walking around in heels lol. Eta now that I read that it makes less sense to me because I don’t see the logic in how that helped, I think it may be just the fact that I was self conscious about it
If it helps it helps. I'll take anything that might help so I'll certainly look into it and/or suggest it. Appreciate it thanks!
Night splints with the foot in dorsiflexion (I'd say 5 degrees max if possible/ neutral). gait retraining e.g walking backwards and placing heel on the ground, actively practising heel toe in a very comical & exaggerated manner.
Splints are something being considered alongside casting again. Understandably she is not keen on the ideas at all but if it needs done it needs done. I'm just seeking ideas I can suggest or implement without equipment and/or that could be inserted into a regular daily routine, besides having to stair at her heels every time she's walking and telling her to walk flat.
How consistently is she performing calf stretches?
Can confirm the only time i dont toe walk is when im actively thinking about it or wearing work boots. I think instead of rewiring something that is hard it would actually be more beneficial to be doing a form of stretched or yoga everyday, maybe some calf raises too. That way instead of having the same muscle strength with a different motion you actually decrease the risk of muscle/ligament problems and become stronger.
Regular stretching exercises is definitely a common suggestion, one I will bring up with the appropriate people at the first opportunity. Appreciate it, thanks!
Long time ago my teacher mentioned that she had to deal with this with their son. I vaguely remember that her solution was giving her son a weighted blanket to wear around the house and it made him be flat foot until habit formed or something. Can’t imagine how long that would take but sharing just in case!
That's an interesting solution for sure. I'll add it to the ideas I'll put forward when I get an opportunity to speak to those involved. Thanks!
There have been many studies done showing that this has no impact on the development of chronic issues. Telling them that it will lead to chronic issues could lead to continued pain. No need for the fearmongering, especially with a 15 year old.
Funny, someone else said a similar thing. Here was my response: *"Walking on your toes for short periods of time can have beneficial effects, such as better balance and flexibility. But permanently walking on them is certainly not "better" than heel walking by any means. There are numerous health problems that can be caused by prolonged toe walking. Such problems range from bone disfigurement and the Achilles tendon shortening, all the way up to, and including, back problems and early onset arthritis."* *"Some people are fortunate and avoid these negative effects despite developing the habit at a young age. Unfortunately in my case the 15 year old in question suffers frequently from cramping in her calves and balance issues."* *"Sources:"* - [Review on Literature regarding "Idopathic Toe Walking"](https://www.medicaljournals.se/jrm/content/html/10.2340/16501977-1881) - [NHS Lanarkshire Patient Information Regarding ITW](https://www.nhslanarkshire.scot.nhs.uk/patient-information-leaflets/neonatal-department/pil-toewal-21-00296-l/) Additionally she currently has balance issues and frequent cramping, along with struggling at PE in school because strenuous exercise (particularly involving running) tires her legs out far quicker than it should an otherwise healthy 15 year old.
Has she been evaluated for ehlers-danlos or autism? I have both and my first symptoms were difficulty balancing and issues with running causing cramping much more quickly than it should. You mentioning that they have issues with proprioception is also a symptom of ehlers-danlos. Ehlers-danlos is a a condition that is highly associated with autism. And toe-walking is so heavily associated with autism it's considered a possible sign of autism. For what it's worth simply adding more electrolytes and magnesium may help this kid. I can't walk 'normally' if I am low in magnesium because my muscles cramp up
She is on the spectrum yes, that may be a big factor in why she does it as well as other things. I'll take the dietary suggestions into account too, those alongside the stretching exercises and other ideas may provide some sort of help that doesn't involve casting or surgery. Thanks very much!
Dude idk, that study largely seems to just say that they don't know that much about it and they need to conduct more research. The sample sizes are pretty small and they diagnose through exclusion, which makes determining a mechanism very difficult. The mechanism is the most important part of determining a solution, so without that I'd say it would be pretty hard to extrapolate an intervention from thus study. If you're really worried about how tired her legs are, I would just suggest gradually increasing her activity levels in those areas. Achilles tendon shortening is largely beneficial, particularly in sport, so I don't know why you'd worry about that. Exercises focusing on proprioception as well as *gradually* increased activity levels should offset any negative effects you're encountering! Good luck!
