Toe-walking
This page explains what toe-walking is, and why it can sometimes occur.
What is toe-walking?
Toe walking is used to describe a pattern of walking or gait. In a typical walking pattern, the heel strikes the ground first and then we take weight on a flat foot finishing on our toe. In toe walking, a person walks on their toe for more, most or all of their walking.
Why do some children walk on their toes?
There are a number of reasons why a child might walk on their toes.
Part of normal gait development
Toe-walking can be a normal part of learning to walk in children. It usually stops by the time they turn 2 years old – it can continue until the age of 7 years old
Sensory reasons
Toe-walking can give increased proprioceptive by giving the brain more information about where the body is in space. For some children, this extra sensory input feels regulating, calming, or more comfortable.
If the vestibular system is not functioning properly, a child may look for different ways to feel more stable or regulated, such as toe-walking.
The tactile system gives us information about texture, shapes, temperatures, and different types of pain. Some children may experience tactile information differently. For this reason, some children may toe-walk as part of sensory avoiding behaviour. It might be too much sensory input for their bodies to have the full soles of their feet on the ground.
Idiopathic toe walking
When there is no known or medical reason for a person to toe walk it is called idiopathic toe walking
Medical reasons
In a small group of children there may be a medical reason for toe walking (eg cerebral palsy). If you are concerned that your child is toe walking for a medical reason or have been told they are walking for a medical reason, contact your CDNT physiotherapist
Is toe-walking harmful?
Idiopathic and sensory toe walking generally doesn’t cause any harm to children. It can be associated with tight calves, which can make it more difficult for a child to walk with their heels down. This can cause some discomfort.
If you are concerned that your child’s calf muscles are getting tight, contact your CDNT physiotherapist
How to check for tightness in calf muscles:
- Ask the child to sit on the floor
- Ask the child to flatten their legs
- See if the child can flatten their feet against a surface, keeping their legs straight.
- If they can’t do this, they may have tight calves.
What can you do to help?
If your child is toe-walking because of a difficulty in one of their sensory systems, activities that are rich in sensory input can be used.
Examples include:
- Weightbearing activities, for example, crawling, push-ups
- Resistance activities, for example, pushing/pulling, heavy lifting, such as carrying books
- Cardiovascular activities, for example, running, jumping on a trampoline
- Oral activities, for example, chewing, blowing bubbles
- Deep pressure, for example, tight hugs
Once your GP has confirmed that your child is not toe walking due to another diagnosis, you can be reassured, as most children who toe-walk for sensory reasons will grow out of this in adulthood.
Frequently used words
Gait is used to describe someone’s pattern of movement when they walk.
Gait development is how your child develops their walking over time through their physical growth, balance, and coordination.
Idiopathic toe walking is toe walking which is not caused by an underlying medical condition.
Hypermobility is used to describe movement in joints which are more than the average amount. Most children have hypermobile joints compared to adults. Most children grow out of this without issue as they get older and their ligaments naturally become less flexible with age.
Proprioception is part of your sensory system. Receptors in our muscles, joints, ligaments and even within our skin and bones are triggered by movement and give feedback to our brain. This gives information about where our arms, legs, hands and feet are in relation to our body.
Vestibular system is responsible for giving us a sense of balance and orientation in space. It is in the inner ear. It is responsible for controlling our muscles, and most of our reflexes
Hypermobility syndrome is a medical condition usually diagnosed by a doctor using a blood test. This condition does not only affect joints and ligaments.