Immediately after the baby is born, they check whether he has dysplasia of the hip joints or congenital shortening of the hips or legs. If the neonatologists missed the defects, then the orthopedist or surgeon at the clinical examination in 1 month will correct the situation. But the mother herself should pay attention to important signs: if you put the baby on the back, and then bend its legs so that the baby's feet stand on the changing table, then the knees should be at the same level. Asymmetrical folds under the buttocks and on the thighs should also be discussed with your doctor.
Exit. Fixing splints, cushions and stirrups, installed up to 6 months, should eliminate hip dysplasia, and the operation will lengthen the shortened parts.
2. Where are the knees looking? Clubfoot in children
Clubfoot in a child can be a serious problem and temporary. In the first case, the child's foot (one or both) and the ankle are turned inward strongly, almost 90 °. And you can notice this feature almost immediately after birth. The second situation is absolutely natural, by the age of 2 it is corrected by itself, but sometimes the process is delayed up to 3-4 years.
Exit. The treatment of severe clubfoot in a child begins at 2 weeks of age. Usually massage and physiotherapy exercises are practiced. If after six months there is no result, they think about the operation.
3. O or X?
In some children under 3-4 years old, when walking, the legs are located with the letters O, X, or both knees look in different directions. It is important to ensure that after two years this feature does not worsen, there are no joint pains and discomfort when walking. The child manages to finally adapt to life in an upright state only by adolescence, which means that everything that happens before fits into the concept of the norm.
Exit. In any case, consultations with a specialist once every six months, massage and physiotherapy exercises will not interfere.
4. Loose support: flat-valgus or varus foot in a child
Doctors make the diagnosis of “flat feet” not earlier than 5 years, and before that they use the terms “flat-valgus foot” - the feet are strongly “overwhelmed” on the inner part, and “varus” - the outer edges serve as a support. The first deformity can develop into flat feet in a child. It becomes difficult for a kid to walk for a long time, and his new shoes in just 1–2 months are worn down from the inside. The second situation never leads to flat feet in a child, but it also gives an increased load on the joints of the legs and the spine, turning around at least in a stoop.
Exit. With timely correction with the help of physiotherapy, the defect can most often be eliminated in a few years.
5. What will the child's gait tell about?
There are several incorrect gaits in children. One - the child rests on his toes, lifts and turns his heels outward, slightly bends his legs at the knee and hip joints, and brings the hips together. The second is identified by dragging the right or left leg, as well as the arm bent and pressed to the body on the same side. The next time the child's gait is characterized by excessive, inappropriate, pretentious movements of the limbs, for example, the knees are raised high, and the feet are "spanked".
Exit. For any deviation from the norm, the baby should be shown to a surgeon, orthopedist and neurologist. Most of the listed features are associated with disruptions in the development of the brain or spinal cord and require timely correction.
Doctor's advice
If you notice that the baby for no apparent reason (uncomfortable shoes) began to limp, drag a leg or take unusual postures when sitting, lying or standing, urgently consult a specialist - a surgeon or orthopedist. The same should be done if the joints are swollen and hot to the touch. Sometimes colds and flu cause inflammation in the musculoskeletal system. And successful recovery depends on how quickly the treatment is started. Until the child is tested, it is important to minimize the stress on the affected leg.
6. The child has sweaty feet
Exit. Traditional medicine offers many methods of treating sweating of the feet in children - foot baths with infusions of oak bark, sage, string, hardening (walking barefoot, pouring cold water), foot massage, various ointments and powders.
7. Calf pain
Parents need to pay due attention to children's complaints of pain in the lower extremities, ask where exactly and what is happening, track changes in the child's gait. Most of the complaints are due to bruises and sprains during active games. Smaller - becomes a consequence of uneven growth of bone and muscle tissue. The zones of more intensive development are ahead of the lagging ones, causing discomfort in them. One fifth of children experience leg pain in the evening. Blood circulates well during the daytime, but at night the blood flow decreases and pain occurs. A light massage should relieve the unpleasant sensation.
Exit. As soon as the child has reported pain in the legs, it is necessary to examine him. Pay attention to general health, appetite, body temperature, mood. However, not all cases are so harmless, and it is better to discuss the situation with your doctor.
