Toe Walking (Infant/toddlers)

What is it: Toe walking refers to a condition where a person walks on his or her toes without putting much weight on the heel or any other part of the foot. Toe-walking in toddlers is common. These children usually adopt a normal walking pattern as they grow older. If a child continues to walk on his or her toes past the age of three, he or she should be evaluated by a doctor.

Up until the age of 3, this kind of behavior can be considered “normal” as children are learning to walk and do a fair amount of experimenting.

What begins as a fun way to get around can turn into a habit, though, and a cause of concern for many parents. This habitual tippy-toe walking is referred to as idiopathic toe walking.

There are instances, however, when toe walking may have a physical cause. The most common cause of toe walking (aside from habit) is having a tight or short Achilles tendon. The Achilles is the tendon located just above the heel and it enables you to point and flex your foot.

Important Facts: Toe walking is sometimes the result of cerebral palsy, muscular dystrophy or another generalized disease of nerve and muscle. Children with autism also may walk on their toes or the balls of their feet, but many do not.

Treatment Duration: Most cases of persistent toe-walking are familial or are simply secondary to tight muscles. Treatment may involve observation, physical therapy, casting or surgery. Toe-walking may indicate a neuromuscular disorder such as cerebral palsy or it could be a sign of developmental dysplasia of the hip or leg length discrepancy.

Do’s/Don’ts: Toe Walking in children can look cute but it is important to recognize that it could be a symptom of other serious issues. If it is consistent and persistent you should talk to your pediatrician about it and have your child examined for any complications or any potential impending medical problems

Avoid aggressively pushing your child into a flat foot position as this may cause pain and injury if you are not careful.

Common Myths: Exercises and walkers have a double negative impact on infant development. They are marketed to parents as helping children learn to stand up and walk. However, the infant is placed in a semi-reclined position with their hips placed in a seated position. This is NOT the position children learn how to walk in. As well, the infant spends time in an extended knee and toes pointed (plantar flexed) position which does promote the negative response of Toe Walking.

There are many people who have been life-long toe walkers with little or no complications. These individuals report that they remember walking on their toes since they were very young and that it seems natural and have been able to live normal lives.