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About Toe Walking

What causes Toe Walking?

Toe Walking is a pattern of walking in which the balls of the feet contact the ground, but the heels do not contact the ground. Children under two who are learning to walk may use this pattern intermittently as part of their walking repertoire. If it persists and the Toe Walking pattern is the only way they choose to walk, it may be a good idea to get an evaluation by a Pediatric Physical Therapist who will be using objective and standardized assessments to determine underlying cause and needs for further referral.

Cute Toddler

When should I be concerned about my child’s Toe Walking?

  • If toe walking is occurring most of the time

  • If muscles at the heel and calf seem tight

  • If your child seems uncoordinated and falls an inordinate amount

  • If your child previously had a heel-toe walking pattern and now is walking on their toes

  • If it seems your child cannot bear weight on the whole foot

  • If along with the toe walking, your child exhibits decreased eye contact, or such behaviors as repetitive rocking, spinning, or arm flapping

What are the possible complications of Toe Walking?

  • Children who spend a lot of time on their toes may develop tight muscles in their calves, and tight hip flexors due to the posture assumed in toe walking.

  • Children who walk on their toes do not get the input and all the messages from their feet in terms of where their body is in space.

  • Children who walk on their toes may be at risk for falls.

  • Children may have difficulty modulating force and pace.

  • Children seem to run more than walk.

  • Children avoid use of Eccentric muscle groups which can impact deceleration. (ability to stop quickly without losing balance)

What are common causes of Toe Walking?

  • Behavioral disorders (Autism or Cognitive Disability)

  • Central Nervous System (Cerebral Palsy, Spinal cord abnormalities, or Dystonia with asymmetrical presentation)

  • Musculoskeletal Issues (Club foot, Leg length difference)

  • Sensory Processing affecting Body Awareness, Balance and Motion or Planning and Ideas. (Physical Therapy Evaluation will examine for underlying causes evaluating posture, range of motion and strength and determine appropriateness for a referral to Occupational Therapy to address Sensory issues).

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