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Toe walking

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Refers to a condition where a person walks on his or her toes without putting much weight on the heel or any other part of the foot.

One study suggests that the toe walking, also called an equinus gait is associated with cerebral palsy presents with an abnormally short medial and lateral gastrocnemius and soleus, the primary muscles involved in plantarflexion.

The gait could be a compensatory movement due to weakened plantarflexion muscles.

A greater plantarflexion force is required for normal heel-to-toe walking than for toe walking.

It is that cerebral palsy in which an equinus gait is present may be due to abnormally weakened plantarflexion that can only manage toe walking.

Is common in toddlers.

These children usually adopt a normal walking pattern as they grow older.

Toe walking can be caused by different factors.

One type of toe walking is habitual or idiopathic where the cause is unknown.

Other causes include: congenital short Achilles tendon, muscle spasticity as associated with cerebral palsy, and paralytic muscle disease such as Duchenne muscular dystrophy.

Congenital shortening of the Achilles tendon can be hereditary, can take place over time as the result of abnormal foot structure which shortens the tendon, or can shorten over time if its full length is not being used.

It is sometimes caused by a bone block located at the ankle which prevents the antagonist movement, dorsiflexion, and Is caused by trauma or arthritis.

It may be a way of accommodating a separate foot drop.

In children has been identified as a potential early sign of autism.

May be associated with cerebral palsy with an abnormally short medial and lateral gastrocnemius and soleus, which are the primary muscles involved in plantarflexion.

For idiopathic toe walking in young children, the child may outgrow the condition.

Other options include: wearing a brace or splint either during the day/ night to limit the ability of the child to walk on his or her toes and stretches the Achilles tendon.

Serial casting where the foot is cast with the tendon stretched.

Botox therapy can be utilized to paralyze the calf muscles and reduce the opposition of the muscles to stretching the Achilles tendon, usually with serial casting or splinting.

If conservative measures fail, after about 12–24 months, surgical lengthening of the tendon is an option.

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