A number of kids when they're beginning to walk, walk up on the toes. This is very normal and often is of no relevance. By the age of three years, they should be walking easily with the whole foot flat on the floor. However a tiny number don’t and continue to toe walk. These need to be reviewed further as there are a number of manageable problems that may be causing it.
There are specific causes of toe walking with about 10% being categorised as idiopathic, which means that the reason is not known. Some neurological disorders for example cerebral palsy or muscular dystrophy which causes the calf muscle to be limited could cause the toe walking. Musculoskeletal conditions such as club foot that is a deformity or severs disease that causes heel pain or simply very tight calf muscles can also result in toe walking. There is another group of kids who are able to get their heels to the floor, but merely prefer to walk on their toes. This later one could be associated with behavioural conditions or related to disorders like the autism spectrum disorders or developmental delay. After all these possible underlying disorders are ruled out, the diagnosis of idiopathic Toe walking can be made in those who persist to walk on the toes.
The treatment of toe walking is aimed at the actual condition that is underlying it. In cases in which idiopathic toe walking has been identified, there are a variety of alternatives such a behavioural interventions, stretching, vibration treatment, plaster casting and Botox injections. If all that fails, a surgical extending of the Achilles tendon can be carried out. Many cases do have a tendency to come right over time, so moderate cases could just be watched to let it resolve or later result in the diagnosis of a disorder that is underlying it. All cases really do need to be taken seriously and further looked at.