Serial Casting for toe walking

Our story:My son Leyton has been a "toe walker" from the day he started walking. At first it was really cute, but as the years past I made a point to ask the doctor about it. Every year they would ask if it was all the time and I would say 99% of the time and they would say, "as long as he can stand on his heals he is fine." But he's not fine. Walking on his toes makes him fall more, makes his feet really hard and muscular, makes his toes stretch out, makes his muscles tight, it's causing him to lose flexibility/mobility...and it can lead to ankle, knee, hip and back problems in his adult life.

So, we're doing something about it.

Today we went to Children's Hospital in St. Paul, MN to start a 8-12 week process of Serial Casting for toe walking.

What is toe walking? Toe walking is a diagnosis in which a person walks with bilateral toe-to-toe walking pattern.  There may be a medical cause or it may be idiopathic in nature. (my definition: he looks like he is walking on his tippy toes all the time)

How does Children’s treat patients who toe walk? 

  • We offer serial casting, orthotic intervention, and physical therapy treatment for treatment of toe walking.
  • Serial casting has been proven to be an effective intervention for toe walkers in treatment of tight heel cords to increase the range of motion and to also weaken the heel cord muscle to allow us to re-train the child’s walking pattern.
  • Children’s and Orthotic Care Services have designed a new type of solid ankle foot orthotic that mimics serial casts for treatment of toe walking.
  • The orthotic brace is a two-pull carbon fiber solid ankle foot orthotic.  The carbon fiber on the outer shell decreases the amount of multi-planar ankle motion that is available which mimics the effects of serial casting through increasing range of motion through the heel cords as well as weakening the heel cords but allows the child more flexibility in that they can take off the brace to shower or participate in certain activities.
  • After serial casting or carbon fiber bracing intervention has been completed, children are then placed in a two-pull plastic ankle foot orthotic to re-train their gait pattern to allow for a consistent heel-toe walking pattern.

Is this how I want him to spend his summer? No, I don't, these casts can't get wet. But, he has a great attitude about it so I will too. I'm going to invest in heavy duty plastic bags and double sided medical tape so that he won't miss out on anything! And we're going to figure out fun new things to do in St. Paul...since we'll be driving there every week to change the old cast for a new one. I'm thankful to live in a country that provides such incredible care for my sweet son.

How do I feel? I have a lot of emotions, but I'm trying to keep perspective. The mommy heart in me hurts for my son.

Sad that he has to struggle, but happy that it won't be his whole life.

Bummed that my son needs to be in casts for 8-12 weeks, thankful that we have the medical coverage that provides it.

Grieved that I can't stop this pain, grateful I have the privilege of walking with him through it.

During our appointment she asked a great question. "Why does he toe walk?" (I'm all about figuring out root causes for things so this conversation was really helpful.) They have done studies linking sensory issues, genetic tightness of that muscle, and other neurological reasons. Leyton is an extreme happy-go-lucky was interesting to separate what I always thought was his personality and what may be toe walking related. We will learn as we go. He is worth it!

I'd love to hear from anyone who has gone through this process...please comment.

Noemi Hedrick

Noemi Hedrick is a passionate wedding and portrait photographer based in Minneapolis. Noemi loves capturing the beauty inside every person. Her vibrant energy for life, love and family are grounded in her own values and loved ones. Noemi has been proudly serving as a wedding photographer for over 15 years and also offers a wide range of photography workshops for professional and amateur photographers.