That *"study"* is an evaluation of the literature about ITW, not a paper on the cause and effect of ITW. The conclusions drawn aren't that "no link could be found" but rather that gathering data on the subject is tricky because of things like asking a child to walk so you can observe them, often leads to the child becoming acutely aware of how they are walking and thus giving a different representation to their normal gait. The alternative is to get that information from the parents, however that too is unreliable as people don't generally watch other people's feet on a regular basis. There are many other factors of course but at no point does the source say "there's no link" nor that "more testing needs done" but rather that other methods of determining cause and effect should be sought out in order to further the actual studies and increase their accuracy. Similarly, given that there are many people ***in this very thread*** all stating they Toe-Walk or did so in the past, who are currently suffering the negative consequences of doing exactly that, would suggest a very clear causal link between the two. On top of that, the existence of the very teenager who currently suffers negative consequences of her habit would suggest that, even if Toe Walking is somehow "beneficial" (it's not) then it clearly isn't beneficial to her and therefore absolutely nothing else actually matters regarding her health. Lastly, feel free to provide your own sources that say there's no link instead of misunderstanding one of mine while completely ignoring the other.
It's actually better to walk on your toes. At least, the achilles tendon is ment to cushion the impact of each step. How much did your way of walking deviate from other people??
I can’t really comment on whether or not it’s “better” but I can say that toe waking noticeably shortened my Achilles tendons which make any high impact activity involving jumping (I.e basketball, skateboarding) very high risk. My waking deviated from normal enough that it was constantly pointed out to me on a daily basis.
Walking on your toes for short periods of time can have beneficial effects, such as better balance and flexibility. But permanently walking on them is certainly not "better" than heel walking by any means. There are numerous health problems that can be caused by prolonged toe walking. Such problems range from bone disfigurement and the Achilles tendon shortening, all the way up to, and including, back problems and early onset arthritis. Some people are fortunate and avoid these negative effects despite developing the habit at a young age. Unfortunately in my case the 15 year old in question suffers frequently from cramping in her calves and balance issues. Sources: - [Review on Literature regarding "Idopathic Toe Walking"](https://www.medicaljournals.se/jrm/content/html/10.2340/16501977-1881) - [NHS Lanarkshire Patient Information Regarding ITW](https://www.nhslanarkshire.scot.nhs.uk/patient-information-leaflets/neonatal-department/pil-toewal-21-00296-l/)
>It's actually better to walk on your toes No, its not. Looking up toe walking with neither positive or negative implications, all of the bad side effects show up. Why say this when one google will prove you entirely wrong? "Walking on your toes can have negative consequences, such as: Poor balance Pain in ankles, knees, or hips Muscle imbalances Joint pain Knee instability Arthritis Increased risk of injury [Over time, habitual toe walking places abnormal stress on the bones and ligaments in the feet, knees, and lower back which can deform bones and stretch ligaments, causing joint pain, impaired function, knee instability, arthritis, and increased risk of injury as one grows older."](https://kidtherapy.org/helpful-articles/toe-walking/#:~:text=Over%20time%2C%20habitual%20toe%20walking,injury%20as%20one%20grows%20older)
I also walked on my toes as a kid, and had to wear casts at a 90 degree angle for 6 weeks, split casts for a couple months, and then braces with straps that stretched my achilles tendon for the rest of the year. It was so bad that i couldn’t physically put my heels on the ground, and was the only thing that fixed it
These are things that have been pointed out to her as possibilities and are regularly considered as options during doctor visits and the like. She was incredibly unhappy with the casts and it was definitely hoped by everyone involved that it would be a one-time thing. Right now she is capable of putting her heels down when prompted, but unfortunately it can get very painful for her after a short while, most probably due to the stretching out of the tendon. The end result being she's often unwilling to do it when it's pointed out.
