What is Toe Walking?

Toe walking is when the heel of the foot does not strike the ground during gait (walking).

Typically, walking consists of:

  • Heel strike – Where the heel hits the ground
  • Midstance – Your weight is transferred to the middle of your foot
  • Toe Off – You propel off your toes to keep yourself moving forward

When toe-walking, these phases do not occur as they should, and you remain on your toes and ball of your foot throughout.

Who is likely to Toe-Walk?

Toe walking primarily occurs in children of toddler age. In a child aged 2 years or younger toe walking is not considered abnormal. However, if toe-walking persists beyond this age, it may be a sign of a neurological condition affecting the child and you should seek an assessment. Toe-walking is also observed in a significant percentage of the healthy child population, with no observable reason as to why it is happening. This is referred to as “idiopathic” toe-walking.

Idiopathic toe-walking is one which may be habitual, meaning that the child is able to walk normally but, out of habit, walks on their toes. Children who have been diagnosed with idiopathic toe-walking exhibit unremarkable medical history, normal birth, and normal neurological development.

Prognosis of Idiopathic Toe-Walking 

If the toe-walking is not corrected, a child may develop problems with the way they walk during their adolescence. This may include

  • Ankle equinus – Unable to bring the foot towards the shin due to restricted ankle motion
  • Over-contracted achilles tendon
  • Changes to the ligaments, muscles, or bones in the foot
  • Abnormal and problematic gait patterns

Treatment of Idiopathic Toe-Walking

An assessment can help determine factors which may be contributing to your child’s toe-walking. If these can be established, a treatment plan involving one or more treatment options can be implemented.

An individualised exercise program encouraging your child to get their heel to make more contact with the ground will be given. These exercises will include a range of stretches and strength specific components.

If treated early, the outlook for idiopathic toe-walking is good, and children can continue to lead normal lives after treatment has ceased.