Idiopathic tip toe walking occurs in otherwise normal children who have the tendency to walk on tip toes when they take their first steps. Idiopathic tip toe walking usually gets better with time and initially no intervention is advisable. It needs to be distinguished from tip toe walking in children with neuromuscular disorders in which either the gastrocnemius or the tendo-achilles are tight which forces the children to walk on their tip toes.
Tip toe walking in an otherwise normal child
When idiopathic tip toe walking persists after the age of four, the option of gradual correction using plasters (serial casting) is discussed with the parents. Surgical intervention may be required after failure of serial casting or in late symptomatic presentations.
