Understanding Toe-Walking in Children: A Comprehensive Guide for Parents

Dr. Brianna explains what toe-walking is, when to be concerned, and how to effectively treat and prevent it. 

Walking is one of the major milestones in a child's development, marking the transition from crawling to becoming more independent on their feet. However, for some children between the ages of 12 to 36 months, a pattern of walking known as toe-walking can emerge. Toe-walking is when a child primarily walks on their tiptoes rather than with a typical heel-to-toe stride. While it's not unusual for toddlers to experiment with toe-walking occasionally, persistent toe-walking might raise concerns for parents.

Understanding Toe-Walking​
Toe-walking can be observed in children for various reasons:

​Developmental Phase: Many children start walking on their toes during their initial attempts at walking. This is usually a phase they outgrow as they develop their walking pattern and gain better control and balance.

Muscle Tightness or Weakness: Tightness in the calf muscles or weakness in the ankle muscles can contribute to toe-walking. Conditions like cerebral palsy, muscular dystrophy, or other neurological issues can lead to toe-walking.

Sensory Processing Issues: Children who have sensory processing challenges might find the sensation of walking on their toes more comfortable.

Autism Spectrum Disorders: Some children on the autism spectrum may exhibit toe-
walking as part of their sensory behaviors.

When to Seek Professional Help
It's essential for parents to observe the duration and frequency of toe-walking in their child. If toe-walking persists beyond the age of three or four, or if it seems to be impacting their
mobility, balance, or causing any discomfort, it's advisable to seek professional guidance.
Physical therapists play a vital role in assessing and addressing toe-walking in children. They conduct evaluations to determine the underlying cause and develop appropriate treatment plans. These plans may include:

Stretching and Strengthening Exercises: To improve muscle flexibility and strength in the
calves and ankles.

Orthotic Devices: In some cases, orthotic devices like braces or splints might be
recommended to help maintain a proper foot position while walking.

Sensory Integration Techniques: For children with sensory processing issues, therapy
might focus on providing sensory input through various activities to encourage a more typical walking pattern.

Gait Training: Therapists work on correcting walking patterns through various exercises
and techniques to encourage heel-to-toe walking.

Preventive Measures:
While some cases of toe-walking are due to underlying conditions, there are some measures parents can take to encourage a healthy walking pattern in their children:

• Encourage a variety of physical activities that involve different movements and positions of the feet.
• Ensure proper footwear that supports the feet and allows for normal movement.
• Regularly engage in stretching exercises with the child, focusing on the calf and ankle muscles.

In Summary:
Toe-walking in children can be a cause of concern for parents, but with timely intervention and appropriate therapy, many cases can be addressed effectively. If you notice persistent toe-walking in your child, it's crucial to consult a pediatrician or a physical therapist for a comprehensive evaluation and guidance. With proper care and support, most children can
overcome toe-walking and continue their development with improved mobility and confidence.

If you have concerns with your child's mobility, balance or they are complaining of foot
pain or discomfort, please reach out to any of our three offices to set up an evaluation!
Staten Island, New York: (718) 477-1911
Holmdel, NJ: (732) 479-2474