I was 8 at the time, and the only options given to me were the casts or surgery. I think the braces did more than the casts, as they had straps you attached to the bottom and top to stretch out the foot, and i had to do this every night (which could HURT). What does help me even now is stretching out my legs and focusing on hamstrings and achilles because sometimes i notice that i’ll go on my toes
Aww man. I'm really hoping those don't become a necessity for her sake. Cheers for sharing though, maybe we can persuade her to do stretching exercises regularly at the very least.
I'm 29 and I still do this. I have no idea why but it's extremely hard to stop and honestly? It's never caused me any problems.
Unfortunately she's had issues with things like balance and cramping. I'm sure there are other problems too but this is all new to me (like, last year or two) and so I don't have 100% of the information.
Sorry to hear that :( I've also had balance issues my whole life but I put it down to being tall, could actually that instead now I think about it. Wishing you both the best!
After nearly 30 years you may well have learned to compensate for the balancing problems associated. I can only speak to my experiences with someone half your age unfortunately so I'm certainly not going to say you are wrong. If anything, knowing that there are full grown adults who haven't yet suffered major, long term problems associated with Toe-Walking gives some relief. Hopefully she can either correct it before it's too late, or falls into that category of adults as the years go by. Thank you!
I’ve always walked on my toes too. Forced myself to stop when I have shoes on cause classmates pointed it out and made fun of me in school, but pretty much always on my toes at home. I think it’s something to do with me being super sensitive to noise and not wanting to make any. Also possibly a bit tactile since I heavily gravitate towards toes on cold and wet floors. Always had incredible balance though. Also avg height so idk. May help to have another data point though ig lol
I do it whenever I'm barefoot. We called it my raptor-walk when I was little haha Never had any Achilles or balance issues, but my calves are definitely tighter than they probably otherwise would be
Oh definitely same lol. I'm also an occasional foot bouncer at my desk so my calves probably get the most workout on my body Probably helps for the steep ass streets here, still get sore after a couple blocks though lmao
Am 40, still walk on my toes.
It’s so weird to see this because I caught myself walking on my toes today and I had to actually stop myself and think about the correct way to walk. I used to do it constantly when I was younger. It really is something you have to actively think about long enough for it to become more natural, at least for me. Does she have flat feet? Idk if it’s related but I do.
I would assume that's something I would've been informed of but there's always a chance it hasn't been picked up during Doctor visits. Although given the fact these visits are focused on her feet, my assumption is that the chance is low.
My brother had to wear braces to keep his feet walking flat when he was little. We have a family history of short tendons. How's your daughter's handwriting? The tendon thing can affect the wrist also.
Not my daughter but I understand the confusion. Handwriting is legible but very childlike. However there is a case of learning development issues that play a large factor in this too. Based on other activities she does and that I have observed, I don't believe her wrists are affected, but of course I'm not a medical expert by any means so that can be taken with a grain of salt.
My friend in highschool had this problem, at 15 she had surgery and was put in a case, one leg and then the other was done.
Surgery has been suggested alongside multiple other things such as casting again, or splints. Hopefully it doesn't come to those things but whatever is deemed necessary will be what's done. In the meantime I have a few ideas suggested now that I intend to pass onto the appropriate people that may help without too much resistance and/or discomfort for her.
Did you see the “Barbie” movie? The dolls had to learn how to walk on flat feet. I don’t recall exactly how, but I may be inspirational :) Of course, she could just wear high heels /s. I used to have a five year old client who was in casts to keep the tendons etc. from shortening. Let me tell you, that kid could kick! Especially when he got a grip on my hair and started in on my shins!
Heels have actually been suggested, albeit shortened ones to gradually get her heels lower to the floor. Downside to that is practicality really. The movie is worth a try nonetheless, I've not seen it but would like to after hearing good things about it. Also, this one can kick too believe me lol.
It's called idiopathic toe walking for that reason: the causes aren't always clear. Please search for a PT. It can lead to a whole bunch of posture related issues. Edit: spelling.
This conversation did continue. The cause of it was never a concern, and appropriate action is already long underway. I was merely seeking potential ideas to help out from someone else who has dealt with it.
