What are walking and gait concerns?
Gait is the way a person walks. Parents may notice that a child limps, turns the feet in or out, walks on tiptoe, drags a leg, swings one arm less or looks stiff.
Some patterns are common in growing children and settle over time. Others deserve a closer look, and a few need a doctor soon. A clear check helps you know which is which.
Which walking patterns are common?
Children are not small adults, and their legs change shape as they grow.
- Toddlers walk with a wide stance and arms held up.
- Feet may turn in or out for a while as the hips and legs develop.
- Knees may look bowed, then knock together, and straighten later.
- Flat-looking feet are normal in the early years; see flat feet in children.
- Some children walk on tiptoe as a habit; read about toe walking.
These patterns are usually painless and the child plays happily. Even so, ask if you are uneasy.
Which patterns need a closer look?
A closer look is worthwhile when you notice the following.
- One leg seems different: shorter, thinner, weaker or stiffer.
- The walk is getting worse rather than better.
- A limp that lasts more than a few days.
- Frequent trips, falls or tiring early.
- A child who has stopped doing something they used to do.
- Stiffness, floppy legs, or uneven wear on shoes.
Film a short walking clip, from the front, side and back, barefoot on a plain floor. It is more useful to the clinician than a description.
When should I see a doctor soon?
See a doctor promptly if your child has a new limp with fever, swelling, redness or a refusal to put weight on the leg. The same applies after a fall or injury, or if your child seems unwell.
Also seek medical advice for sudden weakness, night pain, severe pain in a hip or knee, or a limp that keeps getting worse. In Ipoh, the children’s services of the government and private hospitals can help.
What happens at a home visit?
We start with your story, the birth, milestones and any past injuries. Then we watch your child walk and play on the floors and stairs they know, with and without shoes.
We check the hips, knees, ankles and feet for movement and strength, and look at the whole body, including the spine and posture. We compare the two sides, and watch how your child runs, hops and changes direction.
You hear what we found in plain words and what to do next.
If the pattern is a normal stage, we explain what to watch. If it needs treatment, we plan it with you. If a doctor should look first, we say so, and help you decide where to go.
What can treatment include?
It depends on what we find. Some children need only advice and reassurance, and a plan to review in a few months.
Others benefit from stretching tight muscles, strengthening weaker ones, balance work, walking practice, or advice on shoes and activities. We teach this through games so your child enjoys it. Our page on balance and coordination shows the type of play we use.
What can I do at home?
Keep your child active and comfortable.
- Allow plenty of barefoot time on safe floors.
- Choose roomy, flexible shoes that fit well.
- Encourage running, climbing and playing outdoors, within safe limits.
- Avoid forcing a child to “walk properly”; it adds tension.
- Note when the pattern is worse, such as when tired, and tell us.
Read the guide on baby walkers and development if grandparents use walkers.
How do we help in Ipoh?
We visit families across Ipoh. Seeing the walk on your own floors and stairs gives a more honest picture than a single clinic room.
Our paediatric physiotherapy and home physiotherapy pages explain how a child’s walking is looked at. The Canning Garden centre, near Fatimah Hospital, is opening soon. Send us a short description on WhatsApp and we quote the price.