leg/foot/gait problem, what kind of practitioner?

[iris777888]

Since Sunday our 3yo DS seems to having a problem with his gait. It sort of looks like he is limping. I can't be sure, but it looks like something is up with his left leg/foot. When he walks up the stairs, it looks like it's severely overpronating. He says it doesn't hurt, doesn't react when I press on it, etc. but there is very clearly something not quite right as it is obviously effecting his walking/running. AFAIK he hasn't had any falls or other trauma. The only related thing I can think of is that a couple times the day before he burst out crying, pretty out of the blue (very uncharacteristic but he was tired at the time). He hasn't done that since. MIL thought it might be cramps, since DH got that when he was little, but I just don't think that's it.

How long do I wait to see if it continues before taking him to see someone, and who should it be? Chiro? GP? Someone else? We don't have a strong relationship with any practitioner right now.

[NiteNicole]

My daughter did something very like this last fall so we started with her pediatrician who sent us to both a neurologist and orthopedist. I'm going to warn you that when you tell them your child has a painless limp, they're going to test for a lot of stuff. For my daughter, we still don't have a very specific diagnosis but after a year she's responding really well to meds. Don't let that freak you out, there are a million small things it could be but they will probably want to rule out the bigger ones first.

Don't wait, call your ped tomorrow. I waited and thought it was a bad habit, a small sprain, all kinds of things and it wasn't any of those things. We could be six weeks further along in treatment (and I could've gotten the scary tests out of the ways six weeks earlier) if I had listened to other people and taken her in sooner.

If you don't have a ped, call a friend and ask for a ped recommendation or talk to your GP, just see someone sooner rather than later. I so so SO regret waiting.

Edited to add: take video of him walking if you have time. After about the third appointment, my daughter would just fall apart when they asked to see her walk (she was about 3.5 when this started) and they couldn't really see what was up. Having video helped.

I'm going to keep watching this thread for updates.

[iris777888]

Thank you for the reply, Nicole. We are definitely taking this seriously, and your post really underscores the reasons for doing that. I got myself all worked up looking things up last night even though I knew better. At this point it could still be anything!

We took him to an ICPA chiro today, decided to try that route first. I have concerns about the heavy handed approach the GP's office is likely to push, and lately it's been near impossible to see our main doc on short notice so we would have almost certainly gotten one of the others.

The chiro showed us that there was an obvious leg length difference, also a couple other problem spots too he thought might be contributing. He did an adjustment he thought would help. I am not yet confident that will resolve the issue, but we are going to monitor closely and if we're not seeing progress very soon (by next week sometime at latest I'm thinking) we will take him to the GP next. In general though, the chiro did not seem overly alarmed, so if nothing else that was a small comfort.

[NiteNicole]

Good luck to you and please keep me posted!

We found it really really difficult to get appointments with specialists so if you think you might need them, now is a good time to go ahead and see a ped because sometimes they can get appointments for you when you can't get them yourself. Some of the stuff I found while consulting Dr. Google - scary stuff.

[ameliabedelia]

I would start by seeing the your pediatrician. Generally you need a pediatrician for a referral to specialists anyway.

[Angela512]

I was going to recommend the chiro. I started having walk/gait problems (but I had a small "tender" spot in my back). I went to the doctor and they said that one leg was slightly shorter than the other and sent me to a specialist who insisted that the only way to rectify the problem were these insanely expensive shoe inserts that insurance didn't cover.

I went to the chiro and found that my hips were tilted (one side tilted slightly forward one side tilted slightly back). After a few weeks of adjustments and muscle strengthening exercises, my legs are the same length and I don't need inserts. (I do go to the chiro on a regular basis and work out a lot to keep everything "in line")

When my kids start acting "unusual" I take them to the chiro for adjustments. You don't need anything necessarily traumatic to throw the back out of alignment.

[iris777888]

podiatrist?

He is still limping today. Not that I expected the chiro visit to be a miracle cure. He didn't say it would be, but also didn't recommend any long term treatment plan, or say anything that led me to believe this was anything but a short term problem.

It's in a situation like this where I wish we had a strong relationship with a doctor that we could trust fully. We like ours OK, but he's not that available lately (that branch has grown rapidly) and he's not that holistic minded. He's about the best we can find for our area though.

Has anyone been to a podiatrist for leg/feet/gait issues? That's another option that we've considered because one of his feet and the ankle area does look a bit wrong. We have one near our house and insurance covers it. I don't ask this because we're trying to avoid the GP, just have never really used podiatry and am not sure if this would be an applicable use.

[NiteNicole]

Honestly, start with your GP or any pediatrician who can see you. Call a friend for a recommendation. You could at least rule out some of the more scary things.

What kind of limping is it? Has his walk slowed down? Is it worse when he tries to go faster and does he run?

[mbbinsc]

i agree with starting with you GP. A podiatrist would not be able to address any neurological problems, which is what you want to be able to rule out. A physical therapist could evaluate the gait pattern. Some states and insurances allow a visit to PT without first seeing MD. You could call your local pediatric PT office.

[iris777888]

Thanks for all the input so far. Yesterday we did see some improvement and it seems to be significantly better today. Not totally gone, but close. He's managing the stairs fine too, with his ankle not tilting in so far as it was before. At this point I am keeping a close eye, and hoping like crazy that it doesn't reoccur. I don't feel the need to rule out a neurological problem quite yet, as for all I know it could have been something simple that I didn't notice or or he wasn't telling me about.

As for what kind of limping, no he did not slow down at all. In fact, he kept running and then acting annoyed at his foot/leg. Right along he stayed very active and keeps saying it doesn't hurt. However, he has a language delay, so it's hard to be certain that he's understanding the question and answering appropriately.

[mbbinsc]

If it was my DC, I'd still want an evaluation, especially if there is any chance that the language delay and limping could be related (like some very hard to detect neuro problem that would be better to be addressed early rather than completely missed).