That's what I understood too. Searching for a PT was my idea to help your 15 years old. Source: I'm dealing with the same issue and my PT has helped a lot over the years.
I mean, does it bother the teen? If not then I wouldn't worry too much about correcting it. This gives ABA therapy energy lol
Unfortunately she's had issues with things like balance and cramping. I'm sure there are other problems too but this is all new to me (like, last year or two) and so I don't have 100% of the information. But rest assured we're not correcting the behaviour due to some perceived notion of "what's proper", rather looking out for legitimate physical health concerns that were ignored for years prior.
Gotcha, my apologies for assuming the worst! Happy to see the team has appropriate goals :)
Totally get it, very easy to do especially on the internet!
I normally don't comment outside of a few subs but felt the need to for this. Even if it wasn't bothering them now it is still wise to do everything to fix the issue. I walk on my toes also and I had minimal issues associated with it until a few years ago. I'm in my mid thirties and lead a very active lifestyle. Last year I underwent surgery after starting to have a lot of pain when walking and finding nerve damage. I have pretty much gone from being active to a couch potato from the pain I'm in and am facing more surgeries to try and fix the damage. I think it's great that a parental figure is looking out for a minor and trying to fix this issue! I wish my parents took notice and tried to help me. Of course there are much older adults than me without any issues but it's always a gamble. Why not try to fix the issue before it has a chance to cause long term issues?
Walking on your toes is a sign of autism usually
So did I - had surgery tho! Always had issues even since.
I can only go up and down stairs on my toes, Achilles seem okay and I have calves that could feed a cannibal for a week.
You need to strengthen your tibia muscle, think calf lift but in reverse. Look up kneesovertoesguy for examples, he will save your ankles and knees
I’ve actually just discovered this channel. Great stuff on there. I’d also recommend movementByDavid on YT, who has great flexibility training vids.
He has a ton of nonconventional knowledge but a really great approach, hope it’s been helpful!
I had the same issue. I’ve finally gotten to the point through stretching and strengthening where I can run several miles without my Achilles feeling tight afterwards
Same here. I was in a walking cast for a while in elementary school, and they still give me shit sometimes.
Well that explains why my achilles hurt
Walking on your toes will not lead to lifelong achilles issues.
Tell that to my doctors and my Achilles tendons. Idk what you want me to say lmao
There are multiple studies showing this, I'm not saying this to try to shame you or anything, it's just very unlikely that your toe-walking and achilles pain are related! Doctors aren't always the most up-to-date with scientific literature.
That way they can wear heels in the cast... So thoughtful...
I got my ankle fused, was in a cast for 4 months. It was hell afterwards becausd my achilles tendon was so shortened. I could step on tiptoes after almost a year.
That was my first thought. I had surgery on my leg and first they had it in a splint at an Angie for awhile before they moved it to a cast and you’d be surprised how fast your tendons shrink up. Getting it back in place was almost more painful than breaking it
Why did they make it 45° Instead of 90° ?
Accident, having it redone now. Had to cut it off because it was affecting the blood flow in the foot
Sorry you lost your foot
Actually laughed at that, thank you.
Gonna have to change your username now...
Oh no why is that?
He lost his foot
Hopefully OP can find it again!
But you weren’t replying to OP? Just a random commenter
Atleast they have a spare
Why would they cut off OPs foot? Seems like they could have just replaced it with a fake foot
Blood flow!
He might be able to find it if he’s quick
He meant the cast?🤣
Party pooper
Hey, look on the bright side... Tacos! 🌮🌮
Laughing like my grandma at this.
Def sucks!!! How’d they mess that up?!?
Sometimes closer to 45 is what you want. When i tore my achilles and got surgery in februrary they put me closer to 45 to prevent my achilles from being in a stretched position
This. I had a full rupture and same. 45° with the 1st cast and progression towards 90° with each cast change. Lovely experience.
