Toe Walking

What is Toe Walking?

As children develop they can often walk for some time up on their toes. This is part of normal development but can persist beyond this phase, sometimes for several years. Most children will eventually grow out of the habit.

Is it serious?

Most children who walk on their toes are Idiopathic Toe Walkers. This means that there is no known cause. It can often be a habit which can be difficult to change. Some children may need further investigation to rule out possible causes. Your health professional will have advised you if this is required.

Most of the children who walk on their toes can stand with their heels on the ground. They may also be able to walk heel-toe for short periods when asked and/or find this easier when wearing shoes.

What treatment is needed?

Often no treatment other than advice and reassurance is required. Most children who have a habit of walking on their toes do not go on to develop a permanent fixed tightness in their calf muscles. Research into different treatments has shown there is no definite treatment to break the toe walking habit.

As long as your child maintains adequate length of their muscles, it will likely cause very little long term impact.

You can check if your child’s muscles are long enough by checking if -

• They can stand with their heels down, legs and back straight
• They can squat with their heels down

If they struggle to do this, especially during growth spurts, simple exercises (pictured below) can help. It is usually best to include these in play activities as much as possible, especially with smaller children.

What needs to be done if stretches don’t work?

Sometimes even with stretches, the muscles can become short. This can cause activity related discomfort in the heels/feet.

At this point, you could request a referral back to the Paediatric Orthopaedic clinic. Options that could be considered would be -

• Serial Casting - This is when a series of plaster casts are applied to stretch tight ankle muscles
• Orthotics - It may be some type of splint would be recommended to correct walking pattern.

Summary

This is a very common cause for concern in families but that happily it is almost never a serious problem.

Some children can respond to treatment but there is usually a chance that the problem will reoccur. Even with treatment there is often little improvement as the toe walking cycle is a difficult habit to break. This does not cause any harm and most children eventually grow out of the habit.