<s>[INST] my niece is 3 and her teacher thinks that she has a condition called toe walking . her parents have made an appointment with her pediatrician, but I am worried sick. My niece is extremely smart and very advanced for her age. She is tall and coordinated. I just need your input [/INST] Hi, Toe walking occurs because of tight tendoachilles, cord like structure behind your ankle. Sometimes that is just habitual. All you need to do is to try to check whether you can dorsiflex (flexion towards the shin) your niece feet beyond neutral, if possible then its just habitual otherwise she needs further management depending on the grade of tightness in the cord. Hope I have answered your question. Let me know if I can assist you further.  </s>