Ask the Nurse: Botox Injections for Toe Walkers?

Answer: I have heard that Botox can help some special needs children in the area of “Toe-walking”. Is there any truth to this and if so, how? What might I expect?

Children who have idiopathic toe walking typically outgrow this condition. If there is a reduction in the child’s range of motion there are several options available. These may include:

• Wearing a brace or splint either during the day, night or both which limits the ability of the child to walk on his or her toes and stretches the Achilles tendon. An AFO is one type of brace.
• Serial casting where the foot is cast with the tendon stretched, and the cast is changed weekly with progressive stretching.
• Botox therapy can be used to paralyze the calf muscles to reduce the opposition of the muscles to stretching the Achilles stretching. This is usually used in conjunction with casting or splinting.
• If conservative measures fail to correct the toe walking after about 12–24 months, surgical lengthening of the tendon is an option.

Children who toe walk with more serious neuro-muscular conditions may need to seek additional specialists.

Botox as an option:

New research has found that Botox injections can alter gait patterns and, in some cases, eliminate idiopathic toe walking.

Published in the Journal of Children’s Orthopaedics, the study followed 15 children who received Botox injections in the calf muscles and underwent an exercise program to help reduce idiopathic toe walking. One year after treatment, 11 children remained in the study. Of those, three had stopped toe walking, four had decreased toe walking and four continued to toe walk, according to parents’ reports.

Gait analyses conducted over the course of the year found marked improvement in walking. Researchers concluded that Botox can improve gait, but does not guarantee a reduction in toe walking.

Have a question for “Ask the Nurse”. Send an email to [email protected]. Please make sure to put “Ask the Nurse” in email subject line.

DISCLAIMER: The contents of the Ask the Nurse column (“Column”) such as text, medical information, graphics, images and any and all other material contained in the column (“Content”) are for informational purposes only.  The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your (or your child’s) physician or other qualified health provider with any questions you may have regarding a medical condition. NEVER DISREGARD PROFESSIONAL MEDICAL ADVICE OR DELAY IN SEEKING CARE BECAUSE OF SOMETHING YOU (OR YOUR CHILD) HAVE READ IN ANY MEDICAL LITERATURE!

Helpful Articles

• Fad Treatments Making Good Choices for Your Child
• Good Record Keeping is a Must! Tips on Organizing your Medical Records
• Relationship Rescue: Medications Are There Any Alternatives to Use?
• 10 Tips to an Organized Medicine Cabinet
• Medwaiver Program How the Waiver Can Help Your Child
• PSN My Child’s Medications Form
• My Child’s Medical Provider List Contact Information
• Drowning in paperwork? Here’s what helps us
• Medical Tech Support: Managing Your Family’s Health Care
• Did You Know You Can Receive Rides to Your Medical Appointments?
• Pharmacogenetics: Genetic Testing for Personalized Medical Treatment
• Questions to ask prior to receiving “Alternative Treatments”
• Right Question, Wrong Doctor: How can Medical Education Influence a Doctor’s Acceptance of Complementary Medicine

This post originally appeared on our May/June 2012 Magazine