A lot of kids when they're starting to walk, walk on the toes. This is very normal and often is of no relevance. By the age of three years, the child should be walking easily with the entire foot flat on the ground. However a small number don’t and persist with the toe walk. These really need to be looked into further as there are a variety of serious issues that may be leading to it.
There are specific causes of Toe Walking with about 10% getting classed as idiopathic, meaning that the reason is unknown. Several neurological problems for example cerebral palsy or muscular dystrophy that can cause the calf muscle to be limited may cause it. Musculoskeletal conditions such as club foot that is a deformity or severs disease that causes heel pain or simply very tight calf muscles may also result in toe walking. There is also a group of children who are able to get their heels to the ground, but simply prefer to walk on their toes. This later one may be related to behavioural conditions or linked to conditions like the autism spectrum disorders or developmental delay. After all these types of potential underpinning disorders are ruled out, the diagnosis of idiopathic toe walking can be made in those who continue to walk on the toes.
The management of toe walking targets the root disorder that is underlying it. In cases in which idiopathic toe walking has been clinically determined, there are a variety of alternatives such a behavioural interventions, stretching, vibration therapy, plaster casting and Botox injections. If all that does not work out, a surgical lengthening of the Achilles tendon is possible. Many cases do usually come right after a while, so minor cases could just be monitored to let it resolve or later result in the diagnosis of a condition that is underlying the toe walking. All cases really do need to be taken seriously and further investigated.