What is toe walking? It’s when a young child habitually walks on their tip-toes. Their heels rarely or never touch the ground. This can be a cute practice, reminding parents of ballerinas, and a period of toe walking is common as toddlers learn to walk. If it becomes a persistent habit, however, it may need to be corrected. Because it is an abnormal way of walking, lengthy periods spent toe walking can change the shape and function of muscles and tendons in the feet, ankles, legs and trunk. 

Answers to Common Questions About Toe Walking

  1. When Might Toe Walking Appear? Toe walking is common when toddlers first start walking, so children one and a half to three years old might use this method of getting around.
  2. When Should a Parent Start Being Concerned about Toe Walking? Typically, small children may toe walk for the first six months after they start walking. Then they should progress to normal heel-toe walking. If toe walking continues for more than six months or after the child turns three, then a professional evaluation should be done to determine the need for physical therapy. 
  3. What Are the Causes of Toe Walking? Underlying conditions that tighten muscles or cause sensory issues can cause toe walking, such as cerebral palsy, muscular dystrophy or autism spectrum disorder. Anatomical problems like short Achilles tendons can also be a cause. However, some children simply develop this habit of toe walking with no other cause being present. This is called idiopathic toe walking, meaning that the cause is not known. In all these cases, pediatric physical therapy can provide benefits. 
  4. What Are the long-term effects of toe walking? Continued toe walking can permanently tighten calf muscles and the Achilles tendons, making it difficult for toddlers to place their heels on the ground. Legs may be weaker and less flexible and the child may not be able to balance well. Toe walking places abnormal stress on the whole lower body, which can result in joint pain, early arthritis and even bone deformity in extreme cases. 
  5. How Are Sensory Issues Involved with Toe Walking? Some children with sensory issues may dislike the feeling of the ground under their feet or crave an increased sensory input while walking. Toe walking offers a solution by reducing foot contact with the floor or by concentrating all the foot contact onto the balls of the feet. 

To prevent any long-term problems, physical therapy should start as soon as the problem is observed. 

How Physical Therapy Can Help a Toe Walker

Pediatric physical therapists have many tools and techniques to help a toe walker achieve a more normal, healthy walk and avoid long-term harm. By turning many of these actions into games and applauding each improvement, therapists can engage children’s interest and even enthusiasm. Many children receiving physical therapy look forward to their next sessions with delight so they can play those great games again!

These are just some of the ways therapists can make improvements fun:

  • Having a child walk up a soft incline to get a favorite toy stretches the calf muscles. 
  • Balancing on balance discs (soft, textured and puffy discs) builds strength while the texture provides sensory benefits.
  • Standing on a balance board that leans in both directions helps stretch muscles and improve balance.
  • Picking up small objects (like little pom poms) with the toes strengthens feet.
  • Coasting around the room on a scooter board on wheels encourages children to place their feet flat on the floor. 
  • Standing or hopping on soft, foamy or textured surfaces improves perceptions of floor surfaces and awareness of feet and legs. 
  • Walking like a crab or bear stretches tight calf muscles and the Achilles tendons. 

Of course, direct massage and stretching therapy can also be used to make heel-toe walking easier and more comfortable. While there are also medical and surgical solutions, in so many cases, physical therapy is all that many children need to give them a healthier walk. 

If You’re Concerned about Your Child’s Walk, We Can Help

At Let’s Communicate, we have great success helping children achieve healthy, strong walking patterns. Once they master heel-toe walking, children can run more freely, which helps them keep up with their friends. We start each improvement with an accurate professional evaluation. Then we can explain how physical therapy may be able to help your child. If your child persists in toe walking, please call Let’s Communicate at (678) 963-0694 to schedule an evaluation today.