Toe Walking in Children

Most children begin walking around 12-15 months of age. They often experiment with different foot positions and walking up on their toes may be one of those patterns. This should not become a primary pattern in walking. By around 24 months they should walk with their feet flat on the ground. By 3 years of age they should walk with a heel-toe pattern.

WHAT IS TOE WALKING?

  • Child walks on balls of feet
  • Failure for the heel to make contact with the floor when taking a step resulting in primary toe contact
  • Idiopathic toe walking is the above toe walking pattern with no underlying medical cause
  • Is always symmetrical

DEVELOPMENTAL CHALLENGES

  • Impairs walking and balance
  • Foot and ankle muscles do not develop appropriate strength
  • Can result in tight muscles at ankle and ankle/foot pain
  • Can have sensory issue with soles of feet
  • Can result in bony changes as foot grows
  • Can increase falls
  • Can cause weakness in hip and trunk muscles
  • Impairs safe stair-climbing
  • Can cause increased ankle sprains when learning to run

What should I do if my child walks on their tip toes?

Have your child seen by their primary care doctor.

The doctor may refer your child to physical therapy to aid in improving ankle/foot mobility, lower extremity strength, and improve balance and overall motor skills. In some cases, doctor may also refer to an orthopaedic surgeon for consultation.