- Abnormal: Child who is an idiopathic toewalker usually presents
after obtaining independent
- Normal: The initial gait or
cruising that children do around the couch and table is often associated with
them walking on their toes; after they have gained independence, it is unusual
for them to walk on their toes.
- Important to rule out neurologic conditions, e.g., cerebral spasticity,
spinal dysraphism. Perform a Gower test to rule out muscle disorders.
- Once neurologic conditions have been ruled out the condition is
self-limiting and tends to resolve itself in most cases
before school age.
- For those cases that persist,
one must be concerned about the presence of
muscle, as well as
nerve disorder and
lower spinal anomalies.
- If the child has not come down off his toes by school age, a percutaneous
heel cord release may help.
CHLA Board Review 2005