8. Orthopedic shoes for children
According to statistics, 95% of children are born with healthy legs, but with age, about a third of them acquire various pathologies of the musculoskeletal system. Orthopedic shoes for children can correct many defects in the bones and joints of the legs. It is impossible to buy such things without a doctor's prescription, you can harm the correct development of the child's feet or aggravate existing problems.
Exit. The best amenable to correction with the help of orthopedic shoes for children is flat feet in a child, as well as hallux valgus and varus deformities of the feet.
9. Already in heels?
Actress Katie Holmes and model Heidi Klum caused a public outcry when they let their 4-year-old daughters wear high-heeled shoes. Such antics have been called "parental failure." According to experts, the consequences of such a violation are stretching of the ligaments and curvature of the shape of the foot in a child, as well as deformation of the spine, which will inevitably lead to malfunctions in the work of internal organs.
Exit. Shoes of fashionistas under 7 years old should have a heel no higher than 5-7 mm.
10. Let's put on our shoes! The right shoes for toddlers
The first shoes are put on as soon as the baby begins to learn to walk. The first shoe for children should have a high, rigid heel, an instep pad to form an arch and a spacious toe that does not squeeze the forefoot.
Exit. It is imperative to buy the first shoes for a child. We suggest the following procedure. Let the baby put on an update and look a little like in it, and you watch if his gait has changed.
Charging game for legs
Simple gymnastics, which can be easily turned into a fun game, can be a good prevention of planovalgus deformity and flat feet. Exercises should be performed daily, 5-7 times each.
Uncover your baby and offer him:
* alternately and synchronously bend and straighten the toes on each leg;
* rotate the feet clockwise and counterclockwise;
* walk on toes, heels and leaning on the outer part of the foot;
* collect small objects from the floor with your toes: pebbles, balls, details from a designer with a diameter of 3-4 cm (a complicated version of this exercise looks like this: scatter small objects on the floor, cover them with a handkerchief and invite the crumbs to collect everything without removing the cover);
* sitting on a chair, alternately rolling a tennis ball or gymnastic stick with your right and left foot;
* walk slowly, holding a tennis ball between your feet;
* to resist, holding the hands of an adult, on a fitball, trying to maintain balance;
* walk on a narrow log and climb the rungs of a rope ladder.
It will not be difficult to notice something amiss in your gait. But - more than that: in many cases, he will be able to determine "by eye" what is wrong with your body using it.
Flat step without much rise
Can show: flat feet, a bump on the toe, neuroma.
Flat feet are obvious at first glance: there is almost no visible arch in the foot. But other illnesses can also lead to flat walking. When a person takes a step, the foot is aligned even when the heel is lifted off the ground and when it is about to move into an "arched" position. The heel may move slightly inward. This kind of movement is an attempt to create more stability when there is a painful bone (abnormal expansion of bone or tissue at the base of the big toe) or a neuroma (nerve disease) in the leg.
Shuffling feet
Can show: Parkinson's disease.
Shuffling your legs - leaning forward, barely lifting your feet off the ground - is not an inevitable aspect of aging. This type of gait may mean that the person has Parkinson's disease. A person's steps can also be short and indecisive.
"Shuffling is one of the most common manifestations of Parkinson's disease," says American podiatrist Dr. Blitzer. Along with tremors, this can be an early sign of illness.
Tiptoe walking, both feet
Can show: infantile cerebral palsy or spinal cord injury.
The toe reaches the ground to the heel, not vice versa. This is due to overactive muscle tone caused by improper firing of stretch receptors in the brain. When tiptoeing occurs on both sides, it is almost always due to injuries in the spine and brain, such as with cerebral palsy or spinal cord injury.
Note: sometimes babies walk on tiptoe when they’re just learning to walk, but that doesn’t mean they’re paralyzed. If you are concerned about this, talk to your child's doctor.
Tiptoe walking, one foot
Can show: stroke.
Doctors evaluate tiptoe walking for symmetry: does it happen on both sides or just one? When a person walks on one side only, it is an indicator of a stroke, which usually affects one side of the body.
Can show: unusually tight calf muscles.
