Toe walking is exactly what it sounds like. It is a pattern of walking where a child walks on the balls of their feet with no contact between the heels and the ground. It is common in children under the age of 2 who are just starting to learn how to walk but as we become more proficient at walking, a typical heel strike pattern should emerge. However, for some kids, this does not happen. 

Worried parents are often told by doctors that children will outgrow the condition. This is true…but only in 80% of cases. The other 20% of kids will NOT outgrow the issue, but you won’t know until it’s MUCH MUCH more difficult to treat. 

When babies and toddlers first start to walk, their walking pattern often looks like a waddle with wide legs for extra stability, and sometimes walking on their toes due to uncoordinated muscle activation. Typically we start seeing the heel hit the ground before the toes at approximately 18-24 months of age. In toe walkers, this heel strike may not occur at all, or may only occur some of the time.

There are a few causes of toe walking: it can be due to certain medical conditions such as cerebral palsy, muscular dystrophy or other neurological conditions; but often it is “idiopathic” meaning there is no medical reasoning for it. Some contributing factors could be:

• Muscle or timing imbalances in the lower leg and foot
• Sensory challenges – avoiding textures under the feet OR needing extra stimulation on the balls of their feet 
• Tight muscles in the calves or under the foot which makes it difficult or painful to fully flatten the foot on the floor
• If the child starts walking on their toes at a young age, it can become a habit and breaking a habit can be challenging, even for kids!

Did you know that a physiotherapist can help fix your child’s toe walking? In physiotherapy, we start with a comprehensive assessment of each child to see what combination of factors is contributing to toe walking. Once we have a better idea of what the root cause might be, we can start providing individualized treatment options which might include a combination of:

• Strengthening muscles in the core, hips, lower legs and feet
• Stretching muscles and nerves in the legs and feet
• Sensory integration to help overcome sensory processing challenges (seeing an Occupational Therapist if a child is showing multiple sensory challenges is also recommended)
• Games to help with balance and coordination
• Whole body vibration
• Practicing proper gait patterns
• Hands-on therapy like massage and mobilizations
• Fun games and activities to work on the above items

The trick here is that you intervene as soon as possible. If you decide to “wait and see”, you will miss the best and easiest times to remedy the problem. Act now!