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Toe Walking
December 2003

Q. My 10-year-old son has walked on his toes since he began walking. He does not have any neurological problems. My husband and father-in-law also toe walk, but not to the extent of my son. I was told that the only thing that would correct this is heel cord lengthening surgery. My orthopedist said physical therapy and braces would not help him, that he would toe walk as soon as he stopped therapy and using the braces. What is your opinion on this matter? What are the problems that can occur from the surgery?

A. Toe walking is common in young children learning to walk but usually disappears by age 2. The observation of toe walking in the father and grandfather certainly suggests some genetic link. It will be important to pinpoint the cause if possible to best find treatment options.

Neurologic and muscular conditions can cause toe walking. Examples might include forms of cerebral palsy and muscular dystrophy. Some cases are labeled as "idiopathic," meaning no underlying cause can be found. These cases may be found to have shortening of the Achilles tendon in which progressive casting or surgery is recommended. A pediatric orthopedist and your child's doctor can help sort out these possibilities and work with you to find the best treatment.




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