Toe walking refers to a condition where a person walks on his or her toes without putting much weight on the heel or any other part of the foot. Toe-walking in toddlers is common. These children usually adopt a normal walking pattern as they grow older. If a child continues to walk on his or her toes past the age of three, he or she should be evaluated by a doctor.[1]
Toe walking can be caused by different factors. One type of toe walking is also called "habitual" or "idiopathic" toe walking, where the cause is unknown.[2] Other causes include a congenital short Achilles tendon, muscle spasticity (especially as associated with cerebral palsy) and paralytic muscle disease such as Duchenne muscular dystrophy.[3] It may also be one way of accommodating a separate condition, foot drop. Persistent toe walking in children has been identified as a potential early sign of the neurodevelopmental disorder autism.[4][5]
A doctor will typically evaluate whether there is bilateral (both legs) toe walking, what the child's range of motion is (how far he or she can flex his or her feet) and perform a basic neurological exam. Treatment will depend on the cause of the condition.[6]
For idiopathic toe walking in young children, doctors may prefer to watch and wait: the child may "outgrow" the condition.[7] If there is a reduction in the child's range of motion, there are several options.[3]
For toe walking which results from more serious neuro-muscular conditions, additional specialists may need to be consulted.