Toe walking – is it a problem?
Written by Virginia Chu, Ph.D, OTR/L, Spot On Therapy Group, staff Occupational Therapist
It depends. Many children walk on their toes from time to time when they are learning to walk and explore this newly acquired skill. However, if your child consistently walks on their toes all the time, it could be a cause for concern. While toe walking is associated with certain developmental disorders, most children who consistently walk on their toes are typically developing otherwise. These children are often diagnosed with idiopathic toe walking, which means walking on their toes for unknown reasons. It is still unclear why these children walk on their toes and my colleagues and I are conducting research studies to determine why.
While many children outgrow it, toe walking that persists into school age years can cause other complications. Persistently walking on the toes can lead to shortening of the muscles in the calf. This can result in the calf muscles being really tight, making it hard for the heel to touch the ground, and causing pain in the long run. Severe cases can also lead to bone deformity in the feet. Children who persistently walk on their toes also tend to have poor balance and are at a higher risk of falling. Children also often become more self-aware as they interact with peers at school, and the toe walking can become a source for anxiety and stigma. Therefore, we recommend that parents take a proactive approach, to tackle toe walking as soon as possible.
If you are concerned about your child’s toe walking, here are some steps you can follow:
Rule out medical causes. Toe walking has been associated with neuromotor and developmental disorders such as cerebral palsy, tethered cord syndrome, muscular dystrophy, and autism. While most cases of toe walking are considered idiopathic, talk with your pediatrician if you are concerned about these disorders.
Explore why they walk on their toes. Several different reasons have been proposed as to why children walk on their toes. It could be from years of habits. It could be related to differences in how they process sensory input, including vision, touch, vestibular, and proprioception. It could be due to muscle tightness or excessive extensor tone. It could also be related to anxiety and regulation. If your child is old enough to express themselves, you can explore the underlying reasons with them. However, it is often hard for children to explain reasons, as they may not have experienced how it could be different. Pediatric physical and occupational therapists can assess these functions to give more insight on why your child walks on their toes.
Monitor symptoms. Regardless of the reason for toe walking, it is important to monitor symptoms associated with toe walking. Ask your child if they have any pain when walking and running. Also, check for muscle tightness in the calf muscles. If they cannot reach the neutral position at the ankle (the typical position for standing), the muscle is considered too tight. It is also important to monitor your child’s balance and coordination. If your child appears to struggle with balance and coordination, they can also benefit from therapy intervention. You can check with your pediatrician to seek referral for pediatric physical or occupational therapy services.
Exercise at home. Stretching exercises can help make sure that your child’s calf muscles are not too tight. Gross motor activities can also improve your child’s balance and coordination. Pediatric therapists can give you home exercise programs that are tailored to your child’s specific needs. We also have some activity ideas on our resource page.
If conservative treatments do not improve your child’s toe walking, check with your pediatrician about other treatment options such as foot orthoses, serial casting, botox, and tendon lengthening surgery.
For more information, please check out our resource page (https://rampages.us/toewalking) for families and clinicians. We will update the page with new research and information about our studies.
Comments
Related Posts
- Northstar Academy & Northstar Career Academy Open House
- BSSBA Training – Oct. 23rd, 25th & Oct. 30th in RICHMOND
- Advocacy In Action Annual Fall Meet & Greet
- VDOE Sharing Info On Back To School With An IEP
- 10 Simple Things To Do To Reduce Holiday Stress
- Finding Balance: Tips for Parents of Kids Who Struggle