Children walking on toes walk on their toes for various different reasons. Some parents look at toe-walking as a benefit to the future ballerina and other parents become very concerned when their child is constantly tiptoeing around. Frequently, toe-walking is completely benign; indicating nothing more than the child has a tendency to walk on their toes. Regardless, medical causes should be ruled out and parents should be educated as to their treatment options. Just as an FYI it is not normal to constantly walk on your toes (going on tip toes to reach for something is normal – walking around the room on toes is not).
Children Walking on Toes Can Be Signs Of Two Things
- Sensory processing disorder (toe walking is a “closed chain” activity that increases feedback to the ankle joint giving additional feedback of where you are in space). If there are other signs of sensory issues you may want to consider a Pediatric Occupational Therapy Evaluation or Screening.
- Tight heel cords (which may require stretching) – if you have a hard time flexing your child’s foot (bending the ball of his foot up past a 90 degree (L) angle at ankle joint while knee is straight) then you may want to consider a Pediatric Physical Therapy Evaluation or Screening.
Physical Therapist Help Toe Walkers | Children Walking on Toes
One of the first things a physical therapist will assess in a child who toe-walk is the child’s ankle flexibility, especially with knees straight in long sitting position on floor. Can the child stand flat? If they don’t have enough ankle flexibility to walk heel-toe, that needs to be addressed prior to anything else.
Posture and strength are other important areas to assess. Muscle groups that are commonly weak are the tummy muscles (abdominal obliques), buttocks, shoulders, and ankles. Weakness in these muscles can put a child in a forward leaning position when they stand and a slouching position when they sit. When the child in this posture initiates walking, he would naturally walk up on his toes. In addition, children who are toe walkers don’t use body rotation while walking and may have flexibility restrictions while walking. The child with trunk tightness may also frequently “W” sit over other sitting positions.
Home Tips for Children Walking on Toes
There are a number of games that you can play at home to encourage walking with “heels down” but it depends on the age of your child.
Here are a few ideas to get you started:
- walk in swim fins (with guarding and help of course to prevent falling/tripping)
- walk like a penguin or a duck (waddle side by side while walking on heels)
- tape a penny to the bottom of the shoe so you can hear the “click” noise of the coin in the ground
If your child continues to demonstrate difficulty with these exercises a complete Pediatric Physical Therapy Evaluation or Screening may be indicated.