Idiopathic Toe Walking

What is it?

“Idiopathic Toe Walking” is used to describe a condition whereby a normal child – who can walk or stand with their heels down if prompted – prefer to walk and run on their toes instead.

Who gets it?

Idiopathic toe walking may be experienced by any child who is otherwise healthy, although the exact cause remains unknown.

How does it present?

Idiopathic toe walking is usually present at or soon after first starting to walk. A child will be observed to walk and run on tiptoes, although when asked to walk or stand with heels down, will be able to do so. Over time your child may display tightness in the calf muscle which is likely to contribute to idiopathic toe walking.

How is it treated?

Although controversial, there are several options for treatment ranging from splints, stretches, monitoring and shoe inserts to Botox injections all of which have limited success. If severe enough surgical lengthening of the calf and a period of time in corrective splints is highly effective in resolving the condition.

What is the natural history?

The condition generally resolves or reduces over time, with most children eventually “coming down” onto their heels. Regardless, some children will continue to walk with a “springy” gait following resolution of the initial condition.

When should I see an orthopaedic surgeon?

In some cases, there may be a requirement to see an orthopaedic surgeon:

  • Your child can only comfortably stand with their heels on the ground if they lean forward and have their legs out-turned and wide apart
  • Toe walking is only apparent on one side; or
  • Your child cannot physically stand with heels on the ground
  • The condition developed after a period of time of walking normally
  • It was associated with the development of a neurological condition
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