Why Does My Child Walk on Their Toes?
Does your child frequently walk on their tiptoes instead of with their feet flat on the ground? Toe walking can be a normal part of early development, but when it continues over time, there may be an underlying reason—and physical therapy can help.
My name is Reilly. I’m a physical therapist at Metro Therapy, and today we’re going to be talking about toe walking.
What Is Toe Walking?
Toe walking is when a child walks on their tiptoes. Normally, this can be a part of development. When children are first learning to stand or walk, they might go up on their tiptoes, but eventually, we’d like to see it go away after about six months.
If it persists longer than that, we usually recommend a referral to physical therapy to assess what the cause might be.
Why Do Children Walk on Their Toes?
Some of the reasons your child might toe walk include a neuromotor or neurological disorder, such as cerebral palsy. Toe walking can also be associated with autism, although a child with autism may or may not toe walk. There could also be unknown reasons for toe walking.
It could also be a result of habitually toe walking over time. It might just become a habit for them, and they don’t know how to walk with that proper heel-to-toe gait pattern. After time, that can cause muscle tightness and make it even harder to walk flat on their feet, so they just keep going up on their toes.
Another cause could involve the sensory system. Their vestibular, tactile, visual, and proprioceptive systems may be impacted. This is where an occupational therapy referral might be appropriate. An occupational therapist can address more of those sensory aspects than I would in physical therapy.
What Happens if Toe Walking Continues?
If toe walking continues for a long time, one thing that can happen is the child’s muscles continue to get tighter, and it becomes harder to go flat on the ground. This can lead to deformities in their foot or ankle.
It can also lead to muscle imbalances throughout their body. Their core might get weak, their hamstrings might get tight, and there can be kind of a snowballing effect.
Another thing that can happen is they are at increased risk of injury, falling, and tripping. Those are some big things that we want to prevent, which is why it’s important to seek therapy sooner rather than later.
How Can Physical Therapy Help with Toe Walking?
The biggest things that we address in physical therapy are function of movement, muscle strength, flexibility, and overall endurance.
I talked about core weakness as one of the long-term effects of toe walking, so we would address core strength. We would also do some stretching of tighter muscles, such as the calf muscles, which can get pretty tight.
We would do a lot of balance training because when you’re up on your toes, your balance system is off. This could include lots of balance work and different activities focused on keeping the feet flat.
Depending on whether their sensory system is impacted, we’d also support those needs. If their vestibular system is impacted, we might do more swinging input for them. If their proprioceptive system is involved, we might do more heavy work, joint compressions, and things like that, which their occupational therapist might be doing as well.
Can Orthotics Help with Toe Walking?
Another thing that we might talk about is getting an orthotic referral. For toe walking, this would basically be a brace that goes on their foot and ankle, or up to their knee, which can help support a normal gait pattern. That would only be referred if we find it necessary or appropriate for the child.
Reach Out to Metro Therapy for More Support
If you have any questions about toe walking, how physical therapy can help, or how occupational therapy can help with toe walking, feel free to give Metro Therapy a call at (763) 450-9400. We look forward to helping you and your child.
