What is toe walking?

Toe walking is the act of walking on the toes or ball of the foot and is often seen in very young children. Most children toe walk at some point during their childhood, however, they will normally outgrow this by the age of 5.

Why do Children Toe Walk?

Most toddlers walk on their toes because they are still learning how to control their muscles. This normally continues up until they completely master the art of walking at around two years old.

Additionally, children who continue to walk on their toes after their toddler years do so out of habit, however, this can sometimes be an indication of slow physical development such as a shortened Achilles Tendon.

Toe walking is rarely a cause for concern as long as your child is growing and developing normally. As many as 1 in 10 children toe walk and up to 25% of these toe walkers will continue to do so until well past 5 years old.

Muscle and Nerve Disorders

In very rare cases, children who continue to toe walk beyond what is normal may be suffering from diseases such as Cerebral Palsy (CP) or Muscular Dystrophy. Certain forms of CP cause the Achilles Tendons to become so tight that they cause the heel to be pulled up and the toes to point down.

Additionally, toe walking is associated with autism. Children with autism often present distinctive motor movements, one of which may be walking on their tip-toes.

With that said, it’s important to check for other indications of autism and whether your child is presenting other stereotyped behaviours such as communication or socialisation problems.

At Kay-Dee Educare Centre, we want parents to understand that toe walking does not necessarily indicate an underlying problem with your child’s development. However, if your child meets any of the following criteria we recommend seeing a registered child healthcare specialist.

Be sure to check with your child's healthcare practitioner if:

• Your child walks on his or her toes most of the time;
• Your child has stiff muscles;
• Is uncoordinated or walks awkwardly with an abnormal step or pace.
• Your child seems to have trouble developing fine motor skills or loses motor skills he or she already had;
• Your child cannot bear weight on a flat foot.

Toe Walking Treatment

In certain cases, orthotics (leg braces for toe walking or shoes to prevent toe walking) and or fibreglass castings are recommended in order to help the affected muscle groups develop correctly. In severe cases, your child's doctor may recommend surgery.

Early identification and intervention are extremely important because physical therapy or surgery from a young age can improve motor skills, muscle strength, and prevent further muscle damage or wasting of muscle groups.