Toe_walking
Toe walking
Medical condition
Toe walking refers to a condition where a person walks on their toes without putting much or any weight on the heel or any other part of the foot. This term also includes the inability to connect one's foot fully to the ground while in the standing phase of the walking cycle.[1][2] Toe walking in toddlers is common. Children who toe walk as toddlers commonly adopt a heel-toe walking pattern as they grow older. If a child continues to walk on their toes past the age of three, or cannot get their heels to the ground at all, they should be evaluated by a health professional who is experienced in assessing children's walking.[3]
Toe walking can be caused by a number of health conditions. When there is no medical reason for toe walking and no underlying condition can be identified, health professionals will commonly refer to it as "idiopathic" toe walking. This is not a formal or recognized diagnosis; rather, it is simply a term indicating that there is no identifiable reason or causal factor for the toe walking.[4] Idiopathic toe walking should only be considered after all other conditions have been excluded. [5] Other causes for toe walking include a congenital short Achilles tendon, muscle spasticity (commonly associated with cerebral palsy) or genetic diseases muscle disease such as Duchenne muscular dystrophy.[6] Toe walking may also be caused by a bone block located at the ankle which prevents the ankle from moving. This may be as the result of trauma or arthritis.[7] Toe walking 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 autism.[8][9] Toe walking is commonly found in children who have been placed on the autism spectrum.[10][11] In a recent study, 68% of children on the autism spectrum report experiencing a walking abnormality.[12][13]
It is estimated that 5% of healthy children have no reason for their toe walking (idiopathic toe walking).[14] Idiopathic toe walking has also been observed more in males than females when very large groups of children with toe walking are observed. One study looked for a family history of toe walking, and found a connection with family members all toe walking with no medical reason (idiopathic toe walking). This means there may be a genetic link with idiopathic toe walking.[15] Idiopathic toe walking spontaneously disappears over the years in the majority of cases and is most often not associated with a motor or cognitive issue.[16]