Toe walking, sometimes referred to as tip toe walking, is not a typical gait pattern for children regardless of their stage in motor development. In the first few months of walking, children may not demonstrate a consistent, typical gait pattern and may lead with their toes. However, if you notice that your child is up on their toes most of the time while they are walking, especially after they have been walking independently for over two months, then it is time to come in for an occupational or physical therapy evaluation.
Toe walking can occur for a variety of reasons in children. Therefore, it is crucial to have a skilled physical or occupational therapist evaluate your child to address the root cause of the toe walking. Some reasons why your child or toddler may be walking on their toes include sensory aversions, impaired proprioception and body awareness or neurologic conditions.
Toe walking can lead to tight, stiff muscles in the legs and hips, as well as weakness and impaired balance. If left untreated, tight muscles in the calves can turn into muscle contractures and decreased range of motion which require casting or surgery to correct. However, with appropriate therapeutic intervention, contractures can easily be avoided. Children who walk on their tip toes may also have a harder time achieving higher level gross motor skills compared to their peers.
Physical and occupational therapists can team up to address your child’s foot and ankle alignment, sensory system, strength, and range of motion to work towards a more typical, efficient gait pattern. Therapists will also help to address any gross motor delays and coordination deficits that may be present secondary to toe walking.
In this video, NAPA occupational therapist Tiffany explains toe walking in children. Prefer text? We have the video transcribed for you below.
Hi, I’m Tiffany, I’m an occupational therapist (OT) here at NAPA and today we’re talking about toe walking. Toe walking isn’t a normal gait pattern in childhood. Early walkers sometimes lead with their toes because they’re relying on their visual system to take steps. If your child has been walking for more than a few months and you see that they are up on their toes, it is time to get an evaluation.
Now, why does toe walking happen? It’s a question we often get. Well. unfortunately, there’s many reasons why a child may be toe walking. PT’s often address the ankle and foot misalignment or decreased muscle strength. However, toe walking could be sensory related as well. So, your OT may be able to tell you if the vestibular system or proprioceptive system is giving the brain misinformation about body position and movement.
Additionally, if a child is sensitive to touch, they may raise up on their toes to avoid uncomfortable surfaces. It is important to get your child evaluated if they are toe walking because it could lead to muscle stiffness, joint pain, and decreased function. If you notice that your child is walking on their toes, it’s important to see a therapist to address those underlying causes.