Physical Therapy
Have you ever noticed your little one walking on their toes? This may be common for new walkers between 12-18 months of age but should go away as they become more confident in their walking ability, generally within 3-6 months. Habitual or persistent toe walking beyond 2 years should always be addressed to prevent the development of tightness in the leg muscles as well as potential balance and coordination problems.
Pediatric physical therapists have knowledge that can help address and prevent toe walking. There are several different causes of toe walking in children, including but not limited to those listed below:
- Tight muscles: tightness in the Achilles tendon and gastrocnemius (calf) muscles can develop and cause difficulty in getting the heel to touch the ground when standing.
- Cerebral Palsy/hypertonia: increased tone can increase plantarflexion (toes pointing down) and lead to toe walking and tightness in the leg muscles.
- Sensory Processing Disorders: some children might start toe walking due to increased sensitivity on the bottoms of their feet. They may avoid certain textures (sand, grass, carpet, hardwood) by going up on their toes and you may notice less or more toe walking depending on the surface. These children may also not like the feeling of socks, shoes, or bare feet.
- Autism: some children with autism may walk on their toes.
- Idiopathic/Habitual: toe walking for no specific reason, but may just be a result of walking on toes for a prolonged period of time.
What you may notice as a parent:
- Walking or standing on toes more than 75% of the time.
- Standing on flat feet but then rising up on toes when your child begins to move.
- Family history of toe walking.
- Walks on toes on certain surfaces or when in/out of shoes.
It is important for toe walking to be noticed and treated as early as possible to reduce the risk of problems with muscle development and tightness, impaired balance leading to falls, decreased coordination, and delays in the development of gross motor skills.
If you have noticed your child toe walking, schedule an evaluation with a pediatric physical therapist. They will assist in creating an individualized therapy plan focusing on balance, coordination, stretching, strengthening, sensory stimulation, and referrals for orthotics, inserts, and specific shoes as needed. They will also work with you and develop a customized home strengthening and stretching program!