Some children tend to "toe walk" rather than walking on their feet. This is the same as standing on your tiptoes, and it's common in children who are learning to walk. After they've learned how to walk on their feet, most children stop toe walking without any kind of intervention from their parents or a doctor.
Sometimes, an underlying condition may not allow a child to walk with their foot fully on the ground. At other times, there may not be any condition behind this toe walking.
In either case, some common treatments for the condition include bracing, physical therapy, and casting.
What Is Toe Walking?
Toe walking is a walking pattern in which the child's toes and balls of the feet make contact with the ground, but the heels do not touch the ground. Children typically walk like this when they're in the process of learning how to walk, but if a child is still walking like this after age 2, it could be cause for concern.
What Are the Causes of Toe Walking?
In most cases, there's no cause of toe walking. In scientific terms, the condition is called “idiopathic” -- there’s no known reason for it. The children may have a typical heel-to-toe walking capability but simply prefer walking on their toes.
In other children, though, toe walking is a result of certain medical conditions, like:
- Cerebral palsy or any other brain disorder
- A nerve or muscle disorder such as muscular dystrophy
- Autism spectrum disorder
Cerebral palsy affects the posture, coordination, and muscle tone of the child as well. Children with cerebral palsy may toe walk and have an unsteady walk pattern. They may also have stiff muscles.
Muscular dystrophy is a disorder in which the muscles are weak and waste away over time. Children with this condition could exhibit toe walking as one of the symptoms.
Toe walking may be a symptom of autism spectrum disorder, but toe walking alone does not mean a child has autism. Speak to your doctor if your child is exhibiting other signs of autism spectrum disorder.
What Are the Symptoms of Toe Walking?
The most prominent symptom is that the child walks on their toes rather than toes and heels together.
People with this condition may also have poor balance and coordination. Toe walkers may frequently fall when walking, since their heel is not balancing them.
How Is Toe Walking Diagnosed?
If your child is toe walking after age 2, you may want to share your concerns with their pediatrician. Your doctor will likely ask questions such as whether your child has missed any developmental milestones, if one of your other children also had a habit of toe walking, or if the child can walk on their heels when told to do so. They might also do a physical exam.
Depending on their findings, the doctor may conduct a neurological function test. This will show if your child has cerebral palsy or any other disorder affecting their coordination skills. Typically, doctors only recommend this test if they have found cause for it in the child’s medical history.
However, in most cases, there's no known cause of toe walking.
Is There a Treatment for Toe Walking?
Depending on what's causing your child to toe walk, the doctor will recommend one of the following treatments:
Physical therapy. Toe walking exercises stretch the stiff and tight muscles in the child's body, improving their range of motion. Children can also do these exercises at home.
Bracing. In some cases, doctors may recommend an ankle-foot brace that stretches the foot and helps the child put it on the ground flatly. It encourages the child to walk with a flat foot. Children can also wear it at night to stretch their stiff muscles.
Serial casting. Your doctor may apply short-leg casts to your child's legs to stretch the muscles and improve the foot's positioning on the floor. Some children are also given Botox injections to loosen up their muscles.
The doctor will work with you to develop a treatment plan that helps your child walk without placing any extra strain on their toe or foot.