Question:

My six-year-old son has autism and engages in toe walking constantly. The doctor referred us to an orthopedic specialist to consider a heel-cord surgery. On the other hand, his OT says that toe walking is a sensory behavior. Will the surgery help?

Answer:

I agree with your son’s OT! Toe walking is usually a sensory-seeking behavior. Standing on your toes gives you a lot of feedback from your legs about where your body is in space. However, this sensory-seeking behavior can become an orthopedic issue if the heel cords tighten up and limit a full range of motion. If this is the case, it may be necessary to have the surgery to regain full range of motion in his ankles.

Despite the surgery, if his sensory need isn’t met, he is likely to return to toe walking after the casts are removed. Try using weights on his ankles and waist to give him the proprioceptive feedback he needs. Pair the weight with auditory and physical prompts such as pressing down on his shoulders and saying “Heels down.” Ask your son’s therapist about using kinesio tape as well. With dedication and consistency, he can overcome this habit, but the younger you start, the easier it will be!

Best Wishes,
Gwen