A child's gait can change significantly during growth, and many such variations are a natural part of development. However, doctors from the United Arab Emirates advise parents to pay attention if an unusual pattern persists, worsens, or is accompanied by pain or other symptoms.
Some conditions requiring evaluation include persistent toe walking, significant inward or outward foot turning, curvature, genu varum (bow legs), and differences between the sides of the body.
Medical professionals caution parents not to ignore new limps or sudden changes in their child's walking manner. Sometimes the source of discomfort may not be where the child feels the pain.
Dr. Anand Gorwa, a specialist in orthopedic surgery at Medicare Orthopedics and Spine Hospital, noted that some gait changes are expected as children grow older, but persistent or unusual patterns should not be automatically assumed to be something the child will outgrow.
Dr. Gorwa emphasized: 'For example, persistent toe walking, walking with significant inward or outward foot turning, pronounced curvature or genu varum, or noticeable asymmetry can require evaluation, especially if this pattern continues after the expected developmental stage. A change in a child's gait, particularly if it occurs suddenly, also warrants attention.'
Dr. Nahed Mohamed Abdelghabar Ali, a pediatrician at Burjeel Medical Center, reiterated that evaluation becomes particularly important when the gait pattern is constant, intensifies, causes pain, or begins to affect daily activities.
She added: 'Persistent toe walking after early childhood, especially if associated with Achilles tendon tightness, weakness, asymmetry, or developmental issues, should also be checked. One should not simply observe a new or unexplained limp without an examination. Remember that a child with a hip joint problem may sometimes complain of knee pain instead of hip pain.'
Parents should also monitor symptoms beyond just the gait. Dr. Sruti Sarath, a pediatric specialist at NMC Specialty Hospital, Al Ain, reported that gait problems can lead to balance disorders and frequent falls, and the walking itself can become increasingly tiring and inefficient.
She explained: 'Initially, the condition may be painless, but over time, it can lead to pain in the foot, knee, hip, or back. Differences in leg length may also occur, caused either by one leg genuinely being shorter or longer than the other, or by functional asymmetry due to joint position, muscle tension, pelvic tilt, or deformation. In progressive neurological or musculoskeletal diseases, children may also lose functional independence and develop problems with the pelvis, spine, and hips, along with progressive skeletal malalignment.'
Dr. Nahed noted that early diagnosis does not necessarily mean the child will require treatment. In some cases, reassurance, observation, and follow-up monitoring may suffice.
If treatment is necessary, the approach will depend on the underlying cause and may include physiotherapy, targeted exercises, orthopedic devices, or specialized care. Dr. Nahed concluded: 'The goal of early assessment is not just to 'fix' how the child walks. More importantly, it is to identify children who may have an underlying condition that would benefit from early management.'