Pediatric PT for Toe Walking: Treatment and Strategies

At Leaps and Bounds Pediatric Physical Therapy, we often work with families who are concerned about their child’s walking pattern—particularly when a child walks on their toes instead of using a typical heel-to-toe gait. Toe walking is common in toddlers who are just learning to walk. Between the ages of 10 to 18 months, it's not unusual for children to walk on the balls of their feet as they explore their mobility. Most children naturally grow out of this phase by around age two-three. However, if your child continues to toe walk beyond that age, it could be a sign that further evaluation and support are needed.  In this blog, 
​Dr. Bassem will help us to understand toe walking and how PT can help!

What Causes Toe Walking?
There are a variety of reasons why a child might toe walk. In some cases, it’s idiopathic, meaning there’s no clear underlying cause. About 5% of otherwise healthy children fall into this category and often grow out of it over time.
Other times, toe walking may be related to neurological conditions like cerebral palsy, muscular dystrophy, or sensory processing disorders, including autism. Physical limitations such as a tight Achilles tendon or shortened calf muscles can also prevent the heel from touching the ground. Some children simply develop a habit of toe walking, especially if they have muscle tightness or favor that gait pattern. In a few cases, a family history of toe walking suggests there may even be a genetic component. At Leaps and Bounds PT, we take a compassionate, child-centered approach to treating toe walking. We believe in working closely with families to create a therapy plan that fits your child’s needs while keeping therapy engaging and enjoyable.
Our pediatric physical therapists are experienced in identifying the root causes of abnormal gait and using evidence-based strategies to help your child develop a more functional and comfortable way of walking. Here’s how we help: For children with sensory processing challenges, we incorporate a sensory diet into their therapy. Using tools like vibration board or sensory stepping stones, we provide targeted input to the bottoms of the feet to help children feel more grounded and take more confident steps.
​
Hands-On Therapy
We use soft tissue mobilization techniques on the feet, ankles, and calves to reduce tightness, improve circulation, and enhance sensory feedback. This helps relax overactive muscles and prepares the body for more effective movement. Stretching and Strengthening Our therapists lead children through gentle stretching routines to improve flexibility, particularly in the calves and Achilles tendon. We also focus on strengthening exercises to support better posture and walking patterns. 

Functional, Play-Based Exercises
What sets Leaps and Bounds apart is our ability to make therapy fun and meaningful. We incorporate activities such as:
● Seated scooter boards
● Obstacle courses with textured surfaces and movement challenges
● Animal walks like bear crawls or crab walks
● Backward walking and heel walking
● Climbing stairs, pulling/pushing weighted objects, and balance games
These exercises are not only enjoyable but also essential for improving coordination, balance, and overall motor skills. 

When More Support Is Needed
While many children benefit from conservative physical therapy, some may need additional support. At Leaps and Bounds PT, we collaborate with families and medical providers to determine the best course of action. This may include:
● Bracing with ankle-foot orthotics to help stretch the calves and promote heel contact.
● In rare cases, surgical intervention may be considered.

Why Early PT Matters
Toe walking can affect more than just how your child moves—it can impact their balance, coordination, muscle development, and even confidence. At Leaps and Bounds PT, we believe that early evaluation with a PT can make a lasting difference. Our goal is to help your child move with ease, confidence, and joy. Whether your child is just starting to toe walk or has been doing so for a while, we’re here to help guide you through every step of the journey with expert care and a personalized approach.