Heels and toe walking for doctors

**JRS11** · 02-04-2011, 05:14 PM

This may be a stupid question, but why do they ask us to stand or walk on heels and toes?

Thanks

**Justin** · 02-04-2011, 05:27 PM

Originally Posted by JRS11

This may be a stupid question, but why do they ask us to stand or walk on heels and toes?

Thanks

Waking on your heels is testing L4, which innervates the anterior tibialis muscle. The anterior tibialis muscle helps with dorsiflexion of the foot, or bringing the top of your foot toward your lower leg.

Walking on your toes is testing S1, which innervates the gastrocnemius and soleus muscles that make up one's calf muscle. The gastrocnemius and soleus muscles help bring your foot in a "toe down" motion.

I hope this helps and great question!

**JRS11** · 02-04-2011, 05:32 PM

Originally Posted by Justin

Waking on your heels is testing L4, which innervates the anterior tibialis muscle. The anterior tibialis muscle helps with dorsiflexion of the foot, or bringing the top of your foot toward your lower leg.

Walking on your toes is testing S1, which innervates the gastrocnemius and soleus muscles that make up one's calf muscle. The gastrocnemius and soleus muscles help bring your foot in a "toe down" motion.

I hope this helps and great question!

Thanks Justin, it does help. What does it tell them if I can do this, or if I cannot?

**Justin** · 02-04-2011, 05:51 PM

Originally Posted by JRS11

Thanks Justin, it does help. What does it tell them if I can do this, or if I cannot?

If you are able to perform these tasks without any difficulty, it means that your nerve roots (L4 and S1) are working properly (no nerve root irritation, nerve root damage, etc.). If you can't perform these tasks, then a more thorough work-up is warranted.

BTW, I should say "mostly L4" and "mostly S1," as other nerve roots (namely L5) are also utilized to a certain degree to perform these tasks.

**JRS11** · 02-04-2011, 06:36 PM

Justin, once again, thank you, most helpful. I go to another specialist at Yale Medical in New Haven CT on Wednesday and a new Pain Center, then off to NE Baptist in a week or two more. I will continue to get opinions and if they are all the same then it is clear. My Physical Therapist things he can help me with posture and other manipulation type therapies he does. So far so good but not fixed yet...will continue to try whatever I can.

Thanks

Joel