Unusual is the gait in which the walker literally bounces. This is due to the tense muscles in the lower leg. Women are most vulnerable to this condition because they often walk in heels (a chronically elevated heel position), says podiatrist Dr. Andersen.
“I've seen women in their 60s who can't wear flat shoes,” she says. "The same thing could happen much earlier, for example, with 25-year-old girls who wore stilettos as teenagers."
Walking- one of the most difficult and at the same time common types of physical activity.Cyclic stepping movements trigger the lumbosacral centers of the spinal cord, regulate the cerebral cortex, basal nuclei, brain stem structures and cerebellum. This regulation involves proprioceptive, vestibular, and visual reverse afferentation.
Gait human is a harmonious interaction of muscles, bones, eyes and inner ear. The brain and central nervous system are responsible for coordinating movements.
In case of disorders in certain parts of the central nervous system, various movement disorders can occur: shuffling gait, sharp jerky movements, or difficulty in flexing the joints.
Abasia(Greek ἀ- prefix with the meaning of absence, not-, without- + βάσις - walking, gait) - also dysbasia- violation of gait (walking) or inability to walk due to gross gait disturbances.
1. In a broad sense, the term abasia means gait disturbances in lesions involving various levels of the motor act organization system, and includes such types of gait disturbances as atactic gait, hemiparetic, paraspastic, spastico-atactic, hypokinetic gait (with parkinsonism, progressive supranuclear paralysis and other diseases), gait apraxia (frontal dysbasia), idiopathic senile dysbasia, peroneal gait, duck gait, walking with pronounced lordosis in the lumbar region, hyperkinetic gait, gait in case of diseases of the musculoskeletal system, dysbasia in case of mental retardation, dementia, psychogenic disorders, iatrogenic and drug dysbasia, gait disturbances in epilepsy and paroxysmal dyskinesia.
2. In neurology, the term is often used astasia-abasia, with integrative sensorimotor disorders, more often in the elderly, associated with impaired postural or locomotor synergies or postural reflexes, and often the variant of imbalance (astasia) is combined with walking impairment (abasia). In particular, frontal dysbasia (gait apraxia) is distinguished with damage to the frontal lobes of the brain (as a result of stroke, discirculatory encephalopathy, normotensive hydrocephalus), dysbasia in neurodegenerative diseases, senile dysbasia, as well as gait disturbances observed in hysteria (psychogenic dysbasia).
What diseases there is a violation of gait
The eye and inner ear play a role in causing gait disturbance.Older people with visual impairment develop gait disorders.
A person with an infection of the inner ear may develop balance disorders that can lead to gait disturbances.
One of the most frequent sources of gait disturbances is functional disorders of the central nervous system. These can be conditions associated with the use of sedatives, alcohol and drug abuse. Poor nutrition appears to play a role in gait disturbances, especially in the elderly. Vitamin B12 deficiency often causes limb numbness and imbalance, leading to gait changes. Finally, any disease or condition that damages nerves or muscles can cause gait disturbances.
One of these conditions is infringement of the intervertebral disc in the lower back. This condition is treatable.
More serious gait disorders include amyotrophic lateral sclerosis (Lou Gehrig's disease), multiple sclerosis, muscular dystrophy, and Parkinson's disease.
Diabetes often causes numbness in both legs. Many people with diabetes lose the ability to determine the position of their feet in relation to the floor. Therefore, they have an unstable position and gait disturbances.
Some diseases are accompanied by a violation of the gait. If there are no neurological symptoms, the cause of the gait disturbance is difficult to find out even for an experienced doctor.
Hemiplegic gait is observed with spastic hemiparesis. In severe cases, an altered position of the limbs is characteristic: the shoulder is brought and turned inward, the elbow, wrist and fingers are bent, the leg is unbent at the hip, knee and ankle joints. The step of the affected leg begins with abducting the hip and moving it in a circle, while the body deviates in the opposite direction ("the hand asks, the leg squints").
With moderate spasticity, the position of the hand is normal, but its movements in time with walking are limited. The affected leg is poorly bent and turned outward.
Hemiplegic gait is a common residual disorder after stroke.
With a paraparetic gait, the patient rearranges both legs slowly and tensely, in a circle - just like in hemiparesis. Many patients have their legs crossed when walking, like scissors.
