YES, of course, you are absolutely correct. The said kiddo pictured on my website does in fact have diplegic CP as opposed to idiopathic toe walking. However, when I was creating this webpage, it was the only image I had of a child walking on his or her toes, and I didn't want to lift an image that I didn't own from the internet. It is in desperate need of an update (the whole website, that is!) and I'm hoping to do that some time late summer, early fall. Stay tuned for new and improved images and content.

Kids who idiopathically (for no known/definitive reason) walk on their toes, typically have not only overactive calf muscles, but also overactive quads (causing knees to be straight, as you mentioned) as well as overactive lumbar paraspinals (low back muscles) and lats (upper back muscles). They are driven by extension though not diagnosed with a neuromuscular diagnosis. Their anterior rib cages are in elevation and external rotation, lengthening their lateral abdominals, causing their respiratory diaphragm to be flat, contracted and tonic, making it difficult for them to exhale fully or to functionally use a respiratory zone of apposition. Their anterior neck muscles are also often overactive*. Using postures and positions (and games) where the child reverses this pattern of muscle activation, inhibiting the overactive extensors and putting the flexors in a position of improved biomechanical advantage, with full exhalations, a child can begin to decrease the extensor tone in their systems. But I will say, it is a process, and diligent practice is required to change the automatic, spontaneous muscle chain use of respiration. In my mind it is a critical component of treatment.

Thanks again for your inquiry! Lisa Mangino

* Content learned through and supported by the Postural Restoration Institute® (www.posturalrestoration.com)