Toe walking

Toe walking is characterized by a child walking on their toes, with little or no heel contact with the floor throughout the majority of their day. Physical therapists can be the first line of defense. Educating families on toe walking and initiating conservative treatment measures early on can minimize the need for invasive procedures and reduce the risk of abnormalities as the child ages.

Why is my child toe walking?

  • As a child learns to walk around 12-15 months, it is common that they try different foot positions, such as walking on their tiptoes. However, this normally resolves within the first 6 months to 1 year of learning to walk.
  • Toe walking is commonly caused by a shortened Achilles tendon (heel cord).
  • Other contributing factors may include: tight leg muscles, decreased flexibility, weakness in their tummy and/or leg muscles, lack of leg muscle coordination, and difficulty processing sensory, proprioceptive, vestibular, and/or visual information.
  • Toe walking may be associated with a diagnosis of Cerebral Palsy, Autism, Sensory Integration Disorder, and/or Muscular Dystrophy .

Why is it an issue if my child continues to toe walk?

  • Toe walking can lead to significant muscle tightness that makes it hard to wear shoes, stand with a flat foot, squat, maintain balance, or hop on one foot.
  • Prolonged toe walking puts an abnormal amount of stress on the bones and ligaments in the ankles, knees, and hips. Over time this can cause the bones to grow incorrectly and/or overstretch ligaments which further puts the child at risk for injuries and joint pains as they grow.
  • Like any habit, the longer the child continues to toe walk, the harder it is to break. That is why it is important to have your child evaluated and started in to an intervention program as soon as possible.

When should I be concerned? 

  • If toe walking persists beyond age 2-3.
  • If you notice that toe walking is accompanied by other motor problems, other sensory processing needs, or delayed motor milestones.
  • Look for your child to spend a majority of their time up on their toes throughout their day and notice if they become unsteady when asked to place feet flat on the floor.

Who do I talk to when I notice my child toe walking?

Talk to your Pediatrician and/or Physical Therapist about your concern to get appropriate information on referrals and treatment options.