Why Is My Toddler Limping?
Q)
Dear Dr. Gwenn:
My son is going on two years of age. He has been limping off and on for weeks now. We went to the pediatrician last week and got X-rays and blood work done and everything was normal. However our doctor never told me how long this may go on. He limps worse when he first gets up from sitting for a longer period of time or waking in the AM. I know that when I had a sprained ankle it took weeks almost months, is this the same for him?
Thanks.
HH
A)
Dear HH:
Limping is a very common problem in toddlers and a topic I've written about before. As I've mentioned in the past, the typical cause is either a virus, trauma, or a post-viral condition called ‘toxic synovitis’ where the lining of the joint becomes inflamed during the aftermath of a virus. This is thought to be an autoimmune response – sort of an overreaction of the immune system where the immune system temporarily reacts against its own body.
Your question is an excellent one for a number of reasons. Very often in our offices we see limping toddlers like your son and focus so much on the “don’t worry” part that we forget to give you the perspective of the healing process. It may help you to consider musculoskeletal issues in big kids and athletes. If you consider that a typical ankle sprain, for example, is a 2-4 week healing process, the same applies for young kids. So, your experience is what you should expect for your son. That duration may be a bit longer if he reinjures it which is possible balance issues typical for age.
It is very typical for a limp to be worse when we get up and are stiff from sleeping and to be worse as the day goes on with activity. But, over time the limp should be improving day to day. Since the initial xrays and blood work were reassuring, be reassured. However, if you are finding your son’s limp is persisting past 2-3 weeks, are worsening, he begins to look sick, or the limp is causing him frustration because he can not do what he wants to do, talk to your pediatrician for a reevaluation.
A happily limping child is never as worrisome as a miserably limping child. Go with your gut and the overall appearance of your child. Those two "findings" will never steer you wrong.
Dr. Gwenn
