“People would actually stop and stare when they saw Nicholas walking,” says Beth McMillan. “He was really chubby and walked like a cowboy, with his toes pointed in.” What proved worse for McMillan than the staring were the questions and comments from family and friends, as well as from strangers.
“People would ask us if we were going to get his legs ‘fixed.’ Or they’d tell me that I must have let him walk too early, or that he had rickets because I breastfed, or that it was because I used cloth diapers,” she says. With so much unsolicited advice, parents can’t help but be worried.
The hallmark of toddlerhood is, well, toddling. As the term suggests, toddlers haven’t quite mastered all the nuances of walking, and many have their own unique ways of walking, which can be a worry for parents. “Walking is a frequent concern in my office,” says Barbara Grueger, a paediatrician in Yellowknife. “Most commonly, parents are concerned about toeing in, or what they perceive as ‘weak ankles’ or frequent falling.” Other walking styles that worry parents: knock knees, flat feet, bow legs, tippytoe walking and toeing out.
For parents who are concerned, Grueger suggests a checkup with your family doctor or paediatrician to ensure there is no serious problem. Toddlers who walk persistently on tiptoes or who develop a sudden limp with no apparent cause should also be assessed. “The most important questions I ask are: ‘Is there any pain or discomfort?’ and ‘Is there swelling of the joints?’ Then I physically assess the legs, hips, feet and ankles, and watch the child walk, run and sit,” says Grueger. “If I find no abnormalities, there is generally no treatment since this is a developmental process that will resolve over time.” Most will grow out of these unusual ways of walking by age six, she says, although some will take a few years longer.
Grueger adds that corrective shoes and orthotics are rarely needed. “They are only helpful for a minority of children who have significant pain and underlying bone or joint disease.”
In some cases, an abnormal gait is a sign of more serious problems. Toronto mom Sarah Johns’ son started walking at 10 months, but by 18 months, Johns noticed “Julian was much slower than his little friends. We called his walk ‘a high-speed wobble’ — it was really a kind of limp or skipping step. When he tried to run, he would hold one arm really close and tight to his body, and the other one he waved around. Even with all that arm action, he ran very slowly.” Shortly before Julian’s third birthday, he was diagnosed with juvenile arthritis. “Only in retrospect did we recognize the signs,” says Johns.
Beth McMillan says the paediatrician who saw her son was able to reassure her that Nicholas would likely outgrow his funny way of walking. “He told us that all the fastest runners toe in a bit,” she recalls. Their family doctor did suggest putting his shoes on the wrong feet, to see if that would encourage a straighter gait, but McMillan opted not to do that. Nicholas is 10 years old now, a very athletic boy who walks just fine — and he always laughs when he sees the old videos of him swaggering down the road like a cowboy.
Shoes for toddlers
Not sure how to choose shoes for your child? Some tips:
• Do a safety check: Footwear needs to adequately protect a child’s feet and offer some grip on a smooth surface.
• Ankle boots do not necessarily give more support than low-cut shoes, but are useful because they are harder for toddlers to remove.
• Shoes must fit the foot snugly at the heel to prevent forward movement while walking.
• Allow enough room for the toes, about 1.25 centimetres (thumb 428) between the longest toe and the tip of the shoe, measured standing up.
For more info, visit cps.ca.