Toe-Walking in Children

By Morgan Hamlett, DPT

 

Toe walking is common in children and can be caused by a variety of reasons. Toe walking can be due to loss of range of motion in their calf muscles, neurologic disorders, or sensory issues. So when is toe walking a problem?

 

The biggest misconception is that a child will “grow out” of toe walking. However, this is not always the case. In fact prolonged toe walking can lead to an increase in muscle tightness as the child grows, which prevents them from being able to stand with flat feet and increases the risk of orthopedic issues such as joint pain and increased risk of injuries. This muscle tightness can also affect a child’s balance and ability to perform gross motor activities such as standing on one leg, jumping, hopping, or navigating stairs.

Therefore, it is important for a child to be treated for this as early as possible while following a physical therapy plan of care. Treatment often includes a variety of approaches such as:

Stretches - There are 2 common stretches performed including static stretching and dynamic stretching.

·         Static stretching is where the stretch is held for an extended period of time with the most important being stretching into ‘dorsiflexion’ or bringing your toes up towards your nose. This is more commonly known as a calf stretch and is performed with both the knee straight and the knee bent to stretch both calf muscles.

·         Dynamic stretching is where the stretch is held repeatedly for a short amount of time often times during other movements or activities. This can be done while performing animal walks such as bear walks or walking up inclines.

Strengthening - Another important aspect of treating toe walking is strengthening the muscles which pick up your toes when you walk. This can be done during activities such as heel walking or repeatedly picking up toes while sitting or standing.

Exercises providing sensory input.

·         Exercises such as tapping heels on a step or propelling self using heels on scooterboard can provide sensory input to the heels required for flat-footed walking

Soft tissue massage - In cases where the muscles are tight massage can also be used to improve muscle lengthening in combination with stretches.

Bracing - Bracing can also be a key component of treating toe walking as being in a brace allows for a low load consistent stretch over a long period of time and prevents the child from going up on their toes.

 

Overall, toe walking is a common condition treated with a combination of physical therapy and a home program consisting of all these components. By introducing these activities in a fun way, your kiddo will be on the path to walking confidently!