Toe Walking in Children

What is Toe Walking in Children?

Toe walking in children is when a child walks on the toes or on the ball of the foot and it is pretty common when children are just learning to walk.

Most children outgrow it and some continue to do it into the toddler years as a habit. It is not a cause to be concerned if other growth and developments are normal. However, it can be a sign of another condition such as autism, muscular dystrophy, or cerebral palsy.

Other conditions of the nerves and muscles may be the reason for toe walking in children, as well.

What are the Symptoms of Toe Walking in Children?

The only real sign of toe walking in children is that the child walks on the toes or the ball of the foot most or all of the time. In the first two years, it is not a major concern but if your child is still walking on their toes most of the time after they turn 2 you should consult with your doctor.

If stiffness of the Achilles tendon, tight leg muscles, or lack of muscle coordination comes with the toe walking you should see a doctor before age 2.

Toe Walking in Children Causes

Children typically develop the habit of toe walking when they are learning to walk. Certain cases may be caused by an underlying condition.

Underlying conditions include:

  • Cerebral palsy: this disorder can control movement, posture, or muscle tone, and can cause toe walking. Cerebral palsy is caused by abnormal development or injury of the portion of the brain that is in charge of muscle function.
  • Short Achilles tendon: if the tendon is too short, the heel may not be able to reach the ground. This tendon connects the muscles in the lower leg to the rear portion of the heel bone.
  • Autism: there is a link between autism and toe walking. Autism is a multifaceted group of disorders that affect interaction and communication.
  • Muscular dystrophy: this genetic disease causes muscle fibers to weaken over time and to be highly susceptible to damage. Toe walking can be caused by muscular dystrophy, but this cause is more likely if the child did walk normally at some point before the toe talking began.

How is Toe Walking in Children Treated?

If the toe walking is just a habit, treatment will not likely be needed. Your doctor may monitor the condition during regular visits.

If there is a physical problem that has led to toe walking your doctor may suggest physical therapy to stretch the leg and foot muscles.

If the condition continues, the doctor may have your child fitted for splints or leg braces. If these are no helping, a cast below the knee can encourage and help your child to bring the toes toward the shin. If the problem persists and is causing other problems, surgery may be recommended. This can help to lengthen the muscles or tendons that are at the back of the leg.

If the toe walking is related to another condition, treatment will focus on that condition.

Toe Walking in Children Prevention

Fortunately, toe walking in children is not a severe condition. It can resolve itself on its own without leaving significant problems for the child. Children should not need surgery, normally, but it can be difficult to find out how to prevent toe walking as it typically occurs due to habits.

Certain shoes are designed to prevent toe walking at any stage in the diagnosis. The shoes are engineered to push against the Achilles when the child toe walks, which makes the toe walking uncomfortable. These shoes assist in walking on flat feet.

Ankle-foot orthoses (AFOs) are similar to casts in the sense that the foot must stay in the proper position. AFOs have a hinge by the ankle so that the foot may move, but the pointing of the foot or plantarflexing will be prevented. This method is extremely effective in preventing toe walking, but is more invasive.

Last Reviewed:
October 11, 2016
Last Updated:
September 11, 2017
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