Walking on our toes takes strength and balance. Most people walk on their toes at one time or another, such as when avoiding a cold or wet surface.  Children can walk on their tiptoes when they are trying to be quiet or sneaky. Babies will also walk on their toes as they explore the different ways that they can use their feet for mobility. These are all normal instances in which people walk on their toes, but sometimes toe walking can be cause for concern.

Typically, babies and toddlers display a heel-to-toe gait pattern by the age of 18 months or 5 to 6 months after they begin walking.  (For more specific/scientific information, refer to this brochure from the Cincinnati Children’s hospital.) If a child walks on his/her toes more than on his/her flat feet past the toddler age, it may be cause for concern. Toe walking can be associated with diagnoses such as cerebral palsy, autism, or tethered cord syndrome.  Walking on one’s toes has also been correlated with speech delays and learning disabilities. Toe walking that occurs without any known reason is labeled as “idiopathic toe walking.” Children who walk on their toes more than on a flat foot can experience tightness in their ankles, weakness in their leg muscles, and have balance problems.

Children who toe walk can benefit from therapy in many ways.  A referral to physical therapy is appropriate if the child displays a lack of mobility in his/her ankles, weakness of leg musculature, gait abnormalities, or difficulties with balance.  Physical therapists can assess the tightness of the Achilles’ tendon and help the family come up with a stretching program if necessary. A PT can also use a number of techniques to help with gait training, strengthening, balance training, and selecting appropriate bracing if it is needed.  A referral to an occupational therapist may also be appropriate if it appears that a child is toe walking because of sensory processing issues or if it is related to autism.  

As you can see, there are a number of factors that may influence toe walking in children.  Some more general information on toe walking can be found on Mayo Clinic’s website.  If you or anyone you know has concerns about a child who walks on his or her toes more than on a flat foot, it is important to contact your pediatrician so that possible causes can be ruled out.  A pediatrician can examine your child to try an figure our why he/she might be toe walking.  Our therapists at Beyond the Clinic can also help answer your questions and help your child get the services he/she needs. We work with families all around the Portland metro area.

Call us at (503) 496-0385 to find out more.

(Courtesy of Crystal Bridges, DPT)