Toe walking

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD's medical weight loss NYC, sleep center NYC
Philadelphia medical weight loss and Philadelphia sleep clinics

Toe walking
Synonyms	Idiopathic toe walking
Pronounce	N/A
Specialty	N/A
Symptoms	Walking on the toes or balls of the feet
Complications	Achilles tendon shortening, calf muscle tightness
Onset	Typically in early childhood
Duration	Can be persistent or intermittent
Types	N/A
Causes	Cerebral palsy, autism spectrum disorder, idiopathic
Risks	Family history, developmental disorders
Diagnosis	Clinical evaluation, observation of gait
Differential diagnosis	Cerebral palsy, muscular dystrophy, autism spectrum disorder
Prevention	N/A
Treatment	Physical therapy, orthotic devices, surgery
Medication	N/A
Prognosis	Varies; some children outgrow it, others may require intervention
Frequency	Common in children, especially those with developmental disorders
Deaths	N/A

An overview of toe walking, its causes, and implications

Toe walking is a gait abnormality characterized by walking on the toes or the ball of the foot without the heel touching the ground. It is commonly observed in young children as they learn to walk, but persistent toe walking beyond the age of three may indicate underlying medical conditions.

Causes

Toe walking can be classified into several categories based on its underlying causes:

Idiopathic Toe Walking

Idiopathic toe walking is when no specific medical cause can be identified. It is often seen in otherwise healthy children and may resolve on its own as the child grows.

Neurological Disorders

Toe walking can be associated with neurological disorders such as cerebral palsy, muscular dystrophy, and spinal cord injury. These conditions affect muscle tone and coordination, leading to gait abnormalities.

Autism Spectrum Disorders

Children with autism spectrum disorders (ASD) may exhibit toe walking as part of their motor behavior. The exact cause is not well understood, but it is thought to be related to sensory processing issues or motor planning difficulties.

Shortened Achilles Tendon

A shortened Achilles tendon can cause toe walking, as the heel cannot fully contact the ground. This condition may require physical therapy or surgical intervention to lengthen the tendon.

Diagnosis

Diagnosis of toe walking involves a thorough medical history and physical examination. Healthcare providers may assess the child's gait, muscle tone, and range of motion. In some cases, imaging studies or neurological evaluations may be necessary to rule out underlying conditions.

Treatment

Treatment for toe walking depends on the underlying cause:

• Observation: In idiopathic cases, observation and regular follow-up may be sufficient, especially if the child is young and developing normally.
• Physical Therapy: Stretching exercises and physical therapy can help improve flexibility and gait in children with a shortened Achilles tendon or mild neurological issues.
• Orthotic Devices: Ankle-foot orthoses (AFOs) may be used to encourage heel strike and proper gait mechanics.
• Surgery: In cases where conservative treatments fail, surgical intervention may be necessary to lengthen the Achilles tendon or address other structural issues.

Prognosis

The prognosis for toe walking varies depending on the cause. Idiopathic toe walking often resolves with age, while cases associated with neurological disorders may require ongoing management. Early intervention and appropriate treatment can improve outcomes for most children.

See also

• Gait abnormality
• Cerebral palsy
• Autism spectrum disorder
• Muscular dystrophy