Autism and Foot Problems: What to Know, What to Do

When most people think about autism, feet and podiatry conditions may not be the first issue that comes to mind. The ways autism spectrum disorder (ASD) can affect social skills, communication abilities, and behavior are generally more prominent. However, research has brought several links between autism and foot problems to light.

At least three general characteristics of autism spectrum disorder appear to contribute to its association with foot problems:

1. Problems with Body Awareness Cause Gait Abnormalities

Many individuals on the autism spectrum have trouble with proprioception, the awareness of body position and movement in space. They face challenges with balance, coordination, and gross (large) motor skills. All of these challenges can change their gait patterns—the way they walk or move their limbs while walking.

Abnormal gait patterns can lead to foot problems because they put excessive pressure on the feet and ankles.

2. Sensory Sensitivities Have an Impact

Certain sensory stimuli may cause discomfort or distraction that also affects how someone walks, with consequences for their feet.

Additionally, sensory processing issues can make it challenging for people with autism to tolerate “typical” footwear or certain surfaces (such as grass or sand). These difficulties can lead to insufficient support and foot-related complications.

3. Low Muscle Tone (Hypotonia) Weakens Feet

Low muscle tone, or hypotonia, is characterized by decreased muscle strength, poor muscle control, and difficulty with motor skills. It can affect various parts of the body, including the feet. Half of children with ASD show some degree of hypotonia.

Specific foot problems may arise due to weak muscles in the feet and lower legs. Individuals with hypotonia may have difficulty walking or standing for a long time. They may also be at greater risk of injuries such as sprains or falls.

Podiatrists (specialists in treating the feet) and other healthcare professionals often observe these specific connections, among others, between autism and foot problems:

Flat Feet and Autism

Flat feet, or fallen arches, occur when the arches on the inside of the feet collapse, causing the entire foot to make contact with the ground. This condition can lead to pain, strain on the ligaments, and difficulty with balance. It can also affect the person’s gait and overall mobility.

The most common symptom of flat feet is pain in the foot’s arch or heel. This pain worsens with activity or prolonged periods of standing. Foot and ankle swelling, difficulty fitting into shoes, and an outward tilting of the heel can also be signs. In severe cases, individuals with flat feet may experience knee, hip, or lower back pain.

Idiopathic Toe Walking and Autism

Walking on curled toes or tiptoes, without the heels touching the ground, can be a normal part of development for children learning to walk. Idiopathic toe walking, however, refers to cases of persistent toe walking in which podiatrists can identify no underlying medical reason.

People with idiopathic toe walking may experience frequent falls, fatigue in the legs, and difficulty with activities requiring them to walk long distances. Toe walking can also lead to tightness in the Achilles tendon, shortened calf muscles, and other issues.

Supination and Autism

Supination, also known as underpronation, is the outward rolling of the foot during walking or running. It also manifests as standing on the sides of the feet. When feet are supinated, they become inflexible. Supination can lead to such issues as ankle sprains, plantar fasciitis, and shin splints.

The abnormal gait patterns some individuals with autism exhibit can contribute to supination. A genetic link between supination and autism may also exist, as certain genes associated with autism have also been linked to differences in foot and ankle structure.

Foot problems can significantly impact anyone’s overall well-being and quality of life, and the challenges they pose are particularly pronounced for individuals with autism.
If the person with autism for whom you care has foot problems, seek expert assessment and treatment from a team experienced in working with individuals with special needs.

At The Medical Center at Woods, we know each individual with autism is unique. Our team includes an expert podiatrist who can provide personalized care and treatment plans to address specific foot issues.

Possible treatment plans include:

• Evaluation and referral for appropriate footwear, arch supports, custom orthotics, and/or lower extremity bracing.
• Referral to Physical therapy for muscle stretching / strengthening exercises, range of motion exercises, and balance evaluation and treatment.
• Conservative treatment and surgical consultation for progressive deformities of the lower extremities affecting gait function, balance, and resulting in painful ambulation.

From sensory-friendly footwear to custom orthotic devices to more extensive treatment options, we help each person we treat experience greater comfort, mobility, and overall quality of life.

Schedule an appointment online today, or call us at 215-750-4004.