Does your child need surgery to correct toe walking?

How to Prepare for Achilles Lengthening (Toe-Walking) Surgery

Have you ever noticed how at one point or another, one of your children takes up more space in your thoughts than your other children? It often switches over to whomever is having the bigger issues or problems. Well, this year, my son Caleb has been on my mind a lot.

Caleb often gets overlooked or pushed to the side because he is smack in the middle of five children. The youngest two are twins, and at the age of three, need a lot of hands-on attention. My oldest son is very attention seeking, and my oldest daughter is very helpful with everything. Caleb is none of those, so as a relatively easy child, he is often overlooked; it isn’t right, but it just is.

Does your child need surgery to correct toe walking?

Ever since he learned to walk, he’s been walking on his tip-toes; not just walking, but running or just standing at the table or counter. His calf muscles are impressive! Over the years, at well-check appointments, I’ve mentioned it, but the doctors kept saying he’d grow out of it. He never did, though. We kept saying “Flat feet!” every time we saw him walking on his toes, but we got tired of that every two minutes. Like, seriously. He’d walk to the  pantry, we’d say “Flat feet” and he’d go down on his heels. He’d walk out of the pantry back on his toes, so we’d say “Flat feet” again. He just wasn’t connecting over the long term. He COULD go down on his heels, he just didn’t.

Do you see him standing at the counter on his toes? This was all the time.

The day before surgery, still standing on his toes.

I finally took him to an orthopedic surgeon that I had met when my youngest had to have surgery last year. He said we had two options; do surgery to lengthen his achilles tendons or to just leave it and he’d walk on his toes his whole life. I kind of laughed, because I’ve never seen an adult walk on their toes; my younger sister, who works at Disney and sees thousands of different people every day walking around, said that she’s seen it, and it looks a little odd. They just kind of bounce around when they walk.

My husband was concerned that the surgery would make our son’s legs weaker, and thus potentially ruining his ability to run fast later on in life (my husband is a runner, and that’s important to him.) I trusted the doctor based on our past experience, and he said that after a few months to re-strengthen the legs, he should be just as fast as before. After a month or two of considering the pros and cons, and seeing if my son improved on his own if told about the possibility of surgery (he didn’t improve) we decided to go ahead and schedule it.

What the Surgery Would Entail

The surgery itself, we were told, would be very quick and easy. It’s a simple outpatient surgery since Caleb didn’t have any other preexisting medical conditions. He would go under general anesthesia, they would make three microscopic cuts in the back of his ankle to slice the achilles tendons, then be put in a hard cast for about five weeks. After the cast, he would be fitted for AFOs; while we waited for those to come in, he would have to wear a walking boot (on each foot!) Once he got into the AFOs, he would need to wear them 24/7 for one month, then at night only for two months. In all, it would take about 5-6 months.

The doctor assured us that the recovery is worse than the actual surgery because of the length of time required and the restrictions on activity simply because of the casts and boots. He said to do both the ankles at the same time, however, or we probably wouldn’t ever come in to get the second one done!

Before Surgery

I’m a big planner, so I had all these things planned for how recovery would go. To encourage my son that the casts would be fine, we decided to use paint pens to decorate his casts. After researching, I chose these paint pens. They came in lots of colors, and didn’t run at all. They made a nice dark paint line, and didn’t fade over time. Also, they were easy to use, which was important for when 8 year olds wanted to sign it in class! He was going to be allowed to pick which color his casts would be, and we went with one red and one black. I thought a dark-colored casts would show dirt less, which is important for a cast that’s going to be on the ground all the time.

His black one was going to be for signing, so we had a white, gold and silver paint pen ready for people to use to sign it. His red cast was going to be a Spiderman cast, so the black paint pen was perfect. My husband is pretty good at sketching, so he drew a Spiderman spider and web all across the top and front of the cast the first night home after the surgery.

Another way I prepared was to get him a small gift. I remember when I was a kid, I had my adenoids out and my parents got me a stuffed bear. Now, whenever my kids have a planned surgery (which thankfully, isn’t too often!) we’ve gotten them a stuffed animal. My son had recently been super excited about a Minecraft novel and he really doesn’t like to read, so I jumped on it and ordered the book. Since it was only a few dollars, I also got him a Minecraft skeleton stuffed animal to go with. We gave it to him the night before surgery and he took it with him to the hospital the next day.

Day Of Surgery

Waiting before surgery.

Waiting for surgery to begin.

Caleb’s surgery wasn’t scheduled until about 1:00, but that meant we had to be there by 11:00 am. He couldn’t eat past midnight, so he was a little hungry. We got there on time and waited just a bit before they brought us back to a room. Caleb was able to pick a movie to watch while we waited. Then, lots of different doctors and nurses came and went, asking questions and answering mine.

I was allowed, if I wished, to go back to the operating room with him and stay with him while he fell asleep. I asked Caleb, and he wanted me to do that. I had to put on a white coverall-thing, as well as a hairnet and shoe covers. Believe me when I say, I looked lovely. But away we went.

