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Toe Walking: What’s the Big Deal?

Toe Walking: What’s the Big Deal?

If you look around you will find that people walk differently.  Normal walking should include an initial heel strike and toe push-off. One common abnormality seen in children is toe walking.

What is toe walking?

Toe walking is when a child’s heel does not contact the floor when walking. Often, kids will experiment with going up onto their toes while they are learning to walk. However, if they don’t spend a lot of time in this position and can easily transition onto flat feet, it may not be a problem.

Despite common misconceptions, toe walking is not something that kids outgrow and can have lasting effects.

What causes toe walking?

Toe walking can be broken down into two different categories, idiopathic or non-idiopathic.

  1. Idiopathic: meaning without a cause. The majority of typically developing children that walk on their toes would fall into this category.  This type will always be bilateral and symmetrical in nature.  
  2. Non-idiopathic: meaning due to other medical causes. Common diagnoses that demonstrate toe walking include Cerebral Palsy, Autism, Developmental Coordination Disorder, Leg Length Discrepancy and Duchene’s Muscular Dystrophy.

To determine the cause of your child’s toe walking a thorough evaluation and detailed medical history is vital.

Negative effects of toe walking:

  • Loss of range of motion
  • Poor balance and increased falling
  • Decreased strength of leg and core muscles
  • Pain in the ankle and/or legs
  • Difficulty with squatting and stairs

While not all toe walking may be serious, the earlier you intervene, the better. If you have concerns with your child’s toe walking discuss it with your pediatrician or see a pediatric physical therapist that can provide early strategies to stop the cascade of effects.

What role does a Pediatric Physical Therapist play?  

Pediatric physical therapists are specifically trained to assess kids’ movement patterns and make recommendations for treatment. They can assist in ruling out some of the causes of toe walking and can determine if treatment is necessary and, if so, what treatment techniques may be most effective. 

Physical therapists can not only increase ankle range of motion and strength, but may also use a variety of techniques encourage a more efficient heel to toe walking pattern. These programs are fun and individualized to help meet each specific child’s goals.

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