Paraparetic gait is observed in spinal cord injury and infantile cerebral palsy.
Cock gait is caused by insufficient dorsiflexion of the foot. When stepping forward, the foot hangs partially or completely, so the patient is forced to raise the leg higher - so that the fingers do not touch the floor.
Unilateral disorder occurs with lumbosacral radiculopathy, sciatic nerve neuropathy or peroneal nerve; bilateral - with polyneuropathy and lumbosacral radiculopathy.
Duck gait is explained by the weakness of the proximal muscles of the legs and is usually observed with myopathies, less often with lesions of the neuromuscular synapse or spinal amyotrophy.
Due to the weakness of the hip flexors, the leg is lifted off the floor due to the tilt of the torso, the rotation of the pelvis promotes the movement of the leg forward. Weakness of the proximal muscles of the legs is usually bilateral, so the patient walks waddle.
With parkinsonian (akinetic-rigid) gait, the patient is hunched over, his legs are bent, arms are bent at the elbows and pressed to the body, pronation-supination tremor of rest (with a frequency of 4-6 Hz) is often noticeable. Walking begins by leaning forward. This is followed by mincing, shuffling steps - their speed is steadily increasing, as the body "overtakes" the legs. This is observed when moving both forward (propulsion) and backward (retropulsion). Having lost balance, the patient may fall (see "Extrapyramidal disorders").
Apraxic gait is observed with bilateral lesions of the frontal lobe due to a violation of the ability to plan and perform a sequence of actions.
The apraxic gait resembles a parkinsonian gait - the same "supplicant posture" and mincing steps - but a detailed study reveals significant differences. The patient easily performs the individual movements required for walking, both lying down and standing. But when he is offered to go, he cannot budge for a long time. Having finally made a few steps, the patient stops. After a few seconds, the attempt to walk is repeated.
Apraxic gait is often associated with dementia.
With a choreoathetic gait, the rhythm of walking is disturbed by sharp, violent movements. Due to chaotic movements in the hip joint, the gait looks "loose".
With cerebellar gait, the patient spreads his legs wide, the speed and length of steps are constantly changing.
When the medial zone of the cerebellum is affected, a "drunk" gait and ataxia of the legs are observed. The patient maintains balance with both open and closed eyes, but loses it when changing posture. The gait may be quick, but it is irregular. Often, when walking, the patient experiences uncertainty, but it goes away if he is even slightly supported.
With the defeat of the cerebellar hemispheres, gait disturbances are combined with locomotor ataxia and nystagmus.
The gait in sensory ataxia resembles a cerebellar gait - legs wide apart, loss of balance when changing posture.
The difference is that when the eyes are closed, the patient immediately loses balance and, if not supported, may fall (instability in the Romberg position).
Gait of vestibular ataxia. With vestibular ataxia, the patient always falls to one side - regardless of whether he is standing or walking. There is a clear asymmetric nystagmus. Muscle strength and proprioceptive sensitivity are normal — in contrast to unilateral sensory ataxia and hemiparesis.
Gait in hysteria. Astasia - abasia is a typical gait disturbance in hysteria. The patient has preserved the coordinated movements of the legs - both lying and sitting, but he cannot stand and move without assistance. If the patient is distracted, he maintains balance and takes several normal steps, but then demonstratively falls - into the hands of the doctor or onto the bed.
Which doctor should i contact if there is a violation of gait
NeurologistTraumatologist
Orthopedist
ENT
The so-called duck gait can be a sign of serious hip disease. In this article, we will talk about what kind of diseases this pathology can be in adults and children. And also consider the reasons for the appearance of such a gait in pregnant women.
Causes of pathology in adults
"Duck gait" is typical for diseases, in particular coxarthrosis.
This condition is chronic and leads to the gradual destruction of the bone that forms the hip joints. There are many reasons for the pathology, but the main one is the permanent injury of the musculoskeletal system. The development of the disease leads to the fact that the joint space begins to narrow. In the last stages of the disease, it may disappear completely.
In adults, the "duck gait" (the causes of the disease in children will be discussed below) can be caused mainly only by coxarthrosis. This pathology can develop in people of any age, with the exception of very young children. Men suffer from it more often than women. This is due to the fact that their physical activity is usually higher. Elderly people are most susceptible to coxarthrosis. At this age, tissue nutrition begins to be disrupted, and the body's ability to recover decreases.
