One of the causes may be paralytic muscle disease because all children who present Duchene muscular dystrophy don’t walk normally. In this situation, the deteriorated muscle is replaced by fibrous tissue . Patients who suffer from paralytic muscle disease walk on their toes because like a substitution of their knees.
This condition appears as soon as the child starts walking. The child looks absolutely normal and he or she starts walking at the normal, expected time, and no abnormal reflexes are noticed, so it is rather hard to diagnose this condition forms the stars. Also it is true that at the very beginning, every baby makes the first steps on his toes, but when this way of walking does not disappear then the child may have a problem.
In order to diagnose this condition the doctor will need a physical examination. If the main cause of toe walking is muscle spasticity, then it has to be established if toe walking secondary to contracture of the Achilles tendon and in which conditions is created the jumper’s gait.
Toe walking may not require treatment. If the doctor decides that treatment may help the patient, another decision must be taken whether to perform surgery or not. A common procedure in this situation is to extend the Achilles tendon. Before choosing the treatment, the doctor will need magnetic resonance imaging of the spinal cord and prior to this a radiography. In case of muscle spasticity, a gait analysis may be required.
If toe walking illness will be treated without surgery, this treatment will include stretching of the Achilles tendon (the outcome may be negative ) and orthotics.. If the patient is a little child who has just started walking he or she needs only observation because this may be temporary . If the child reaches the age of three and he or she still has this bad habit then treatment is needed. Another treatment method that does not include surgery is using an instrument called articulated molded ankle-foot orthotics, which fits in a shoe without problems.
When this measures fail to help the patient walk normally, the next step in the treatment will be surgery. The doctor may perform an extension of the heel-cord (especially when the patient suffers from paralytic muscle disease and the knee can be fully extended) or of the Achilles tendon. In the first type of operation the first problem that may appear is the reappearance. If after an operation the patient walks normally for more than one year than he can be considered cured.
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