Pomarino - Toe Walking / Zehenspitzengang

Pomarino - Toe Walking / Zehenspitzengang Specialized in the diagnosis, therapy and treatment of toe walking.

👣 Specialized in Idiopathic Toe Walking & Gait
🔬 20+ years of biomechanical research & analysis
🇩🇪 Based in Hamburg | Serving patients worldwide 🌍
👇 Book your consultation & Info

Meet the Founder: David Pomarino 👨‍⚕️„They’ll just grow out of it.“ This is a sentence many parents hear, but it rarely ...
05/02/2026

Meet the Founder: David Pomarino 👨‍⚕️

„They’ll just grow out of it.“ This is a sentence many parents hear, but it rarely provides a real solution.
After 20+ years of research, David Pomarino knows: Toe walking is more than just a habit. It is a complex interaction between neurology, biomechanics, and genetics. If you only look at the feet, you miss the system behind the movement.

This insight led to the creation of The Pomarino Method.
Instead of using force, our specialized Pyramid Insoles speak the body’s language. By providing targeted sensory input, they „remind“ the brain to lower the heel. We work with the child’s nervous system, not against it. ✨

Why families worldwide trust David Pomarino:
✅ 25+ Years of specialized clinical practice.
✅ 300,000+ Patients successfully treated.
✅ Global Expert: Helping families from over 30 countries.

Don’t just wait for it to disappear. Give your child the foundation for a functional, stable, and natural gait.

The equinus foot, also called Pes equinus or “horse foot”🐴, is a condition in which the foot remains in permanent planta...
04/02/2026

The equinus foot, also called Pes equinus or “horse foot”🐴, is a condition in which the foot remains in permanent plantarflexion: the heel is lifted and the toes point downward.

As a result, most of the body weight is carried by the forefoot while walking, and the heel barely makes contact with the ground. The severity can be assessed by the distance between the heel and the floor when the forefoot is placed flat.

Equinus foot is often linked to a shortened calf muscle and limited dorsiflexion in the ankle joint. Over time, this can influence posture, balance, and overall gait mechanics.

You can think of it like a horse’s hoof: the heel never truly lands, which alters how the entire leg functions. Early assessment and targeted therapy play a key role in supporting a more stable and flat-footed gait.

Understanding Foot Function: It’s all about the movement 👣A footprint or a static photo can be a helpful starting point,...
03/02/2026

Understanding Foot Function: It’s all about the movement 👣

A footprint or a static photo can be a helpful starting point, but it only shows one single moment in time. To truly understand how a child’s body works, we have to look closer.

Why movement matters: When a child walks or runs, their feet aren’t just „shapes“, they are dynamic systems constantly adapting to load, speed, and posture. This is where the real story unfolds:

How is the weight actually distributed?
How stable is each step?
How does the foot interact with the rest of the body?

By observing the foot in motion, we see beyond the structure. We focus on how movement develops over time, allowing us to create meaningful, individualized support for a healthy gait.

Do you have questions about your child’s walking pattern? Let’s connect in the comments! 👇

Persistent Toe Walking & Genetics: What We’re Learning 🧬Our latest study explored children with Persistent Toe Walking (...
29/01/2026

Persistent Toe Walking & Genetics: What We’re Learning 🧬

Our latest study explored children with Persistent Toe Walking (TW) who carry heterozygous PYGM variants. While TW is often thought to be harmless or idiopathic, our findings suggest there may be subtle neuromuscular differences in some children:

✅ Bilateral TW was seen in all children.
✅ Restricted ankle dorsiflexion in most cases.
✅ Pes Cavus (high arches) in 93%.
✅ Muscle symptoms like fatigue, cramps, or pain in about one-third.
✅ Speech delays reported in over half.

While these findings don’t prove causation, they highlight the importance of early recognition, monitoring, and individualized care. Genetic testing can be considered when clinical signs suggest a neuromuscular or metabolic component.

Understanding the connection between Toe Walking and PYGM variants may help families and clinicians support children early and prevent secondary complications.

🔗 Link in Bio!

An unsere deutschen Follower und Kollegen!🇩🇪Medizinische Fortbildung: Myofasziotomie nach der Ulzibat-MethodeWir laden S...
27/01/2026

An unsere deutschen Follower und Kollegen!🇩🇪

Medizinische Fortbildung: Myofasziotomie nach der Ulzibat-Methode

Wir laden Sie herzlich in die Praxis Pomarino ein, um tiefer in die aktuellen Ansätze bei der Behandlung von Kindern mit Zerebralparese (CP) und Zehenspitzengang einzutauchen.

🎙 Unsere Referenten:
Dr. Alexander Nazarkin (Leiter der Ulzibat-Klinik, Tula) – Vortrag auf Englisch.
David Pomarino – Vortrag auf Deutsch.

