A case study published on September 13, 2018, in the Journal of Pediatric, Maternal & Family Health documents the improvement of a 15-month-old child who was suffering with toe-walking and feeding problems. Toe walking is not considered a medical issue by itself under the age of two years. However, above the age of two, toe walking is considered abnormal.
According to the American Academy of Orthopedic Surgeons, “Toe walking is a pattern of walking in which a child walks on balls of his or her feet, with no contact between the heels and ground. Toe walking is common in children who are learning to walk. After the age of 2, however, most children outgrow toe walking and begin to walk with a normal heel-to-toe pattern.”
Toe walking has been associated with disorders such as cerebral palsy, congenital contracture of the Achilles tendon or paralytic muscular disorders and some developmental disorders such as autism or myopathic and neuropathic disorders. It is estimated that 2-5% of children at age 5.5 years still have toe walking. Among children with a neuropsychiatric diagnosis or developmental delays, the percentage of toe walking is much higher at 41%. If other conditions are ruled out, toe walking by itself can be referred to as idiopathic toe walking.
In this case, a 15-month-old girl was brought to the chiropractor by her mother. The girl’s problems included toe walking and a reported difficulty in eating. Her mother reported that her daughter has been toe walking since she started walking at 12 to 13 months of age. Since that point, the girl has never walked normally. It was reported that the girl would take a few steps with flat feet and then start walking on her toes by the fourth or fifth step.
In addition to the toe walking, the girl has also had eating problems since she was 3-months-old. Her mother reported that her daughter refused to nurse or bottle-feed, so her mother was forced to spent hours each day spoon-feeding her pumped breast milk. Once eating solid food the girl would only eat if distracted and food was placed into her mouth. The girl did not suffer from any neurodevelopmental disorders or from other disorders associated with toe walking.
A chiropractic examination was performed which found some positive findings from palpation, a posture analysis and reflex tests. It was determined that subluxations were present. With the mother’s consent, specific pediatric chiropractic care was started.
On the fifth visit, the girl’s mother stated that her daughter was no longer toe walking, and was walking normally. Her mother also reported that her daughter was demonstrating an increased interest in food and eating, and appeared to be physically more comfortable while eating. During a three-month follow-up visit, it was reported that the girl was still free from toe walking.
In the study discussion and conclusion the authors wrote, “The infant presented in this case report presented with both difficulty eating and toe walking. The focus of this case report was her toe walking but we acknowledge the impact of chiropractic care in improving the infant’s feeding mechanics and feeding habits.” They continued, “This case report provides supporting evidence on the benefits of chiropractic care in a child with toe-walking.”
