Toewalkers

I am seeing an increasing number of children who toewalk.Does anyone have any guidelines for treatment or is anyone doing any research in this area?I would be interested to hear from anyone. Thanks

It depends if the toe walking is idiopathic or habitual or spastic diplegia. If idiopathic then the child should be refered for a developmental screen. Can be due to shortened TA and the child will normall develop normal walking patterns and growth. >3 yrs of age and a neuromuscular problem considered.

I am a general physio in a rural area so am definately not an expert on paeds. But I have seen quite a few young toewalkers- many of them have been placed in those horrible walkers from an early age, and they encourage toewalking as well as hip flexion/ER. So, if they seem otherwise normally developed but were in a walker I usually tell the parents to get them out of the walker. many of them toewalk less if they have shoes on. I had one such patient whom I discussed with physios at a childrens hospital. They suggested serial casting, not to lengthen his muscles, but to get him out of the havit of toewalking and we had success with that.