Why do kids walk on their toes?

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 outgrown, 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 the 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 overstimulation and toe walking is an easy way to avoid this.

When should help be sought?

If your child is over the age of 2 and toe walking regularly, it is worth flagging it with your paediatrician or a therapist.

How is it treated?

Treating toe walking involves a multidisciplinary approach with input from occupational therapists, physiotherapists and speech therapists 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.

For more information about how Therapy Focus can provide support for the development of movement and mobility visit therapyfocus.org.au or call 1300 135 373. If you are already accessing Therapy Focus services, speak with your therapy team regarding any concerns you have.