Alles Wichtige auf einen Blick:
📅 Wann: 27. März 2025 um 18:00 Uhr.
🏢 Wo: Rothenbaumchaussee 114, 20149 Hamburg.
🎓 Punkte: 4 Fortbildungspunkte der Ärztekammer.

📧 Anmeldung unter: info@ptz-pomarino.de
(Teilnahme kostenfrei, Anmeldung verbindlich)

Wir freuen uns auf einen spannenden Abend mit Ihnen! 🤝

Normal gait vs. Toe Walking 👣In a typical walking pattern, children place the heel on the ground first, then roll the fo...
21/01/2026

Normal gait vs. Toe Walking 👣

In a typical walking pattern, children place the heel on the ground first, then roll the foot forward and push off with the toes.
This heel-to-toe movement helps distribute forces evenly and supports healthy development of muscles, joints, and posture.

With persistent Toe Walking, this sequence changes.
The heel rarely or never touches the ground, which shifts the load to the forefoot and calves. Over time, this can influence muscle length, balance, posture, and even how a child moves in everyday activities.

For some children, Toe Walking is just a temporary phase.
For others, it can persist and have different underlying reasons that are worth looking into.
Which one are you?🩵

Is Persistent Toe Walking More Than Just a Habit? 👣🧬Persistent Toe Walking (PTW) is often considered a diagnosis of excl...
20/01/2026

Is Persistent Toe Walking More Than Just a Habit? 👣🧬

Persistent Toe Walking (PTW) is often considered a diagnosis of exclusion. However, our recent research suggests that, in some children, it may be part of a broader genetic and neurological context.

In this study, we examined a cohort of children with PTW who carry variants in the PMP22 gene. Although PMP22 is classically associated with conditions such as CMT1A and HNPP, our findings point toward a distinct clinical profile:

• Genetic overlap: A high proportion of children showed features commonly associated with peripheral nerve involvement, including pes cavus (90.9%), tremor (68.2%), and reduced reflexes.
• Structural patterns: Musculoskeletal characteristics such as lumbar hyperlordosis and clinodactyly were frequently observed.

Why does this matter?
Recognizing a potential genetic background can support earlier identification of neurological involvement and encourage a more differentiated diagnostic and therapeutic approach.

🔗 Link to full publication in bio!


The term idiopathic is often used when no clear explanation can be identified.In medicine, it frequently reflects the li...
15/01/2026

The term idiopathic is often used when no clear explanation can be identified.
In medicine, it frequently reflects the limits of current knowledge rather than the absence of an underlying cause.

Persistent Toe Walking in children is commonly classified as idiopathic. However, growing evidence suggests that in some cases, this label may overlook relevant neurological and genetic mechanisms.

In our recent study, persistent Toe Walking was associated with PMP22-related neuropathies. PMP22 is a gene essential for normal peripheral nerve myelination and nerve conduction. Variants in this gene are known from hereditary neuropathies and may present in childhood long before classic neurological symptoms become apparent.

Viewing persistent Toe Walking through this lens allows for earlier recognition, more precise diagnostic pathways, and thoughtful long-term follow-up.

Sometimes, the gait is not the diagnosis, it is the clue.🩵

📍Save this for clinical work involving Toe Walking.
More details, link in Bio.

Looking at the bigger picture. 🌿✨This beautiful cover of „päd – Practical Pediatrics“ perfectly captures how complex and...
09/01/2026

Looking at the bigger picture. 🌿✨

This beautiful cover of „päd – Practical Pediatrics“ perfectly captures how complex and interconnected the world of pediatric medicine truly is.
When it comes to Toe Walking, we never just look at the foot, we look at the whole child. From analyzing underlying causes to understanding individual developmental milestones, we take the time for a holistic assessment to provide the best possible care. 👣💪

Research is the foundation of our work. If you want to dive deeper into the science behind our methods, you can find our latest studies and publications on our website, link in Bio!🔗

Hello, I’m David Pomarino.I’m a gait specialist and physiotherapist with a long-standing focus on childhood Toe Walking....
07/01/2026

Hello, I’m David Pomarino.

I’m a gait specialist and physiotherapist with a long-standing focus on childhood Toe Walking. Since the 1990s, I’ve been working with children and families, combining clinical experience with research and gaining international recognition in this field.

Over the years, this work has led to the development of practical tools such as our Pomarino pyramid insoles and the Toe Walking Test, supporting a structured and gentle approach to assessment and treatment.

My aim is to better understand its causes, including genetic factors, and to support effective, evidence-based care worldwide.🩵👣

Adresse

Rothenbaumchaussee 114
Hamburg
20149

Öffnungszeiten

Montag 09:00 - 16:00
Dienstag 09:00 - 16:00
Mittwoch 09:00 - 16:00
Donnerstag 09:00 - 16:00
Freitag 09:00 - 15:00

Telefon

+494051320880

Benachrichtigungen

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