Toe Walking – What You Need To Know

Written by: Gina Marie Stamos, PT, DPT, ATC, Advanced Clinician Physical Therapist, Spaulding Outpatient Center for Children in Lexington

Idiopathic toe walking is a type of walking pattern that occurs when children walk on their tip-toes instead of using the more “typical” heel first pattern. Idiopathic is a term that refers to the fact that this toe walking occurs spontaneously, usually out of habit, and is not due to another medical cause. 

A non-idiopathic cause may be cerebral palsy, autism, sensory processing disorder, muscular dystrophy or brain injury. As children learn to walk, some toe walking is to be expected. When this becomes a strong habit that they do not grow out of, or the predominant pattern as they are new walkers, then several issues can arise.

The following are negative consequences of toe walking:

• Tight ankles or contractures can develop
• Poor balance reactions, frequent falling
• Muscle imbalances “up the chain” meaning decreased hip or core strength due to the different postural alignment
• Difficulty with body mechanics including squatting or performing stairs, secondary to tight calve muscles
• Inability to stand with heels flat on the ground
• Pain in ankles, knees or hips due to faulty mechanics
• Surgery, casting, night splinting or daily bracing may be necessary

While some toe walking should not be alarming, the earlier you intervene, the better. Discuss this with your pediatrician or see a physical therapist who can provide early strategies to stop the cascade of effects that can be seen later.

For more information please contact Spaulding Outpatient Center for Children in Lexington at 781-860-1742.