This edition has a new appendix of apps, 70 new photos, 50 new activities, updated activities, and new chapters on increasing arches of the foot, decreasing external rotation of the hips, decreasing internal rotation of the hips, and addressing toe walking. ([umlaut] Ringgold, Inc., Portland, OR)
Almost all of these kids will stop toe walking by age three and really don't need a referral or any further tests, though sometimes, if the exam isn't quite right, then an orthopedic evaluation can be a good idea.
* Is there a family history of toe walking? Tiptoe walking is idiopathic in about 40% of children with a family history of tiptoe walkers, but it is important to obtain a family history because this can help in diagnosing Charcot-Marie-Tooth disease, Duchenne's muscular dystrophy, or a psychiatric disorder.
In addition, this decline in developmental level may be associated with the appearance of neurological abnormalities including hyperreflexia, toe walking, tremors, weakness, abnormal muscle tone, and progressive motor dysfunction.
Although common among children learning to walk, persistent toe walking can cause physical harm due to inefficient gate, and, in some cases, result in negative social interactions such as teasing and bullying.