Understanding Toe Walking in Children: Signs, Causes, and Solutions

 
 

Paediatric toe walking refers to the habit of children walking on their toes or the balls of their feet. This habit is a common phase amongst a child’s early developmental stages, but it can sometimes persist beyond the toddler years, although most children grow out of the habit. Typically, by the age of two years, most children transition into the heel-to-toe gait. Toe walking beyond this age can raise questions and may be a cause for concern, becoming a more permanent issue in some instances.

If toe walking persists, more common causes may include one the following:

  • Habit – toddlers may adapt to toe walking and this may become habitual.

  • A short Achilles tendon and calf complex preventing the heel from touching the ground.

  • Hypermobility – Children with hypermobility are often unable to stabilise or control movement in the pelvis due to instability. This then leads to an overuse of the calf muscles and hamstrings. This adaptive change can lead to toe walking.

  • Autism - Children on the autism spectrum disorder, especially children on the ASD with sensory issues may become habitual toe walkers.

Rare causes may include the following:

  • Cerebral Palsy – Children with Cerebral Palsy loose muscle tone and control of muscle function resulting in toe walking.

  • Muscular Dystrophy – a genetic disease in which muscle fibers become damaged.

When to Seek Professional Advice:

We generally recommend seeking a podiatrist’s guidance if any of the following present:

  • Toe walking persists beyond the age of two years.

  • Pain

  • Signs of stiffness and poor flexibility.

  • Difficulty with balance, coordination or tripping frequently.

  • Family history of related medical conditions.

Management includes clear communication on the potential cause, Carbon Foot Plates, worn in the child’s shoe, to encourage the heel to the ground, footwear advice, stretching and when required night splints and braces. On occasions functional orthotics may be required with a strengthening program. In extremely rare cases surgery may be required.

Understanding paediatric toe walking can help parents make informed decisions about their child’s growth and development. Our Podiatrists are experienced in children’s podiatry and are dedicated to supporting healthy foot development. If you have concerns about your child’s walking patterns, we’re here to help with expert advice and tailored care.

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