Twice in the last month, as part of the past medical history, a parent reported that their child had a problem with tip-toe walking that required orthopaedic intervention.
Tip-toe walking is a common and usually transient behaviour in toddlers. When the problem is persistent, the conventional medical literature reports a variety of causes that include neurological problems such as cerebral palsy and muscular dystrophy. The behaviour is more common in children with autism. When tip-toe walking persists for years, the muscles of the legs might not develop in a normal fashion, and this can lead to orthopaedic problems.
What is not commonly recognised is that tip-toe walking might be a clue to constipation in the child.
Children with constipation routinely hold in their stool to avoid pooping. Stool withholding is fundamental to the evolution of constipation.
Children adopt a variety of stool withholding postures to hold in the poop, and tip-toe walking is one of the common postures.
Tip-toe walking results in an increase in the tension in the pelvic floor muscles and pelvic floor muscle tension is necessary to hold in the poop.
Other stool withholding postures include squeezing the thighs together, crossing the legs, squeezing the bum cheeks together, arching backwards while standing. Some children adopt a posture and then brace their upper body against furniture to improve the mechanical advantage and increase the tension in the pelvic floor muscles.
To improve bowel health, I teach three fundamentals. One is a morning poop. Second is great emptying. Third is soft poop.
Optimal posture is fundamental for emptying. The correct posture relaxes the pelvic floor muscles and is the opposite of stool withholding postures. For relaxation of the pelvic floor muscles the knees must be apart and the heels must be flat.
Tip-toe walking is a common and usually transient behaviour in toddlers. When the problem is persistent, the conventional medical literature reports a variety of causes that include neurological problems such as cerebral palsy and muscular dystrophy. The behaviour is more common in children with autism. When tip-toe walking persists for years, the muscles of the legs might not develop in a normal fashion, and this can lead to orthopaedic problems.
What is not commonly recognised is that tip-toe walking might be a clue to constipation in the child.
Children with constipation routinely hold in their stool to avoid pooping. Stool withholding is fundamental to the evolution of constipation.
Children adopt a variety of stool withholding postures to hold in the poop, and tip-toe walking is one of the common postures.
Tip-toe walking results in an increase in the tension in the pelvic floor muscles and pelvic floor muscle tension is necessary to hold in the poop.
Other stool withholding postures include squeezing the thighs together, crossing the legs, squeezing the bum cheeks together, arching backwards while standing. Some children adopt a posture and then brace their upper body against furniture to improve the mechanical advantage and increase the tension in the pelvic floor muscles.
To improve bowel health, I teach three fundamentals. One is a morning poop. Second is great emptying. Third is soft poop.
Optimal posture is fundamental for emptying. The correct posture relaxes the pelvic floor muscles and is the opposite of stool withholding postures. For relaxation of the pelvic floor muscles the knees must be apart and the heels must be flat.
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