Limping

Q: My 6 year old son limps while walking. I have checked for the difference in the length of the legs but there is no such problem. Can you please suggest some treatment or exercises for him.

A:Limping in a child can have many causes. It can be because of a lesion in the spine, hip, knee, or foot. Walking with the heel raised is called talipes equinus. The cause which I can think of in this case is shortened tendoachilles or the tendoachilles is not keeping pace with the growth of the extremity. Tendoachilles in the heel cord that we can feel at the back of the ankle. This can either be congenital (from birth but noticed later) or it can be acquired. The limp can be because a lesion in the heel or because of a flexion contracture of the knee joint, i.e. the knee cannot be kept straight. It can be because of a hip pathology.for eg: synovitis or inflammation of the hip joint can force the hip to remain flexed, which can decrease the length of th leg and force one to walk with an equinus gait. It can be because of developmental dysplasia of the hip (DDH). Even the spine can be involoved: this can lead to tilting of the pelvis, which can be a cause. It is also important to know whether the limp is painful or painless. Painful limp may be suggestive of an active, inflammatory condition. Painless limp can be due to developmental failures. I think a limp in a child should not be neglected and a thorough evaluation whould be done. Consultation with a orthopaedic surgeon is advisable.

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