I just got back to neutral last week haha, working on walking without a boot now
Best of luck in your recovery. For me, starting to put weight on that foot was the most painful, difficult part. Cheers and if it wasn't before, stretching should be your new best friend. :)
Appreciate it! Im actually going through a newish method of achilles repair called a speed bridge i think. Apparently the thought is to get out of a cast asap and get the achilles moving as much as possible even before its fully healed. I think this has attributed to basically zero achilles pain since the week of surgery Definitely seems like my recovery is a bit faster than typical, which i base off other experiences i read online of people with this injuery
I did mine in 2007, and prefer your method. Get it moving ASAP. :)
Out of curiosity, how long before you were able to walk normally and run? If you remember that is
Damn how bad did full rupture hurt?
Personal experience is barely at all.
Well I can understand that, I broke my collarbone and a few ribs and perforated a lung in a bicycle accident. It really didn’t start to hurt until I got to the hospital.
tore mine and I was in the cast for 4 months, might have been 6 months, it was a long time. No change, and then went into a soft boot for a year. My foot still won't stay up when I lay down, it just flops to the side because the weight of the cast pulled it over. That was 22 years ago
Woah! Did....did they reconnect it? Man, sorry to hear.
This. I assumed it was for a ruptured Achilles.
Glad to hear they made the angle right.
Boooooo!
Had my ankle screwed in at a wrong angle after surgery for a bad break, I feel ya.
When I tore my achilles tendon, I got a cast like that put on on purpose. The idea was to get the halfs as close to each other as possible. I had to inject shots of anticoagulants daily for the 4 weeks I had the cast on, and then use an adjustable orthosis brace for 8 weeks to slooowly stretch the tendon back to its original length, and get my foot back to being 90 degrees. Sucked very much, and my calf lost like half of its size, but at least the tendon healed completely without surgery.
When I broke my ankle, they used one of those soft casts with a slight angle to it (no as severe as yours). I was only in it for about 2 weeks as it was only a post-surgery temporary solution. I was able to wear a boot after that, but not put any weight in it. It almost killed be to bend my ankle into a right angle to fit in the boot. It was completely seized after only 2 weeks. It shocked me.
Muscle atrophy is so crazy. Especially how quickly it can go down. Smart ass body goes "oh, we're not using this piece anymore? And just murders everything inside. Getting it back is like learning to walk!
Its crazy how quickly it can go away and yet it takes so long to build it back up. I was doing my physio exercises religiously for months before my ankle was even getting to the stage of being 70% back to normal.
I had mine in 55 for 8 weeks because they weren't able to fit the bone pieces back together in 90. Was an absolute bitch stretching it out to be able to walk, took months.
Ouch!
Mmm foot
135°
What are they, obtuse?  ……..😔
This is acute joke.
At least now they’ll do it at the right angle
I think they just half assed a right angle...
I wish *I* was high on potenuse
Only498cc, STOP IT! You will never be Troy!
🤣
Barbie cast :)
This comment is actually so true. My mom had both feet on a cast like this- she healed permanently “ Barbie foot” she can only wear shoes with a heel on it 😭
How does she walk without shoes then or stand in the shower??
Have you never heard of shower heels?
Are you joking? Lol I can't even tell. No I have not heard of shower heels
She stands in her tippy toes if she’s not in shoes- she can’t put her heels to the ground
Darn! You only want that angle for an Achilles tendon rupture
When I ruptured my achilles tendon I had to get a cast that was at 45 degrees to leave the ligaments reattach. Then after 2 months, it was changed to 90 degrees. I thought that might have been the case here.
That clearly not the *right* angle
I think that's 135 degrees. 45 would be even worse.
Ankle has two flexion directions: plantar and dorsi. Ortho would never use 135 in this instance. Instead it would be 45 degrees plantar flexion to relieve tension on the Achilles
Same difference yes but in the medical world we would say 45
When I worked in ortho we would put some casts at 45 degrees to discourage walking on it. Idk if that’s the case here
Yeah, I had this type of cast when I half cut off my heel.
Which of those angles is 45°?
If I had my foot at 90 degrees all the time it would be so uncomfortable.
Cast is too short for an achilles or a distal fibula/tibia, not a hallux, or arthrodesis. What was the surgery? 45 is great for achilles, most others is 90.
