Idiopathic Toe Walking: Definition, Symptoms, Causes, Diagnosis and Treatments

Do you have a child older than three who constantly walks on her tippy toes? Does your child bounce when he walks and runs? Is she unable to press her heel to the floor? These are all signs of idiopathic toe walking.

What is Idiopathic Toe Walking?

Idiopathic toe walking is a condition in which the patient is unable to walk in a normal heel-toe rhythm. Medically, it's referred to as 'idiopathic' because there doesn't seem to be any physical or medical reason for the toe walking, such as cerebral palsy. In other words, the toe walking is simply habitual.

However, toe walking can be a sign of autism, especially Asperger's Syndrome, in which no other obvious developmental symptoms are seen until the child is older. Toe walking can also be a sign of cerebral palsy.

What are the Symptoms of Idiopathic Toe Walking?

Watch your child. Does she go up on her tippy toes every once in a while, or is she constantly walking on her toes? If she is always up on her toes, she may have idiopathic toe walking.

Children who toe walk often have very poor balance and physical coordination. They may trip over air, walk and run slowly, have a bouncy gait, and show an aversion to athletics.

With my son, he is physically unable to walk heel-toe. When reminded, he can press his heels closer to the ground when he walks, but it's only for a couple steps and then he's right back to toe walking. He has walked on his toes since the onset of walking, and he is now six.

What Causes Idiopathic Toe Walking?

No one knows for sure what causes idiopathic toe walking. It could be a mimicked behavior that becomes habitual, and then physically necessary. As mentioned before, it could be a sign of cerebral palsy or autism, but then it is not classified as 'idiopathic' toe walking.

Idiopathic toe walking could be an inherited trait. I believe my son inherited his idiopathic toe walking from his father. His father has always walked on his toes and has suffered all his life from leg and foot pain. Until our son's diagnosis, his father had never heard of idiopathic toe walking and had figured that was just how he was built.

In my son's case, regardless of what initially caused it, his toe walking stems from a shortened Achilles tendon. His tendon in each leg is simply too short to allow the heel to drop.

How is Idiopathic Toe Walking Diagnosed?

Only a doctor can correctly diagnose idiopathic toe walking. If you have a child who is older than three years of age and who walks on her toes, it's best to see your doctor.

My son was diagnosed by an orthopedic nurse practitioner from the Shriners Hospital in Minneapolis, Minn. I thought my son's toe walking was something he would outgrow, but when my local county nurse referred me to a free orthopedic evaluation sponsored by a local Shriners group, I took my son. There I learned that at six years of age, my son was rather old to be diagnosed with idiopathic toe walking and he was referred to see an orthopedic specialist at the Shriners Hospital.

How is Idiopathic Toe Walking Treated?

Typically, the first course of treatment for idiopathic toe walking is to prescribe stretches to lengthen the constricted tendon. If stretches aren't helping, the next step of treatment of idiopathic toe walking is to fit the child with braces, which will force the tendon to stretch.

Serial casting is an effective way of treating idiopathic toe walking. Casts should be changed weekly to further stretch the tendon. If after twelve months the braces or casts do not work, there is a surgical option to elongate the tendon.

In my son's case, the orthopedic nurse practitioner explained he is too old for stretches to correct his idiopathic toe walking without the assistance of braces or casts.

If you have a child aged three or older who walks on his toes, the sooner that child is evaluated for idiopathic toe walking, the better. Remember, this article can not diagnose your child. I am not a medical doctor, only a mother whose son has idiopathic toe walking. Please consult your pediatrician if you have concerns about idiopathic toe walking.

Sources:

"Toe Walking in Children: A Cause for Concern?", MayoClinic.com

"Toe Walking", EMedicine.com