Does your child walk on their knees instead of on their feet? Here’s a rundown from a pediatric physical therapist of the ramifications, causes, and the potential treatments of knee walking.
What is Knee Walking?
Knee walking is a pattern of locomotion where a child “walks” on their knees in a tall kneeling position. The typical progression of learning to walk is as follows: crawling, pulling to stand up, walking sideways while holding onto furniture, walking holding a hand, then finally walking independently. Some children do not follow this pattern, and begin walking on their knees instead. These children may or may not have learned to pull to stand up.
Is Knee Walking a Problem?
While knee walking may seem like a functional way to get around for a toddler, there are actually many drawbacks to this motor pattern. First, knee walking will not work for your child long term. As they get older, walking upright on their feet will be required. Many children who knee walk do not grow out of it, so it is always better to address it sooner rather than later. Another factor to consider is how knee walking affects posture. Knee walking promotes arching your lower back, and is not an advantageous position for core and leg strength to develop.
One of the biggest concerns for knee walkers is the progression of motor skills. As a child learns to walk on their feet, they are building foundational skills that will lead to running, climbing, walking up stairs, jumping, and all sorts of play. If a child knee walks, they are not building the foundation needed to progress their skills. Without intervention, children may become stuck in their motor development.
What Causes Knee Walking?
Knee walking is typically caused by two factors. The first is joint instability. When a child walks on their knees, the hip is the only joint of the lower extremity that is doing any work. By knee walking, the child has taken their ankle and knee joints out of the equation. Children typically do this when they feel that those joints are unstable. The ankle or knee may be unstable due to poor joint alignment, flat feet, low muscle tone or muscle weakness in the ankle or leg.
The second reason a child might knee walk is impairments in the vestibular system. The vestibular system is comprised of the fluid in the inner ear; it sends signals to the brain that provide information about where the head is in relation to gravity. If this system is not working the way it is intended to, standing upright on the feet independently can be a very scary feeling. Children may resort to knee walking to keep their bodies closer to the ground so that they feel safer.
A child’s knee walking may be caused by one or a combination of these two factors. A physical therapist can help determine the underlying cause of a child’s knee walking.
How Can a Pediatric Physical Therapist Help?
Physical therapy is the best treatment for knee walking. If your child is knee walking, a pediatric PT will determine the underlying cause and develop a treatment plan to get your child up and on their feet. Treatments may include orthotics for the feet to stabilize the ankle and knee joints, strengthening exercises for the core and legs, postural correction, and treatment of the vestibular system. If your child is knee walking, give us a call today at 773-687-9241 to schedule an evaluation with one of our pediatric PTs!
