AOPT Health Blog
Toe Walking

Does your child tend to prefer walking on their tip toes? Toe walking is a specific gait pattern in which a child walks on the balls of their feet with no heel contact. Toe walking can be normal in children who are first learning to walk but after the age of 2, a typically developing child should be walking with a heel-to-toe gait pattern.

Why is my child toe walking?

There are many potential causes of toe walking, from “idiopathic” (meaning the cause is unknown)to neurological. Here are a few common causes of toe walking in children:

  • Idiopathic: The cause of toe walking can be unknown. In some children, this can also become a habit if they were consistently toe walking when learning to walk.
  • Sensory seeking or sensory avoiding: Toe walking can often be seen in children with Autism Spectrum Disorder. In these cases, children begin walking on their toes in an attempt to avoid certain textures and surfaces.
  • Cerebral Palsy: This is a neurological disorder that affects muscle tone, motor skills, coordination, etc. which can lead to tightness and shortening of muscles contributing to toe walking.
  • Decreased Range of motion: Children who persistently walked on their toes when first learning to walk can develop tightness in their ankles and calf muscles leading to continued toe walking.

Treatment

There are many activities and exercises you can start incorporating at home with your child.

Some activities to start to incorporate into your child’s daily routine include:

  • A daily stretching routine – When a child is persistently walking on their toes, it can lead to muscle shortening through the back of the legs. Stretching the calves and hamstrings may help alleviate some of that resulting tension.
  • Encouraging your child to walk on different textures, environments, and with their shoes off. This can include walking barefoot on the grass, carpet, rocks, and exposure to different cold and hot surfaces. Incorporating these changes will help decrease hypersensitivity to different textures and surfaces.
  • General strengthening through their feet, ankles, and lower extremities. This can help improve balance, coordination, and motor skill development to help achieve gross motor milestones.

How Can Physical Therapy Help?

If you notice that your child is spending an increased amount of time on their toes when walking or running, a Physical Therapist can provide you with an assessment of your child’s range of motion, gross motor skills, neurological development, foot posture, and developmental milestones. At Advanced Orthopedic Physical Therapy we have two pediatric physical therapists who are equipped to provide you with a free screening of your little one and address any questions or concerns you may have.

References

Hirsch, G., & Wagner, B. (2007). The natural history of idiopathic toe-walking: a long-term follow-up of fourteen conservatively treated children. Acta Paediatrica, 93(2), 196–199. doi: 10.1111/j.1651-2227.2004.tb00705.x
Toe Walking. (2020). Retrieved from https://www.hopkinsmedicine.org/health/conditions-and-diseases/toe-walking


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