Design: Treatment of Idiopathic Toe Walking

Published 2014-06-19
Kevin discusses idiopathic toe walking as well as the pros and cons of common treatment options with emphasis on the SMO with plantarflexion stop.

- Kevin Matthews, CO/LO

All Comments (21)
  • @SunfireWoods
    This video showed up in my recommended section. I recorded a video on YouTube a few years ago about living as an idiopathic toe walker (search for Kerry Hyder Idiopathic toe walking) Currently as I write this, I am 52 years old, female. In the early 70's as an eight year old child, my parents set out to "fix" me. I've done it all (except botox, as that wasn't available in the 70's.) Physical therapy, serial casting and dorsiflexing back for nearly a year, ATL surgery, and braces. None of it worked. I laugh at the serial casting now, looking back, because I was walking on my toes in the casts. The ATL surgery had me back in casts post surgery and at that point I could no longer walk on my toes. The ugly scars are still there, and the ATL didn't "take." I can attest that everything you've stated is truth. It is very difficult to find shoes that fit me now, and my legs are very strong, especially at the thighs. I can walk flat footed, but I cannot walk on only my heels. My feet do not dorsiflex far enough to enable heel walking. I toe walk out of habit and it is my normality, I have no sensory or medical issues that cause toe walking. To add to the oddity that is "me," I am unable to stand up straight (flat footed) with my feet pointed forward. If I try to stand with feet forward, I will fall backward. I stand with my feet splayed out (duck foot posture) or stand on the balls of my feet. I prefer to be barefoot and on my toes in my home, but I mostly walk flat footed in shoes outside the home. More to avoid the stares or questions I might otherwise get. Barefoot flat footed walking feels weird and uncomfortable to me, I rarely walk that way. I am unable to run heel to toe, either with or without shoes. I run on my toes with a running gate, legs stretched out (as apposed to a spring knee as you demonstrated in your video above.) I have not experienced any hammer toe issues, and my feet have high arches. As I get older, I have not experienced any issues in my knees or hips at all. I will say that I did not start off walking this way. As a toddler I'd already begun to walk and then was stricken with spinal meningitis. I was hospitalized for weeks, and when I finally got out of the hospital my walking gate started up on my toes. Despite all available avenues of medical intervention, I have always been a chronic toe walker with little impact on my life. My childhood during the "fix me" years was not ideal. I do carry a bit of a grudge about it as an adult because it was all for naught. Too much time spent and wasted in medical clinics over three years' time, when I was already too old at eight years of age to start a toe walking intervention.
  • @laila.jw08
    Help. I did ballet when I was 5 but stopped when I was 9, I still do it and I can't even stand up on my heels how do I stop that? Although, when I wear my shoes I walk normally?
  • My oldest son had to have bilateral achilles lengthening surgery when he was 10 years old (5 years ago) and now my 6 year old and 4 year old are both walking on their toes ALL the time. I keep trying to get them to stop, but they won't. I took my my 6 year old to an orthopedic specialist a few months ago and he said that my son was fine and I could just keep stretching his legs, etc. Keep an eye on it.....I am NOT wanting to go through the surgery again. I know the suffering. By the time my son hit the stage of being picked on, it was impossible for him to walk flat. I want to find a treatment to help stop it before it happens with my younger two. I'm glad to see there are braces out there...now I need to find a doctor who will be concerned enough to go this route and not blow it off. Thanks so much!
  • My son has been walking on his toes since he was six months old his Achilles tendon prevents him from even achieving A flat foot he has been walking on his toes since as long as I can remember he cannot physically put his heel on the ground without falling on his butt it is literally impossible for him to be flat footed what do I do in a situation he is not able to put his heel on the ground his Achilles tendon is too shortI need help someone please
  • @Senorita_jesusa
    Hi doc i went to my doctor last monday.. he told me that if he lengthen (do surgery) my tendon / heel cords it might just tear because my tendon is too short and tight... Doc what should I do now? He wants me to get second opinion on other doctor here in the Philippines, doc I'm already 24 years old now, what other opinion should I do i already did alot of therapy since i was just 8 years old as still doing therapy until now it's not working... Please doctor reply what should I do now? What other opinion you recommend? Thank you! 💙
  • @minakostova1952
