What is walking on toes and what causes it? What is the prognosis (prognosis) of children walking on their toes?


Toe walking is a common anomaly in infants’ gait patterns and is characterized by the use of toes instead of heels during the gait cycle (repeated gait). Inadequate contact between the heel and the floor can cause the toes of the foot to deform.

Toe walking overview:

In most cases, walking on a child’s toes does not cause problems and is considered a normal part of development and learning in the early stages of walking. Most children usually start walking normally on their own without intervention. However, you need to evaluate a sustained toe walk.

What does idiopathic walking mean?

Idiopathic walking is when a healthy child walks on toes for unknown reasons. This may include older children who continue walking on their toes due to habits, behavioral reasons, or tightening of tendon muscles due to prolonged walking on their toes. Many children develop the habit of walking on toes for unknown reasons. This condition is called idiopathic walking.

What Causes Toe Walking?

Some underlying conditions may also be associated with walking on a child’s toes, including:

  1. Cerebral palsy:People with cerebral palsy have difficulty walking and are out of balance. This stiffens the toe muscles and can result in the use of the toes instead of the feet during the walk cycle.
  2. Autism Spectrum Disorder (ASD):Autism is a hereditary neuropathy. Children with autism have difficulty socializing and communicating and can walk on their toes habitually.
  • Birth defects:

Birth defects, such as congenital spinal abnormalities, make it difficult to maintain balance and lead to walking on the child’s toes.

Muscular dystrophy is an endemic hereditary disorder that causes progressive weakness of the muscles. As a result of muscle loss, muscle fiber weakness, and postural changes, affected children may begin to walk on their toes to stabilize their body while walking.

  • Achilles tendon defect:

The Achilles tendon is the muscle that connects the calf muscle to the heel bone. Children with congenital abnormal foot structures or short Achilles tendon muscles may walk on their toes.

What are the symptoms of walking on toes?

The most common and prominent symptom of walking on toes is the inability to walk with your feet on the ground. Affected children may have difficulty wearing shoes, participating in sporting activities, and stabilizing themselves while walking. Other symptoms are:

  • Muscle tendon stiffness
  • Weak or unable to walk flat
  • Difficulty in movement such as running and sprinting
  • Too many trips and falls

When do you consult a doctor?

Fortunately, walking on toes does not cause life-threatening illness. This is considered a common learning stage for early gait in babies. In most cases, children start walking with flat feet with their heels in contact with the ground without medical intervention.

However, if your child is experiencing a chronic condition of walking on toes (2 years or older) or difficulty walking, or if walking on toes recurs after a normal walking period, it is advisable to see a doctor immediately. To do.

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How is toe walking diagnosed?

A doctor or pediatrician will perform a general physical examination of the muscles, tendons, and skeletal structure of the foot to rule out major medical problems. These physical exams are usually sufficient to diagnose most equinus walking conditions. However, if the doctor suspects another underlying condition, he may recommend further evaluation by a professional orthopedic surgeon or neurologist.

How is walking on toes treated?

Toe walking treatment is highly dependent on the condition of the foot and the age of the affected person. In mild and moderate cases, non-surgical options follow. Surgical options are recommended for severely deformed toe structures.

1. Non-surgical method for treating toe walking:

  • Physical therapy: Stretching and gentle massage of the leg muscles may improve gait patterns in early, mild, and moderate cases of infant walking.
  • Leg orthosis-ankle-foot orthosis: Ankle-Bath orthosis is a special type of orthosis designed to support the ankle in the correct position. These braces reduce the pressure on the toe muscles caused by long toe walks. Ankles-Foot braces help improve the range of motion of the foot and relax the muscles of the foot.
  • Drug-Onaboturinus Toxin A: Onaboturinus toxin A is a site-specific injection (acts only on the site of injection). They are widely used to treat muscle hypertrophy (muscle loss and weakness) in children. These injections are used in combination with leg braces to promote stretching of the leg muscles.

2. Surgical methods for treating toe walking:

  • Surgery: Gastrocnemius extension

If other conservative treatments prove to be inefficient, equinus surgical treatment is considered the final option. Toe walking surgery requires the Achilles tendon of the leg muscles to be surgically stretched. This tendon extension promotes wider range of motion and allows for proper foot and ankle function.

What are the complications associated with walking on toes?

Walking toes puts excessive stress on the muscles of the toes. This long period of weight pressure on the toes can cause the Achilles tendon and calf muscles to tighten over time. This limits the normal range of the toe muscles and makes walking difficult.

How to prevent a child walking on toes?

There is no standard preventive measure for walking on toes, as children usually employ normal walking over a period of time. Certain exercises and muscle stretching in children under the age of 6 can prevent the possibility of later adopting or practicing toe walking.

Conclusion-Prospects and Prognosis:

Perspective depends largely on the degree of abnormal gait patterns, foot deformities, and habitual causes. However, most children with abnormal gait patterns (toe walking) improve over a period of time with medical assistance and lead a normal life without difficulty walking. However, in some cases, walking on toes will recur after a normal walking period.

Frequently Asked Questions (FAQS):

  1. How can I help my child if he is walking on his toes?

If your child is experiencing signs or symptoms of walking on toes, the following methods may help facilitate a heel-to-floor connection.

  • Stretching your child’s legs and gently massaging them will improve blood circulation.
  • Encourage the child to practice bilateral foot jumps to improve foot-ground contact.
  • Be sure to make corrections when observing a child’s toe walk. This prevents habitual walking on your toes.
  1. Is walking on toes a sign of ADHD?

Children with Attention Deficit Hyperactivity Disorder (ADHD) are very sensitive to walking on toes and shortening the Achilles tendon.

  1. At what age should I stop walking on my toes?

In general, a child’s toe walking stops naturally by the age of five.

  1. What are some commonly suggested treatments for walking on toes?

Your doctor may suggest one of the following treatments,

  • Support brace
  • Surgery
  • Special leg cast
  • Botox injection

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