How coxarthrosis develops
So, what kind of disease occurs in adults? Basically, with coxarthrosis, since it can only be caused by the destruction of the joints. But how does it happen and where does it start? How not to start the process and start treatment on time?
Regardless of what caused the appearance of the disease, it will always develop according to the same pattern. Healthy joint surfaces always correspond to each other, so that the load is evenly distributed. However, due to various harmful effects, deformation of the main component of the articular cavity occurs. This leads to a violation of the congruence of the articular surfaces. And this already results in an uneven distribution of the load on the joint during movement. The part of the cartilage that accounts for most of the weight gradually deforms and even cracks. And the surface of the joints becomes rough and uneven.
This process entails compensatory responses. First, cartilaginous tissue begins to grow in the damaged area. If the load does not decrease, then it gradually dies, and a bone is formed in its place. This leads to the formation of osteophytes (bony outgrowths), which gradually fill the joint. Around this time, the "duck walk" appears. It indicates a neglected state of the disease. If you do not start treatment on time, then the joints can finally lose their mobility.
Causes of the onset of the disease
The cause of coxarthrosis can be:
- Degenerative senile changes.
- Dysplasia is a congenital pathology (we will talk about it in more detail below).
- Injuries.
- Infectious diseases that cause damage to the musculoskeletal system.
- Aseptic necrosis of the femoral head.
- Perthes disease.
There is also idiopathic coxarthrosis, the cause of which is still unknown to medicine.
Symptoms accompanying joint destruction
The danger of coxarthrosis is that it is diagnosed at a later stage. The fact is that in the affected areas there is no swelling of tissues, various swellings, etc.
Let's list the main symptoms of the disease:
- Limitation of joint mobility - this symptom appears quite early, but it can also be a symptom of another disease. Its cause is the narrowing of the joint space.
- Distinct "crunch". It appears due to the friction of the joints against each other. As the disease develops, the volume of the sound emitted will increase.
- Painful sensations. They appear due to damage to the intra-articular structures and a decrease in the amount of intra-articular fluid. The stronger the friction, the more painful the patient will be.
- Muscle spasms. They are due to the weakening of the joint capsules.
- Shortening of the affected leg. Appears already in the later stages. The leg on the side of the affected joint may be 1-2 cm shorter than the healthy one.
- "Duck gait" is another symptom that appears in the later stages. And it belongs to extremely unfavorable signs. The reason for the appearance is that a person, due to changes, can no longer maintain balance with the correct position of the legs. Gradually, the patient simply physically loses the ability to straighten the knee joints and stand up straight.
How to identify the disease before the appearance of "duck walk"
"Duck gait" in itself is a serious clinical sign for the diagnosis. But at this stage, the treatment will already be ineffective, so it is better to start it much earlier. And for this you need to diagnose coxarthrosis at earlier stages. To do this, there are a number of methods that should be used when the first signs appear. Let's list the main diagnostic tools:
- Computed tomography is much more effective than conventional X-ray, as it allows you to obtain information about the quantity and quality of the articular tissue.
- X-ray examinations.
- Comparison of the length of the legs - this method is suitable only for the later stages, when serious degenerative changes in the joints have occurred.
- Magnetic resonance imaging.
Characteristics of gait in coxarthrosis
With this pathology, patients have two options for changing gait. The first appears when only one joint is affected, the second when two are diseased. The last option is called "duck walk". Let's take a closer look at what is happening at this moment with the joints.
So, the wrong approach appears after the bone tissue in the articular cavities has begun to crack. At this moment, the "adductive contracture" begins to form, that is, the patient's legs take a slightly bent position inwards. And the patient can no longer return to a normal state on his own. During movement, a person is forced to transfer the weight of the whole body from one leg to the other. This is accompanied by swaying movements from side to side. That is why the gait is popularly called "duck".
However, such a serious change in the position of the musculoskeletal system is characteristic even for advanced stages of the disease. What is especially dangerous, such a transfer of the weight of the body leads to curvature of the spine and lesions of the knee joints. Therefore, doctors advise using crutches or walking sticks (two are required) to reduce stress.
