Tip Toe Walking

How we correct tip toe walking in children and adults.

Tip Toe WalkingTip Toe walking refers to a gait pattern where a person walks on their toes or balls of feet, without putting much if any weight through the heel or any other part of the foot.

Tip Toe walking in toddlers is common under the age of 3 and most of these children will grow out of this and adopt a normal walking pattern. If a child continues to toe walk they should be assessed by a podiatrist.

Causes of Toe Walking:

  • Habitual or idiopathic toe walking, where the cause is unknown but the child is physically capable to stand flat footed, they have always just walked on their toes.
  • Congenitally short or contracted Achilles Tendon.
  • Muscle spasticity (I.E. Cerebral Palsy). Reflexes are increased and walking may be delayed.
  • Paralytic muscle disease (I.E. Duchene Muscular Dystrophy). There will usually be enlarged calves and signs of muscle weakness. A serum blood test for a specific muscle enzyme level is recommended.
  • Autism, as persistent toe walking may be an early sign of this condition.
  • Hypersensitivity or sensory complications.

Diagnosis of Toe Walking:

  • In depth medical history reporting and comparing the normal age for stage child milestone developmental accomplishments.
  • Gait and range of motion assessment.
  • Basic neurological assessment.

Treatment for Toe Walking:

  • Depending on the cause of the toe walking, treatment may vary considerably.
  • Idiopathic toe walking should be monitored to see if the child “outgrows” the condition, with passive stretching, massage and desensitisation with increased sensory feedback to the heels of the feet.
  • Heel raises in the shoe that progressively reduce with a stretching regime and increased sensory feedback.
  • Carbon fibre plates may also be use in the shoe to prevent tip toe walking in severe habitual cases.
  • Night splints, AFO braces or serial casting may be used if there is a reduction in calf range of motion.
  • Botox therapy is used in severe cases to paralyse the calf muscles to prevent resistance to stretching, most often used with serial casting.
  • Surgical lengthening of the Achilles tendon may be necessary if conservative treatment fails.  This is normally day surgery and done in conjunction with serial casting for 6 weeks and then a brace for the remaining numerous months.
  • Toe walking caused by more serious neuro-muscular disorders should be referred to a specialist.

Well Heeled Podiatry has a range of treatment options for toe walker and can assess, diagnose and treat abnormalities of the lower limb, as well as ensuring you as a parent what is the appropriate age for stage developmental milestones.

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