Frequently Asked Questions About Toe Walking in Kids

When you see individuals walking around on tiptoes, you probably assume that they either suffer from foot pain or want to avoid disturbing others with unnecessary noise. In young children, however, toe walking is a common behavior. This behavior may resolve itself, or it may require treatment due to an underlying condition.

As a loving parent, you may naturally be concerned if your child doesn’t seem able or willing to walk in a normal, flat-footed manner. The more you understand about toe walking, the more effectively you can help your child overcome this challenge. These frequently asked questions and their answers may prove enlightening.

Why Does Toe Walking Develop as a Habit?

Toe walking in children may develop for a variety of reasons. In fact, many cases of toe walking get classified by doctors as idiopathic, meaning that they stem from no known cause. As kids learn to walk (a process that typically occurs between the ages of 8 to 18 months), they may simply adopt this walking style in error.

Other cases of toe walking may occur due to an underlying medical issue. Neurological conditions, such as autism spectrum disorder, muscular dystrophy, or cerebral palsy, can cause a child to walk abnormally. Painful calluses, short Achilles tendons, and other physical issues can also encourage this behavior.

When Might Your Child Need Medical Evaluation?

Children who walk on their toes simply as a learned behavior (or for no known reason) will most likely abandon the habit by the time they reach five years of age. Beyond that age, some idiopathic toe walkers may toe walk only occasionally, while toe walkers who suffer from an underlying medical cause will more likely continue.

Your pediatrician can monitor the condition during these first few years of life, referring your child to a neurologist if necessary to check for medical conditions that might call for timely treatment. A pediatric orthopedic specialist can examine your child for structural problems in the feet or Achilles tendons.

What Kinds of Non-Surgical Treatments Can Correct Toe Walking?

Your child’s orthopedic doctor may recommend treatment for toe walking either before or after the five-year mark, depending on the risk of complications, such as foot pain or potential wasting of muscles and tendons. However, if a neurological issue causes toe walking, you should seek treatment for that issue first.

Children who can walk flat-footed (but simply choose not to do so) may benefit from any of several non-surgical treatment options. Stretching exercises can lengthen the Achilles tendons, improve calf muscle function, and encourage a more normal stance. Examples include wall stretches, manual calf stretches, and squatting motions.

Casts and braces can also stretch short Achilles tendons over time. Children who need this form of treatment may go through a slightly different set of casts every couple of weeks as the tendons slowly lengthen. After undergoing this treatment technique, the orthopedic doctor may prescribe braces to complete this stretching process.

Kids who struggle with a neurological condition may need help relaxing chronically tight calf muscles. In this scenario, an orthopedic specialist may administer botulinum A toxin injections to weaken these muscles and permit a greater range of motion for stretching exercises.

How Can Surgery Restore Normal Walking Ability in Kids?

If non-surgical treatment can’t fix stubbornly short or tight Achilles tendons, your child can still benefit from corrective surgery. Different surgical approaches can address different points on these tendons. Children who receive the surgery can go home the same day, but they’ll need to wear lower-leg casts for several weeks.

Arizona Institute of Motion can provide evaluation and treatment for many children with pervasive toe walking problems. Contact us to learn more about our services and schedule a pediatric orthopedic evaluation.