Toe walking is something many children do while learning to walk. For some kids it’s a completely normal part of development and is quickly out grown, while for others it can be a sign of a bigger problem that requires the support of a multidisciplinary therapy team.
As physiotherapists, toe walking is something we are asked about all the time. While the causes and treatments will be different for everyone, knowing the basics about toe walking can help you understand whether it is a normal part of development, and when you need to speak to a therapist.
What is toe walking?
Toe walking is exactly what it sounds like, walking up on your toes rather than having your heel make first contact with the ground in each step.
Up until the age of 2-3, toe walking is a normal part of learning to walk. If toe walking persists after this age, then it can be classified as idiopathic toe walking, or it could be related to disability.
What causes it?
There are three main areas of the body that may cause a child or adult to toe walk. These are the musculoskeletal system (muscles), sensory system (sensory processing difficulties) or neurological system (muscle tone, reflexes or proprioception).
For children with cerebral palsy or muscular dystrophy, toe walking can be in response to tight muscles and tendons around the calf and heel. This feeling of tightness makes it very uncomfortable to place the sole of the foot on the ground.
Some children with autism will continue to toe walk long after the usual 2-3 year-old point. This can either be a learned habit, or it may relate to sensory processing or motor coordination difficulties. For some children with autism, walking on the whole foot causes over-stimulation and toe walking is an easy way to avoid this.
Should you seek help?
If your child is over the age of 2 and toe walking regularly, it is worth flagging this with your paediatrician or a therapist.
How is it treated?
Toe walking involves a multidisciplinary approach using input from occupational therapists, physiotherapists and speech pathologists to determine why the toe walking is occurring. This will ensure the most effective therapeutic intervention is chosen.
Treatment can include strengthening exercises, stretching, walking retraining, serial casting, botox injections and orthotic management. There’s no one size fits all treatment. Your therapist will look at your child’s individual case and make recommendations based on their findings.
Concerned about your child’s development? Contact us today for more information about the services Therapy Focus can provide to improve movement and mobility for children with disabilities and developmental delays.
If you are already accessing Therapy Focus services, speak with your therapy team.
Pictured: Physiotherapist Laura Martin applying casts to Michael’s legs to help develop his walking