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Dear Doctor

July 2020

Question:

My son is 4yrs old and walks up on his toes. If asked he will try to stand flat footed. However is back up on toes within seconds to walk. His pediatrician said to not worry however I am an wondered where would go for second opinion?

- Michigan (Parent)

Answer:

        I would have him evaluated by a pediatric orthopedic surgeon, and there are number of excellent ones in Michigan.  There are a number of reasons a child this age would be toe walking. Sometimes it is a neurologic problem like cerebral palsy or a problem with the spinal cord. Some kids with sensory integration disorder walk on their toes because they don’t like a cold floor or the texture of carpet. Physical therapy or a series of stretching casts often will help. If the Achilles’ tendon is very tight, sometimes a surgery is needed.
    Some kids sometimes walk on their toes just because they can. If they are easily able to stand flat when prompted, they can be left alone as your pediatrician says. They are often quite fast runners, and in fact I caution parents to not be on the kids too much about toe-walking because it can interfere with the child’s natural fluid running gait. Good runners get onto the front part of their foot when they run.
 
Good luck!

- Michigan (Parent)