Toe Walking: What Every Parent Should Know

When babies first learn to walk, they often put the weight on the balls of their feet rather than press the entire foot to the floor. While toe walking creates an unsteady platform that increases their risk for falling, it looks cute! 

Usually, kids grow out of toe-walking by the age of two. It’s not an efficient way to walk, increasing the chance of a tumble. But what if your child remains on tippy-toe? 

At North Park Podiatry, our expert podiatrists — Trent Brookshier, DPM, and Ricardo Navarette, DPM — offer pediatric foot care at our San Diego, California, office. If your child continues to walk on tip-toe past the learning stage, it’s time to take action.

A physical problem can sometimes prevent your child’s foot from striking the ground properly. Or they could have a neurological issue.

The following are a few common reasons.

They may have short tendons or muscles

The Achilles tendon runs from the calf muscle to the heel. It’s the thickest tendon in the body. 

The Achilles tendon allows your foot to flex and stretch. However, if your child’s Achilles tendon is too short, they may be unable to lay their heel flat on the floor or ground. Or the calf muscle may be overly tight.

If we determine that your child has a short Achilles tendon or a tight calf, we may recommend night bracing to stretch the calf muscle. During the day, they should work with a physical therapist and follow an at-home stretching routine. 

We might also recommend short-term casting that progressively stretches tight muscles. Botox® injections may also help relax the muscle. If these measures don’t work, your child may need surgery to lengthen their Achilles tendons. 

Your child may have autism or a vision issue

Toe walking is associated with autism spectrum disorders. Autism is marked by a vestibular system dysfunction, which provides your brain feedback from your body about where it is in space.

You may be able to improve toe walking by having your child engage in occupational therapy, which may include swinging and other activities that engage the vestibular system. 

In some cases, vestibular dysfunction could be related to a vision problem. Prism lenses, which displace the child’s field of vision, are worn while performing visual-motor exercises. After wearing the lenses, parents often notice immediate changes in their child’s behavior, including toe walking.

Your child may have another disorder

Cerebral palsy affects the way that their muscles function. In some instances, bracing, physical therapy, and other interventions for tight muscles or short tendons may help or alleviate the toe walking. Another possibility is muscular dystrophy (MD), a disease that destroys muscle tissue. 

If your child is over two and walks on their toes, they may grow out of it. However, if you’re worried about toe walking or if your child is older than five, they should be evaluated. Toe walking increases the risk of falls and may make socialization with other children difficult.

Does your child walk on their toes? Find out why with a pediatric evaluation by calling our friendly team today. You can also schedule a consultation using our easy online appointment form.