Problems with gait are common in young children. If you notice that your child is missing important milestones, experiencing pain, or suffering functional limitations, contact a podiatrist for an evaluation and to discuss possible options for treatment.
Signs of a Childhood Gait Problem
Many gait abnormalities can occur in young children. Children can have issues such as flat feet, in-toeing, out-toeing, bow legs, or toe walking. These abnormalities will most likely resolve as the child ages. If these issues seem to get worse or do not resolve, however, you may need to consult with a podiatrist for an evaluation. Missing milestones such as walking independently, climbing up or walking down stairs, skipping, or being able to balance on one foot can also indicate a gait problem.
The following are often common signs that there is a childhood gait problem that should be evaluated:
- Issues with gait are worsening instead of improving
- Problems with balance
- Pain is present in their feet or ankles
- Limping, tripping, or falling
- General developmental delays
Diagnosing Childhood Gait Problems
If your child is experiencing a gait abnormality, consult with a podiatrist for an evaluation. An experienced podiatrist can diagnose a problem with your child’s gait by performing a physical exam. The exam may consist of:
- Observation of your child while walking or running
- Exam of your child’s legs to check for shape and alignment
- Review of your child’s and your family’s medical history since many gait problems run in families
In addition, the following may also be done to obtain a proper diagnosis:
X-ray.
An X-ray may be done to check for any issues with bone structure, length, and alignment.
Magnetic Resonance Imaging (MRI).
An MRI may be done to check for any problems with the soft tissue within the body. This can help diagnose any issues with the nerves or spinal cord that can contribute to gait problems.
Computerized Tomography Scan (CT scan).
A CT scan can show detailed images of the joints and bones in the body.
Types of Gait Abnormalities in Children
There are a variety of gait abnormalities that are seen in children such as:
Antalgic Gait.
Antalgic gait is caused by pain. It reduces a child’s time spent bearing weight on the side of the body being affected. When a child is hesitant to put weight on one side over another, antalgic gait is seen. There are numerous causes for this condition and it can be seen in children with juvenile idiopathic arthritis.
Circumduction Gait.
Circumduction gait is commonly seen in children with a discrepancy in their leg length. This condition results in hip abduction that overextends as the leg swings forward. It can be seen in children with hemiplegic cerebral palsy.
Spastic Gait.
Spastic gait is characterized by foot dragging that is stiff with foot inversion and can be seen in children with an upper motor neurological disease such as diplegic or quadriplegic curable palsy. It can also be seen in children who suffer a stroke.
Ataxic Gait.
Ataxic gait causes children to stumble, lose stability, and take wide base steps. This is commonly seen in ataxic cerebral palsy cases that affect the cerebellum.
Trendelenberg's Gait.
Trendelenberg's gait is the result of weak hip abductor muscles or hip pain. A common sign of this condition is a waddle-type walk where the feet, knees, and hips are rotated externally. It can be seen in children with arthritis, muscle disease, Perthes’ disease, and developmental hip dysplasia.
Toe-Walking Gait.
Toe walking is common among children but when it becomes persistent and there is an absence of heel contact, this becomes an issue. Toe-walking gait can indicate a neurological disease such as cerebral palsy.
Stepping Gait.
Stepping gait is a condition where the child’s entire leg lifts at the hip. It can happen due to a weak ankle dorsiflexor and causes an increase in the flexion of the knee. It can be seen in conditions such as spina bifida, polio, or Charcot-Marie-Tooth disease.
Clumsy Gait.
Clumsy gait is present in children who are having difficulties in their fine and gross motor skills. These children may fall often or have trouble with tasks such as getting dressed or feeding themselves. Children with clumsy gait may have a learning disability, poor handwriting skills, or other neurological disabilities.
Treatment Options for Childhood Gait Problems
Most childhood gait issues are monitored closely over time since many can resolve on their own. Intervention is not always needed. For gait problems that do not resolve, conservative treatments may be recommended. These can include:
Custom orthotics.
Orthotics worn inside the shoes can be used to help with foot alignment and help a child’s feet develop properly. A brace may also be used to keep the legs and feet in the proper position.
Footwear.
Specific footwear may be recommended to help hold the feet in proper position while walking or standing.
Exercises.
Exercises can be used that target specific groups of muscles in the legs and feet. This can help with developing a proper gait. Stretches can be done to help improve muscle balance and coordination.
Medication.
To provide relief from pain or inflammation, a medication such as an anti-inflammatory or a muscle relaxer may be needed.
Surgery.
Surgery is not typically recommended right away. If conservative treatments and time do not resolve an abnormality with gait, surgery to correct leg alignment or to lengthen tendons or muscles may be done.
To prevent a childhood gait problem, be sure to have your child checked at the first sign of an abnormality with their gait or development. It is important to teach your children proper posture and seating positions and to keep your children active.
Do You Need a Caring and Experienced Podiatrist?
If your child is experiencing gait problems or has pain in their feet or ankles, contact Dr. Bruce Scudday and his team for an evaluation. You can contact us online to schedule your appointment or call one of our convenient El Paso offices directly. To reach our Sierra Tower Building podiatrist office, please call 915.533.5151. You can find driving directions here. To reach our George Dieter Drive podiatry office, please call 915.856.3331. Driving directions are available here.
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