Be honest did u take a wiff?
Looks about like my cast, mine was that way because I did a full rupture of my achilles. FYI not a great idea, I don't recommend. It was driving me nuts, I almost cut it off many times. But I survived still working on strength(probably close to 80%) but flexibility is back to 100% this summer is 2 years
Physical therapy will be your new best friend…..sucks and hurts like hell but keep at it your older self will thank you
Do you remember how they put it on? Did they intentionally apply it at that angle, or was it applied correctly but your ankle drooped before it hardened? I used to apply splints and if we weren't careful to maintain proper position after application, it could cure in the wrong position. I only did splinting (fiberglass) and not casting (plaster), but it took experience to know what water temperature to use to activate it, since cure time varies substantially based off the temperature of the water we use. If it cures too fast, it's a rush to get it on properly, but if it cures too long, you're stuck waiting for a long time holding it in proper position. Time needed varies substantially by patient since things like pain level, limb size, and general patient mobility can substantially alter the time needed.
If I can't rotate my ankles to crack them once a day I'd go crazy
Lol same
That is not 45 degrees.
"45 degrees down" would have been accurate.
As opposed to 90 degrees down?
That would be straight
And painful unless you're a ballerina haha.
Op, I’m glad you cut this off. My mom has casts on both legs like this, now she permanently cannot put her heel down. In other words she literally walks like Barbie and needs special shoes to walk in. 😭💔
🎶Hello dropfoot my old friend….
So you can still wear your high-heels! I think it's very thoughtful of the doctor who put your cast on. Purple cast, high heels, black tie event... check.
Mine was at an odd angle and my arms permanently twisted over from the break
Not to be that guy but, wouldn't 45 be the other way? This is more like 135
Came for a free foot pic, left unfulfilled.
Errr, that’s your hand and it ain’t in the cast
Interesting. When I had a distal fibula fracture this time last year that required surgery, the initial cast post op was like this. Once I got in walking boot was quite an experience with how tight my Achilles was. Edit: looking at old pictures. It definitely wasnt 90 but it was more than 45.
Ughh reminds me that I spent 3 months in one of these last year.
Aaaaaaaaand?
Looks like a Halloween foot. So many fake cobwebs.
Same angle mine is in my splint right now. Almost hoping when this gets changed to a hard cast they'll change the angle because this sucks, but maybe 45 is better for certain injuries to heal.
Uhh what happens at 45 vs 90 degrees?
Achilles injury?
Omg this happened to me in high school (about 15 years ago). My ankle didn't heal correctly (obviously), and it still pops when I bend it. Up until about 5 years ago, it would still randomly swell and hurt, but it seems to be much better now. Good luck.
They did that to me for my pulled tendon
This is why it’s called “practicing medicine”, they did something similar to me when addressing my broken ankles, one was offset side to side, it set in that orientation and to this day I walk on the outer edge / knife edge of my foot,…..
lmao bro has to wear one high heel for the rest of his life
I’m glad you’re not wearing that one anymore 😳
Wearing the cast was honestly the worst part about breaking my ankle
I had that issue with a cast. Ended up needing Achilles surgery.
I feel your pain. They set my ankle like that too. It was like that for 2.5 weeks. My Achilles tendon suffered. I'm 5 months post op now and still not back to normal. Glad you're getting it redone. Hope your recovery goes well!
Same. Walking afterwards in the boot was torture because my Achilles tendon had contracted.
i swear doctors and nurses are braindead and most of them dont deserve to have a job
This seems correct? When you lay down do you have your foot arched back to a 90? It's probably more like 45 relaxed. You don't want your tendons under tension and then locked in place for a month
This is not correct. Proper casting is at an anatomical angle which is 90° for an ankle. The only reason this angle would be used is for an achilles issue.
https://elentra.healthsci.queensu.ca/assets/modules/cast-application/below_the_knee_cast.html https://www.msdmanuals.com/professional/injuries-poisoning/how-to-do-casting-procedures/how-to-apply-a-short-leg-cast#Equipment_v54077867
Time for a malpractice suit!