It is common for children to have different gait problems when they are learning to walk. Some of these problems resolve on their own over time, but some may need to be evaluated by a child podiatrist. When children are having issues with their balance or showing signs of developmental delays, it may indicate there are underlying childhood gait problems that need to be addressed.
Gait problems rarely cause pain in children. Instead, you may notice that your child’s shoes are wearing down more in one specific area, especially at the tips of the toes, or your child is overly tired after walking or physical activity. In addition, your child may have flat feet, or their feet may resemble a “C” shape.
Different Types of Childhood Gait Problems
There are many types of gait problems in children. Two of the most common are intoeing and out-toeing. Neither of these problems are painful and are commonly caused by a rotation of the leg bones. The distinction between the two are:
- Intoeing. The child walks with their feet turned inward.
- Out-toeing. The child walks with their feet turned outward.
Some other common childhood gait problems include:
- Ataxic gait. Ataxic gait can cause a child to have problems with balance. They may stumble or feel unstable when walking and may alternate their steps with a narrow to wide base. This type of gait problem can impact children with conditions such as ataxic cerebral palsy that affects the cerebellum, cerebellar ataxia, and Friedreich’s ataxia.
- Circumduction gait. Circumduction gait is common in children with a distinct difference in the length of their legs. It can also occur in those with restricted joint movement. With circumduction gait, children have excessive hip abduction as they swing their leg forward. This type of gait is often seen in those with juvenile idiopathic arthritis.
- Clumsy gait. Children with a clumsy gait may have issues with their gross and fine motor skills and may experience frequent falls. Their gait appears clumsy. Poor handwriting and learning disabilities are common with children who have clumsy gait.
- Spastic gait. Spastic gait can cause children to drag their feet and toes when walking. They may walk stiffly and hold their legs close together. Children with an upper motor neurological disease or who have had a stroke can develop a spastic gait.
- Stepping gait. Stepping gait can cause a child to lift their leg high at the hip in order to clear the ground when walking, much like walking up a step. Children with spina bifida or polio can have stepping gait as well as those with peripheral neuropathies that cause difficulty with walking such as Charcot-Marie-Tooth disease.
- Toe-walking gait with absent heel contact. Toe walking is common for children when they first learn to walk. Children with a difference in their leg lengths or those with tight muscles may toe walk. If toe walking continues and the child is not making heel contact to the floor when taking steps, it can be due to an underlying neuromuscular problem such as cerebral palsy.
- Trendelenberg's gait. Trendelenberg’s gait can cause a child to waddle when they walk. It can also cause limping in order for a child to keep their balance. Children with Trendelenberg’s gait may have weak hip or glute muscles that cause their hips, knees, and feet to rotate externally when taking steps. This type of gait occurs in children with Perthes disease, hip arthritis, muscle disease, or neurological conditions.
- Antalgic gait. Antalgic gait is often caused by pain and changes the way a child walks. You may notice your child limping to avoid pain, and they may trip or fall. A child may even spend less time bearing weight on the side that has pain. For some children, juvenile arthritis can be the cause of antalgic gait.
Diagnosis and Treatment Options
To diagnose a childhood foot problem, a child podiatrist can do a physical exam and observe the child while they walk or run. They will check for areas of pain and do a family and medical history. Imaging test such as an X-ray, a CT scan, or an MRI may also be used to help with the diagnosis.
Once the cause of the gait problem is determined and any underlying medical problems are addressed, options such as custom orthotics, braces, or physical therapy may be used to treat the problem. Surgery is not recommended to treat a gait problem in children unless conservative options and time do not resolve the issue or it worsens significantly over time.
Contact Our Child Podiatrist in Grapevine or Keller Today!
If you are concerned about a problem with your child’s gait, contact Alliance Foot & Ankle Specialists for a consultation with our child podiatrist. To schedule an appointment in our Grapevine or Keller office, fill out our convenient online contact form, or call us at (817) 481-4000 today.