"Duck walk" during pregnancy
A change in gait in a woman during pregnancy has nothing to do with coxarthrosis, and it is caused by completely different reasons. Usually, the gait changes in late pregnancy, in the eighth or ninth month. Women really start to spread their legs wide and at the same time waddle a little from one leg to the other.
But still, let's find out the reasons for such changes. Of course, they depend on the physiological changes occurring in the female body:
- Weight gain, and therefore an increase in the load on the spinal column. The reason for this is also the lower back pain, which pregnant women so often complain about.
- The center of gravity is shifted. Pregnant women are a little disoriented in space, to which, of course, the body reflexively reacts and slightly changes gait for greater stability.
- When approaching childbirth, the joints of the pelvis become mobile.
In this case, there should be no pain in the hip joints. If they appear, then we can talk about symphysitis, then you need to urgently consult a doctor. Otherwise, nothing terrible happens. Gait change is a natural process.
What should pregnant women do when they have a "duck gait"?
"Duck walk" in women can be a real psychological problem. Expectant mothers are already emotionally vulnerable, and such a huge, from their point of view, flaw deprives them of any attractiveness. However, do not despair. As polls show, such a gait of pregnant women causes only tenderness and a lot of positive emotions in those around them.
Unfortunately, it is impossible to answer the question of how to get rid of the "duck gait" during pregnancy. We'll have to wait for the birth. As soon as the child is born, the same step will return to you. A brace can slightly ease the position, which will reduce the load on the spine. But this will not bring any cardinal changes.
"Duck walk" in a child
The cause of pathology (dysbasia) in a child may be changes of an orthopedic or neurological nature. These changes can be caused by diseases of the central nervous system and peripheral, as well as diseases and birth defects of the joints. There are more than 20 variants of gait disturbance, but "duck" is the most common.
This type of pathology is characterized by the shifting from foot to foot already described above. And the reason for its appearance is changes in the hip joints, accompanied by pain. This gait not only causes discomfort, but also leads to other disorders of the musculoskeletal system.
Causes of "duck gait" in children
In 90% of cases, a "duck gait" appears in a child with dysplasia, pathological changes in the hip joints. This ailment leads to pseudoarthrosis and chronic dislocations.
Dysplasia is a very common condition that affects 3% of all newborns. And in 80% of all cases, girls suffer from ailment. If the pathology was discovered in infancy, you can try to correct it with the help of special bandages.
Also, the cause of "duck gait" can be inflammatory processes in the nerves of the lumbosacral plexus or sacroiliac joint.
Treatment of children
A child's "duck gait" indicates the presence of a rather serious abnormality that needs to be diagnosed and treated.
The therapeutic complex will depend only on the cause of the disease. As noted above, in some cases, with an early diagnosis, it is possible to completely get rid of such a gait. But it all depends on the specific case, the speed of assistance and the qualifications of the specialists who prescribe the treatment.
Exercises to correct gait
Exercises to correct the "duck gait" in case of illness should be carried out only after consultation with the attending physician. Here we do not consider cases with pregnant women and children, since this is a completely different category, and the exercise therapy complex should be developed individually for them.
- Lie on your back, relax, start slowly alternately bending your legs at the hip and knee joints, trying to press the knee to your chest.
- Lie on your stomach. Lift your right leg, then your left, then both. In this case, the legs should be straight and not bend at the knee joints.
- Lie on your back and begin to spread your legs to the sides, returning to the starting position.
These exercises are designed not to load the diseased joint, but to develop it. No need to rush, complete all tasks very slowly. Don't overload your legs. If pain occurs, the complex must be interrupted. Don't do all the exercises at once. First, master the first, then after a couple of days connect the second, and so on. You can gradually increase the number of approaches, but only in the absence of discomfort in the joints. It takes a lot of patience and perseverance, but the result is worth the effort.
What measures are not taken by parents to wean their child from tiptoeing! Some strictly forbid the baby to climb on his toes, others begin to actively drive the baby to the doctors, take tests and look for the culprit of the disease. And all this is because in such a way of moving, adults necessarily see some kind of "abnormality".
