Why does my child walk on their tippy toes?

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Starting to walk is an exciting time for all those involved in a child’s life. When your child gets to this milestone you may notice that they are walking on their tippy toes. While this behaviour is relatively common in young children, understanding the reasons behind it and knowing when to seek help can be important for your child’s development.

What is Toe Walking?

Toe walking is when a child walks on the balls of their feet and keeps their heels maintained off of the ground. Sometimes it’s normal for toddlers when they first start walking, or if they have a sore on their heel at any time. It is when this toe walking persists beyond the toddler years that it could potentially signify an underlying reason.

Common Reasons for Toe Walking

Habitual: Some children develop this gait pattern out of pure habit. This may have been how they learned to walk, or what felt natural or preferred. Whilst this may concern you, it is of no medical concern if it is habitual and can resolve with time.
Shortened Achilles Tendon: The achilles tendon is the tendon that connects the calf muscle to the heel bone, on the back of the leg. If this muscle is shortened (tightened), it points the foot and can prevent the heel from touching the floor, causing a child to walk on their toes.
Sensory Processing Issues: Children with sensory processing disorders may walk on their toes due to hypersensitivity to texture or sensations. These may be the type of surface or the pressure on their flat foot. Walking on their toes might feel more comfortable and provide a sense of security for them.
Neurological Conditions: Toe walking can sometimes be associated with neurological conditions such as cerebral palsy, muscular dystrophy, or spinal cord abnormalities. These conditions can affect muscle tone, coordination, and balance, leading to toe walking.
Autism Spectrum Disorder: Toe walking is more common among children with autism spectrum disorder (ASD), although not all children who walk on their toes have a diagnosis of ASD. In this case, it may be related to sensory processing or motor planning difficulties.

How can we help them?

If your child is toe walking, our team at Strong and Courageous Kids can use fun strengthening exercises to build the muscles that support functional walking patterns and improve their balance and coordination.
If it is sensory processing issues that are contributing to toe walking, we can use sensory integration therapy. This type of therapy can help your child process sensory information more effectively and develop strategies to help their toe walking.
In some cases, along with other modalities like strength training, we will use orthotic devices such as braces or shoe inserts to encourage heel-to-ground walking. We can help liaise with doctors and other professionals around what orthoses we think will be the best help.
Along with these we will always focus on gait training. These focused therapy sessions teach your child how to walk with a more typical gait pattern, using visual or tactile cues.

Should I be Concerned?

Whilst toe walking can be quite harmless and resolve on its own, you should seek professional advice if:

Your child is over 2-3 years old and still consistently walks on their toes.
Your child cannot put their heels on the ground even when they are asked to.
When it is accompanied by other symptoms such as poor coordination, muscle weakness, or developmental delays.
Their toe walking causes them pain.

Who do I see if I have concerns?

While toe walking in young children is often a phase that they outgrow, persistent toe walking can sometimes be a sign of an underlying issue. Early intervention through physiotherapy can help address any physical or neurological challenges, ensuring your child’s feet are firmly planted on the path to healthy development. At Strong and Courageous Kids, we are able to support children and their families through a multidisciplinary team effort and evidence based practice. Our therapists are specially qualified to help identify reasons as to why a child may be toe walking, and help them using modalities like TASES, spider cage, Dynamic Movement Intervention, reflex integration, and much much more. We can also liaise with professionals that create orthoses and get the best support for your child.

Contact us now to find out more information and how Strong and Courageous Kids Therapy services can help you.