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Cresswell Physical Therapy February Newsletter

February 2018

Toe-Walking In Children

Imagine a tiny, bright-eyed three-year-old child tip-toeing joyfully from room to room. You can’t help but be delighted at this adorable child and view the toe-walking as part of a sweet feminine package.

The identical behavior in an equally adorable little boy draws an indulgent smile and the conviction that he will soon grow out of it.

The same child walking on tippy toes at six or seven years old starts to raise concerns.

Children’s development tends to unfold in predictable ways. When we see unexpected behavior, particularly behavior which doesn’t go away, we need to take a deeper look. Is one thing developing more quickly or more slowly than another?

That is not to say that all unexpected behavior is a developmental issue. Rather, it serves as a signal to investigate further.

Toe-walking should be investigated for a variety of reasons, not the least of which is safety as well as the child’s enhanced ability to participate in fun activities such as dance or sports.

Why Do Some Children Walk on Tippy-toes?

As young children mature and develop skill in walking, their ability to know which muscles need to be stiff, and which muscles need to be loose and dynamic, improves.

The knee joint should be maintained fairly stiff and stable, but the ankle joint needs to be much more nimble and dynamic. As the child matures, successfully separating out the job of the knee from the job of the ankle, allows for improved function. The speed of walking picks up. Navigating stairs and uneven terrain with sloped surfaces improves.

While the knee is stable, the foot is dynamic. The stretch experience that occurs when the foot hits the ground is the result of a stretch to the small muscles located deep in the arches of the foot.

This stretch experience can sometimes be misinterpreted by the brain. When this problem happens, an inappropriate tightening of various groups of muscles through-out the lower legs result. The tight muscle groups cause the heel to lift and will shift the body weight to the front of the foot. Toe-walking feels very compelling and mandatory to these children.

Strategies to Reduce Toe-Walking

Walking in ReverseWalking backward, walking up a hill and walking backward down a hill requires using the heel of the foot. Toe-walking while walking backward or up a hill is extremely difficult to maintain, so it’s a fun way to incorporate a playful way for the child’s brain to experience their foot. Research has shown that this may result in several minutes to several hours of normal heel-to-toe-walking following these strategies.

Exercise for the Small Ninja – For the older child, wall sits, crouching, lunging, partial squats, and kicking a soccer ball are also useful activities that incorporate high level coordination in the leg muscle that lends to foot and ankle control for walking.

Housekeeping – And finally, it may help to loosen the bed sheets at the base of the child’s bed. Try to prevent flattening out the ankle with heavy bedsheets that can hold the foot in a tippy-toe posture all night long.

For more information on children and toe-walking contact Cresswell Physical Therapy and Hand Rehabilitation.  We have a physical therapy clinic located inside Sun Oaks Tennis and Fitness to help you with all your physical therapy needs.  Most insurances accepted.  Call us at 530-244-7686 or visit our website  HYPERLINK “” .

United for Fitness

Sun Oaks Tennis & Fitness and the United Way have teamed up for United for Fitness, a weeklong event with fun activities for the whole family.


Click here for calendar and registration information


When: March 12-18

Where: Sun Oaks Tennis and Fitness

Why: So adults can play like kids to support and inspire todays youth!

How: Check out our calendar of events, get a team together, register and PLAY!

Good health is both a community responsibility and a community benefit. It goes beyond personal diet, exercise and the many other individual choices we make. The foundation for a healthy life is in the neighborhoods we build and environments we inhabit.

This event is focused on creating healthy lifestyles and habits for youth in our community. When our residents have access to quality foods, exercise and strong pathways, they are more likely to succeed in school, work and life.

All money raised will support local after-school enrichment and mentoring programs funded by United Way, including Catalyst Mentoring, Anderson Teen Center, Shasta Family YMCA, Shasta Union High School District and Sun Oaks youth initiatives like The Ascension Project and Sun Oaks Aquatic Racing (SOAR).

Cresswell Physical Therapy Newsletter – January

Sun Oaks –  January 2018 

Cresswell Physical Therapy Newsletter



With the New Year upon us and our New Year’s resolution for self‑improvement in hand, ask any parent or child and their goal is to “do better”. As parents, we want to turn over a fresh leaf and support our children in moving toward independence in their day to day activities. Teachers also hope to take a fresh look at their classrooms and aim to motivate and develop independence in learning styles. Children seek turning over a new leaf and making new friends. All of us seek to learn and develop greater skill.

When we talk about learning and gaining skill by experiencing the world around us, we are really talking about the sensory system that perceives our world. The sensory system, perceives the gravitational pull of the earth’s surface and creates an innate drive for balance. This drive informs the muscle and joint system that allows the body to smoothly respond to different shifts in the center of gravity. The infant learns to roll, sit, crawl and stand by developing the sensory system.

We correct our balance while riding a bicycle by a small action of a specific muscle and joint system.  Sometimes, just tilting the head to the side is sufficient in overcoming any slight loss of balance when cycling around a curve. Cycling requires the integration of the sensory system with the muscular system.

If these two systems aren’t functioning properly, the brain will struggle to learn. They are foundational to learning, just as the sense of emotional and physical security.

Why do you enjoy yoga so much?  It’s because you’re continually challenging your center of gravity with the gravitational pull around you. Matching this and successfully balancing is associated with a positive emotional response.

The balance system  provides an overall calming response with a sense of emotional security. This may explain why taking a walk is so pleasant. Movement, exercise, sports, martial arts, yoga, dancing, and juggling all offer excellent opportunities for the movement system to stimulate and help facilitate brain functioning.

The unique learner that has difficulty sequencing, reasoning, and independently problem‑solving literally needs physical movement [often more beneficial than added homework] in order to facilitate effective thinking.

A more typical student may seem to respond well to practice, practice, practice. A unique learner seems to respond better to practice, movement, practice, movement.

Now you understand your unique learner better. Your New Year’s resolution of doing better is already achieved because doing better, for these children, requires a better understanding of their actions.

Now that you can judge their performance based on problem‑solving skills versus the standard metrics of speed of performance and accuracy of responses, you can support your unique learner’s growth by embedding movement as a part of the fuel necessary to grow the brain.

Learn more about your sensory system during your individualized physical and occupational therapy sessions.

Call us at (530) 244-7686. We have an office inside Sun Oaks Tennis and Fitness as well as a clinic in downtown Redding. We accept most medical insurance.