Toe walking is a gait abnormality characterized by an absence of normal heel-to-floor contact (heel strike) by both feet during gait, with the forefoot engaging in the majority of floor contact throughout the gait cycle. Toe walking has multiple etiologies, ranging from idiosyncratic habit to profound neuromuscular disease.
Critical to the management of toe walking is the exclusion of neurologic or muscular diseases as a cause of the perceived gait abnormality. Treatment depends on the patient’s age and severity of the gait abnormality. Specific treatment options range from simple observation to surgical lengthening of muscles or tendons in the lower extremity.
Most children begin walking at 12 to 14 months with their feet flat on the ground. However, there are some children who begin walking on their tiptoes instead. This pattern normally disappears within 3 to 6 months of learning how to walk. It almost always is completely gone by the end of the third year.
Idiopathic toe walking is when a child continues to walk on his tiptoes beyond 3 years of age. He will often stand with his feet flat on the ground, but when walking or running will prefer to be on his toes. If your child does not outgrow tip toe walking by 3 years of age, take him to see a health care professional.
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