Out-toeing 4 year old

[Ravenclaw]

Our 4 year old DD has been walking on her tip toes since she began walking. She has always been slightly behind on her gross motor skills (needed early intervention around 10 months due to not crawling and then later EI's goal was to get her to walk). She walked late - at 17 months. Every annual visit I've mentioned DD's out-toeing and tip toe walking, and gross motor deficiencies (not enough to qualify for early intervention but they are there) and have been told to just encourage her to be more active. Finally at DD's 4 year check-up the pediatrician thought it was a good idea to send her to a physical therapist, who diagnosed her with collapsed arches. She wants her to get fitted for custom orthotics - the one that go up to the ankle - to correct her out-toeing. DH has read some studies that showed orthotics were not recommended at this age since it's hard to tell if they'll grow out of their flat feet and it can cause psychological problems (due to the discomfort I guess?). DH wants to continue PT but hold off on orthotics. My brother has a similar problem that went completely untreated. He says it's painful to walk and as a result, is fairly sedentary and is overweight. I'm so worried we're making the wrong decision but at the same time I don't want to cause DD any psych issues for something that may not even help. She is already extremely sensitive to pain - real and perceive; she has a very cautious personality by nature.

If anyone has any experience with this, I'd be so grateful to hear it.

[L.Jane]

The little boy I nanny for has this. His parents started intervention very early. he is 2.5 and did pt and is in the orthotics and it has helped tremendously. They had his climbing every bit of every playground they could find. We walk up five flights of stairs at his apartment complex a few times a day and practicing jumping off things and other jumping games. In the beginning climbing was extremely hard for him and he could not jump at all. With therapy and activity he has improved a lot. When he gets excited he still toe walks and sometimes he is not a fan of his orthotics, but it does make a difference. For him we just call them his basketball shoes (he is a fan of all things sports. ) This is like the one he has http://www.surestep.net/smo.php

[Ravenclaw]

Thanks! DH is adamantly against orthotics for now but I'm trying to convince him to at least try the pre-fab ones for now. DD can't jump off of things at this point; I'm hoping she improves with the PT. Breaks my heart to see her struggling compared to her peers.

[diggitydot]

DS (10y/o) is almost always on his toes. It's a family thing (DH and all of his sibs did it, too), and we discovered that it's a shorter than normal Achille's tendon. When DS is sore from frowning pains, it's worse than usual. We make him stretch and it helps a ton. He also doesn't jump that well, either.

Could it be a combination of things?

[Deebs]

You took her to a pediatric PT? We have friends whose daughter had this with no intervention and had to have progressive orthotics and PT to avoid surgery, starting at age 5 when they finally changed pediatricians. Her Achille's was shorter, but they were told it was a result of the toe-walking, not the cause, and the reason she had to have intervention was to prevent the Achille's tendon from snapping during normal activity. The PT also worked with the family to have them remind her to get off her toes.