With complaints that the child walks on tiptoes, parents also turn to the famous doctor Yevgeny Komarovsky, who is happy to explain what such a gait can mean and how to react to it to parents.
Causes
Most often, tiptoeing is not a sign of any pathology, says Evgeny Komarovsky. For children under the age of 2 years, occasional attempts to walk on tiptoes are an absolute norm, which should not in any way worry mom and dad.
Anatomically, this phenomenon can be explained by the fact that children, even those who have not yet begun to walk at all, have a rather developed gastrocnemius muscle. And when the baby stands up and tries to take the first independent steps, it is the tone in this calf area that can easily put the child on tiptoe. This is okay, because as the rest of the muscles develop, the calves will be less muscular, and the foot will take the correct position when walking.
Quite often, parents are themselves to blame for the fact that the baby walks on tiptoes. This may be due to the fact that from a very early age, sometimes even before 6 months, devices such as walkers are used. Doctor Komarovsky spoke about the dangers of these devices from the point of view of the load on the immature spine many times.
There is one more disadvantage in their use - the baby in the walker rests on the socks. He does not always reach the floor, and then it is quite difficult for him to get used to the fact that he can lean on his foot in some other way. In such a situation, according to Evgeny Komarovsky, the child then needs to be retrained, to instill in him a new useful habit of walking correctly.
However, not all 100% of children who walk on tiptoes have such harmless reasons for walking. There are situations when walking on tiptoe is a sign of one of the serious neurological disorders associated with impaired muscle tone and pathologies of the central nervous system:
- muscular dystonia;
- pyramidal insufficiency.
But when a child has one of these diseases, walking on toes will clearly not be the only symptom. In addition, most likely, parents will find out about the disease much earlier than the baby begins to walk. And therefore, if at 2-3 years old a child feels well, nothing hurts him, nothing bothers him, and the only thing parents complain about is walking on their toes, then there is no reason to worry, says Evgeny Komarovsky.
Such a child does not need treatment, you can not torture him and not take him to numerous doctor's offices.
Babies also have psychological reasons for walking on their toes. The toddler sees that he is being praised for growing up, that he is already big. Naturally, he wants to be even bigger and taller, and therefore he also rises on his toes from time to time. Often such a gait is characteristic of curious, very mobile, hurried, impressionable children who are always in a hurry and run somewhere.
How to fix gait?
If the child has no pathologies, as well as neurological diagnoses, then the parents may be faced with the question of how to correct the baby's gait. Evgeny Komarovsky claims that there is no need to do this purposefully until 3 years old. But some of the measures taken by the parents will help the child quickly master the correct skills of setting feet:
- you can buy shoes for your child that will fix the leg well. She should have closed toes and a solid heel. Evgeny Komarovsky advises choosing such models that have a small heel - this will additionally help in the prevention of flat feet. It is good if the shoes are tightly fastened with Velcro or laces, fixing the leg in one position. No special orthopedic shoes are required when walking on toes;
- more time should be devoted to active walks in the fresh air associated with walking, running, jumping. It's great if the kid learns to ride a bike, because he will have to rely on his entire foot;
- at home and in the yard (if the family lives in a private house), the child should walk barefoot more often;
- with a pronounced habit of walking on tiptoes, you can do physical therapy, for this it is enough to contact your district pediatrician, who will give a referral to the exercise therapy office;
- a child with the habit of walking on tiptoes should definitely do a daily restorative massage. To massage the legs and feet, you should consult a massage therapist to show you the points for acupressure, which can effectively relax the calf muscles and stimulate others.
About treatment
Unfortunately, the reality is, says Yevgeny Komarovsky, that a mother who turns to a local doctor complaining that a child walks on tiptoes is likely to receive recommendations to start giving the child medications. There is nothing wrong with a doctor prescribing vitamins and massage.
But often the child is prescribed not so harmless methods of treatment. So, nootropic drugs, vascular, sedatives can be recommended. Evgeny Komarovsky advises avoiding their use without an obvious reason, that is, the presence of a serious (often congenital) neurological disease. These medications have a lot of side effects, and a healthy child, who just doesn’t walk the way his mother wants, doesn’t need them at all.
For more information on this problem, see a small video by Dr. Komarovsky.