Understanding Idiopathic Toe Walking: Expert Insights from Mr. Alpesh Kothari

Are you concerned about your child consistently walking on their toes? This common childhood phenomenon, known as Idiopathic Toe Walking (ITW), can raise many questions for parents.

Mr. Alpesh Kothari, a Consultant Paediatric Orthopaedic Surgeon at Oxford University Hospitals NHS Foundation Trust, is at the forefront of understanding and managing this condition.

Mr. Kothari is an integral part of the BSCOS Paediatric Idiopathic Toe Walking Consensus Group, a collective of experts dedicated to standardizing the assessment and treatment of ITW. Their recent publication, "The management of idiopathic toe walking", underscores the importance of a unified approach to this condition.

What is Idiopathic Toe Walking (ITW)?

Idiopathic Toe Walking refers to a walking pattern where a child walks on the balls of their feet, without the heels touching the ground, and without any underlying neurological or muscular condition to explain it. While toe walking is common in toddlers just learning to walk, it typically resolves by the age of five. If it persists beyond this age, it's crucial to seek professional evaluation.

Key Characteristics of ITW:

• Persistent Toe Walking: The most obvious sign is consistent walking on the toes.

• Absence of Underlying Conditions: ITW is diagnosed when other potential causes, such as cerebral palsy, muscular dystrophy, or shortened Achilles tendons, are ruled out.

• Varying Degrees of Severity: Some children may toe walk occasionally, while others do so constantly.

• Potential for Tightness: Over time, consistent toe walking can lead to tightness in the calf muscles and Achilles tendon.

Why Early Intervention is Important:

Untreated ITW can lead to several complications, including:

• Tightening of the calf muscles and Achilles tendon, limiting ankle flexibility.

• Difficulty wearing shoes.

• Balance and coordination issues.

• Potential for social stigma.

How Mr. Alpesh Kothari Can Help:

Mr. Kothari's expertise, informed by the latest consensus guidelines, ensures that children with ITW receive individualised and effective care. He can provide:

• Thorough Assessment: A comprehensive evaluation to rule out other potential causes and determine the severity of ITW.

• Personalised Treatment Plans: Tailored strategies, which may include physical therapy, stretching exercises, orthotics, or, in some cases, surgical intervention.

• Up to date knowledge: As a member of the BSCOS Consensus Group, Mr. Kothari is up to date on the most current recommendations.

• Ongoing Monitoring: Regular follow-up appointments to track progress and adjust treatment as needed.

What to Expect During a Consultation:

During a consultation with Mr. Kothari, he will:

• Review your child's medical history.

• Conduct a physical examination to assess their gait, muscle strength, and flexibility.

• Discuss potential treatment options and answer any questions you may have.

If you're concerned about your child's toe walking, don't hesitate to seek expert advice. Mr. Alpesh Kothari at Oxford University Hospitals NHS Foundation Trust is dedicated to providing compassionate and effective care for children with ITW.