Idiopathic Toe Walking Diagnostic and Treatment












Idiopathic Toe Walking (ITW) Diagnostic and Treatment Center

Pomarino’s treatment center was founded in 2004 and is located in Hamburg-Germany. Pomarino’s center is specialized on the treatment of children with idiopathic toe walking (ITW). 

David Pomarino, Pomarino’s treatment center founder, focuses his work on finding effective treatment options for idiopathic toe walkers. With his experience and knowledge he developed the pyramid insoles and later the step by step treatment approach in which children are treated using the pyramid insoles, in some cases, in combination with physical therapy and night splits.

Currently this is one of the most efficient therapeutic options for children with this idiopathic gait condition.

Even though we focus on the treatment of children, teenagers and adults are also welcome to our treatment center. 

In addition to physical examination, diagnosis and treatment of this condition, Pomarino’s treatment center invests his time and resources investigating and learning more about the characteristics, causes and treatments for this idiopathic condition.

Therefore, Pomarino’s treatment center is in cooperation with several Universities and Social Institutions in Germany and South America, in order to keep developing different researches and investigation projects.

Our Therapy Center for adults and children in combination with our biomechanical laboratory are equipped for physical and technical analyses as well as for scientific works.

What should you expect when you visit us from abroad? (3 days visit)

1st Day:
Mr. Pomarino will examine your child and conduct a differential diagnosis and classification of the condition.
Then the use of the pyramid insoles will be determined, as well as the use of night splints. In the case that your child will need the insoles and the night splints, our technicians will proceed to take the measurements of the feet in order to manufacture the custom made therapeutic aids.

2nd Day:
The Pyramid insoles and the night splints will be given to the child and they will need to use them for one day and one night before the first follow-up.

3rd Day:
The first follow-up will take place and Mr. Pomarino will make sure that the insoles already have had a positive effect on the child’s gait.
In the case that any adjustments need to be done, they will be done immediately (approximately 1 hour).

Two more follow - ups will be done in order to determine if the treatment is being successful or any changes need to be done. The follow-ups will
be done after 6 months and 1 year after the start of treatment


Frequent Questions 

- Since our insoles are custom made we do not process any online order.

- The insoles need to be use all the time including physical activities, physical education class and during the performance of any sport (football, basketball, handball, etc)
  or at home with house slippers.

- We offer 6 months warranty on all our products. We will kindly ask you to send us the broken insoles back, in order to keep improving the quality of our products.

- For the first examination please bring the shoes that your child wears regularly. We do not recommend buying new shoes until the insoles are handle-in since in some
  cases the child will need to wear a size bigger.

- For the first examination we recommend to the parents bringing any specialized diagnosis exams like X-rays or doctor’s report if available.

Our Success Rate:

At Pomarino’s treatment center we receive annually an average of 1500 idiopathic toe walkers. In addition to the patients that we receive at our center, Mr. Pomarino travels to different countries like Bolivia and Brazil in order to offer a treatment option for children of Latin-American countries. 

Approximately 80% of our patients with Idiopathic Toe Walking adjust their walking pattern with the implementation of the step by step pyramid insole treatment; about 5% of our patients need insoles, physical therapy and night splint; and just about 2% of the patients need to be treated with Botulinum Toxin Type A additionally.


Idiopathic Toe Walking

If you wish to have more information about out treatment or you will like to book an appointment, please send as an email to



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Therapy Center · David Pomarino · Research and Development · Orthopaedic Technology · Pediatric Orthopaedics
Germany · Rahlstedter Bahnhofstrasse 9 · 22143 Hamburg · Tel.: +49 (0)40 / 513 20 880 ·  Fax: +49 (0)40 / 513 20 881 · Email: 


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