    Hello,my 9 y/o nephew has toe walking problem and his dad is gp doctor.My sister took him to many specialist doctors they said he might be fine with pt later they said achilles lengthening surgery.His father doesn't conscent to surgery (his fear is permanent damage of achilles tendon resulting in loss of mobility) also neurologist said mri but his father again objected to the contrast dye injected during.His toes have low position and I am not sure if he has flexability enough for casting or this kind of braces,is that mean it would be painful to wear them for the child without 90 degrees flexability?His ankles are extremely tensed by now ,can this muscle tendon shortening and position of foot become permanent?
  • @urmomlol23
    Only one of my feet walk JUST NORMAL, while the other one stands only on toes. Ive been doing this since i started walking. And i used to ignore it. Now im little so scared about it. When i try to falt foot it hurts so bad. Even when im standing. And im starting to think im getting surgery. My mom said it will be okay. But i dont know. She wants me to wear special cure shoes, i hope it works. If not ill probably will need surgery and i just hate the word surgery
  • @ziMela8162
    Thanks for this elaborate explanations. How can I get these design you hold, the blue one. My daughter is 3yrs and still toe walks
  • @far0123
    hi, my daughter is 2.6 years old she was a toe Walker,she was was unable to walk independently since 18months so she had a tendon lengthening procedure last year in April. initially she start some walk but from 4 5 month she is not walking independently ,started crying when ever we ask her to walk and fall oftenly
  • Hello dr My child is cerebral palsy He is 3 year old. He still Walking on toe. I am doing his physiotherapy from last 18 month. But he still walk on toes. There is hardness come in his toe. What should I do
  • @slssshri5683
    Hi Dr, My 15 month old son toe walks alternatively in both legs.. is it a time to see Dr or shd I wait to get it corrected for some more time?
  • Hi, my 1.5 years kid is walking in tip toe on both legs. So ortho Doctor suggested for casting . Is this good option? or can we try any special shoes, braces etc. To correct this? Please clarify.
  • @djskqisizj450
    I'm 12 and I've been tip toeing my whole life. It feels weird to tip toe in my shoes but at home it feels weird to stand normally. It doesn't hurt but I still do it and can't stop. My sisters also did it and they stopped but I didn't. Any tips?
  • @cozyseasons2835
    Hi there, I have a question for you, I would love it if you could help me with this but I know it may get lost in all the comments. I am 21 years old and have walked on my toes all my life. When I was 16, I saw a podiatrist who made me very uncomfortable and scolded me for toe walking. He said if I didn't fix this, I would need to have surgery by the time I was 18 to lengthen my Achilles tendon. He took an x-ray of my feet and said something about how the ball of my foot had pivoted (I can't exactly remember, since it was so many years ago) and then he pretty much yelled at my dad for letting me toe walk. I don't think my dad could have even stopped me, it's so natural for me. I have not been diagnosed with anything but I have a brother with autism and another brother with Tourette's, so I believe it could be a sensory issue that's never been addressed. I haven't seen a podiatrist or orthopedist since that time. For a while after that appointment, I was stretching every day, but that would leave my ankles feeling very sore. My ankles would often get sprained and once I broke my foot just because my ankle felt weak from exercise from the day before and twisted wrong. My family tries to remind me to walk flat footed, but it feels very uncomfortable when I do. I can still touch my heels to the ground but recently my lower back has been hurting and the tops of my feet are aching a lot when I stand, no matter how I stand. Is there anything I can do at this point? Thank you so much!
  • @julielobato9766
    Hi ! My son is 6 years old and is on his toes 100% of the time.. even standing still. (He has autism and adhd) When he tries to stand flat footed, he has to have his knees bent and his ankles buckle inward (vagus?). He haa wide front width as well as claw toes. He has leg pain at night. I have seen 3 doctors in my area (small farm town) and no one seems to want to treat him or refer him out. I love in california by the Bay area. Do you have any recommendation of a colleague in my area or any advice on what my next step would be?
  • @mjbmjb9525
    I've been walking on my toes all my life im 43 its crazy to work it because wat will happen to you young people your back will start hurting
  • Hi i am 14 years old and i have been walking on my tip toes all my life. I find it difficult to walk flat footed my friend and family have been telling me to stop but i dont realise when im tip toeing iv visited a physiotherapist and just shower me some exercises which have not worked. I have also been getting alot of pain at the back of my leg when i put my foot down but the doctors have just given me vitamin tablets for that which have not worked. Is there any advice you can give