Toe walking refers to the lack of heel strike during the stance phase of the 
gait cycle. It is a common variation of normal gait development in children. 
Persistent toe walking past 2-3 years of age warrants further evaluation as toe 
walking can be associated with cerebral palsy, muscular dystrophy, and autism 
spectrum disorders. The diagnosis of idiopathic toe walking is a diagnosis of 
exclusion used for children with persistent toe walking and no associated 
medical condition. Despite variable pathophysiology, the treatment of toe 
walking has similarities across diagnoses as it is focused on the maintenance of 
range of motion through the ankle.