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Quick reference medical handouts used by Pediatric offices


My son is 15 years old and is a toe walker. His doctor asked us to take him for a neurological evaluation which we did. The neurologist said he had some weakness in his hands and feet and would like to do further testing. Do you know what they are looking for?
    
Has your son always walked on his toes or is it of recent onset? And at what age did he start walking? How is his coordination? Has that changed recently? These are just some of the questions that we would need to know in order to give you a better answer to your question. But from what you told us, we think you are getting good medical advice for your teenager. Further testing by the neurologist would be an excellent idea in order to determine if there is a more serious problem causing the toe walking.

Toe walking is actually quite common in the first year after a child starts walking. However, a child should be checked by their physician if it persists past the second birthday, then a child should be checked by their physician. Occasional toe walking is generally nothing to worry about.

The most common causes of persistent toe walking are:

• Tightness of the calf (gastrocnemius) muscle, usually a manifestation of cerebral palsy. As the muscle becomes tight over time, it causes the ankle to be pointed downward. Surgery is usually necessary to lengthen the heel cord (Achilles tendon).

• Congenital tight heel cords with no other problems. The cause is unknown, but heel cord legenthening is usually needed. • Habit. Some children walk on their toes out of habit. They can walk normally but when they are not thinking about it they begin to walk on their toes again.

• Unequal leg length deformities

• Certain neuromuscular disorders such as one of the muscular dystrophies.

 

As a reminder, this information should not be relied on as medical advice and is not intended to replace the advice of your child’s pediatrician. Please read our full disclaimer.

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