We wheeled down the hall to the OR and hung out a few minutes waiting for the anesthesiologist; that was rough, looking around at all the equipment, even though most of it wasn’t going to be used. Caleb was starting to get nervous, as well. Finally, it was time for him to breathe the laughing gas; this was much rougher than I thought it would be to watch. I was holding his hand while the nurse held the mask over his face. He was fighting the sleep, and tears were leaking from his eyes while he squeezed my hand. It only took a minute for him to fall asleep, and they escorted me out. I had tears of my own streaming down my face!

Once I was out of the room, they put in an IV and did the surgery. I was able to go back to the recovery room within an hour, and he was already awake, drinking a slushie and watching TV. He looked tired and was cold, so they put a warm blanket on him. This kid, though; nothing gets him down for long. He was ready for the IV port to be out so we could go home.

His casts when we first got home.

We left about an hour later; they wanted to make sure he could keep down the slushie and snacks they brought him before they released him. When we got home, we made a nest of pillows and blankets on the couch and he chilled out there for the remainder of the afternoon. He insisted on hobbling around on his own, to go to the bathroom or upstairs for bed, and by the next day, he was barely slowing down.

Toe Walking surgery

Do you get the Toy Story reference?

His recovery has gone well, if long. We had to do sponge baths when he had his casts on. We considered getting waterproof bag-things to put his legs into, but then thought about the fact that the water would run down his legs right into the cast, if the seal wasn’t perfect. We decided, for the sake of his casts, to just do sponge baths. I washed his hair in the kitchen sink.

 

 

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His Spiderman cast just before they got cut off.

Now that he’s got the boots on, we can take them off for a bath. He typically takes a shower, but he’s still unsteady on his legs without the support of the casts or boots, so I have him take a bath. He’s enjoying that, although it makes bath-time twice as long. The boots are annoying for him because they are super heavy and hot. He can walk just fine, but he gets tired after awhile because of the weight of them.

 

His brand new boots! SO MANY STRAPS!

The AFOs took awhile to come in, but they are the smallest thing on his feet since before the surgery. They fit inside his sneakers, which he hasn’t worn in two months. They are lightweight and he doesn’t seem to mind them at all. He’ll be able to wear them only at night starting about a week before Christmas, so that’s a great gift!
In all, the surgery has gone well and we feel it’s been worth it. He has occasionally walked without the boots, like when he takes them off to take a shower, put on pajamas, walk around for a few minutes while I’m doing something else and can’t help him  put them back on for a few minutes. He walks flat footed all the time at this point.
AFOs getting put on! They're super slim, especially compared to the boots.He tried the other day to go up on his toes, just to see if he could, and he barely could get up on them, and they made his achilles tendons sore. This will strengthen over time, but by then he will be so used to walking flat footed that he will only use his tip toes for short term, like to reach something.AFOs getting put on! They're super slim, especially compared to the boots.

Let me know: does your child walk on their toes? What different things have you done to try to correct it? Let me know in the comments!

Click Here for a Free Printable PDF version Does your child have an outpatient surgery coming up? This handy checklist will help you be prepared for the big day.

5 Comments

  • Katherine Betts November 21, 2016 at 10:30 pm

    Interesting! I have a friend who’s daughter was late to come off her toes and she told me about this surgery. It does make your eyes squint at the thought, brace Caleb! #BloggersSupportGroup

    Reply
    • Rebekah @ My Circus My Monkeys November 21, 2016 at 10:40 pm

      It’s a big decision to go with elective surgery, but he’s been a trooper! Just a few more weeks, he’ll be done with them by Christmas. Did your friend have the surgery done for her daughter?

      Reply
  • Chilli Regina November 22, 2016 at 9:48 am

    Oh, he’s so brave. I’m sure it was a hard decission, but a the one you had to make in order for him to wald normal..It’s a looong recovery, I know, as my father in law had operation on it and was going back and forward with physiotherapy for a year…All the best wishes go to caleb and your family!

    Reply
    • Rebekah @ My Circus My Monkeys November 22, 2016 at 11:42 am

      Thank you so much! He’s actually not going to have to do much therapy, maybe because he’s so young? But he’s more than ready to not have things on his feet and legs!

      Reply
  • Drea-M September 24, 2017 at 4:01 am

    I have twins who will both be going through a similar surgery. One is a little worse than the other. Besides the Achilles tendon being lengthened in both legs, they will have muscles behind the knees tightened as well. I was hoping someone posted some information online as to some things to expect or think about. Since they are my only two and no one I know, whether family or friends have gone through similar, I’m stuck with minimal information. I know the Dr will go through a lot of into but I was hoping for personal tips and tools from someone who has had a child go through similar. Thank you for sharing your story. It has helped me with a few ideas for mine. They won’t be getting it done at the same time but i at least want to be as prepared as I can be for the first time.

    Reply

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