Toe walking is walking on the toes or balls of the feet while it is not a huge concern when children are first learning to walk, it can become an issue once they transition into their toddler years. Read more about some at home excercises you can do to help overcome toe walking.

What is Toe Walking?

Toe walking is common amongst children who are just beginning to walk; however, they should outgrow it around 2 years old. If children continue to toe walk past 2 or 3 years old, there could be additional contributing factors. Otherwise, if the child is developing normally then it is unlikely to be of concern. Toe walking can cause tight calf muscles, decreased ankle flexibility and weak muscles in the front of the lower leg. Early identification and intervention will assist in decreasing complications as a child grows. 

What Causes Toe Walking?

• A short achilles tendon: short tendon can cause decrease in heel contact with the ground. 
• Cerebral Palsy: abnormal development causing increase in tone and spasticity which can shorten muscles and tendons.
• Muscular Dystrophy: genetic disease which causes damage and weakens muscle fibers. 
• Autism: Autism can sometimes present with a dysfunctional vestibular system. The vestibular system provides the brain with a sense of awareness of body position. If there is a dysfunction within the vestibular system it can cause visual changes which can contribute to toe walking. Therapeutic vestibular stimulation can assist in reducing toe walking. 
• Sensory Processing/Integration: some children cannot process the sensory input through their feet or they find it overwhelming or disturbing which can result in toe walking. 

Treatments for Toe Walking

• Physical Therapy: stretching, strengthening, balance and improving gait
• Occupational Therapy: improving sensory awareness or desensitization
• Casting or bracing devices: can assist in range of motion and help promote a normal gait

7 Excercises to Help with Toe-Walking

Inch Worm: core strength and gastroc stretching.

1. Begin in pike position with hands and feet on floor
2. Slowly walk hands out until in a plank position
3. Walk feet forward until you are back in start position
4. Keep core tight with heels pointed down 

Walking on incline or bear walking: encourages ankle range of motion, core activation and increased strength to muscles on the front of the leg.

1. Walk forward (up) with both hands and feet alternating on incline, with the least amount of knee bending possible. There should be no (lateral) side-to-side movement.

Sit to stands: strengthening and heel activation with appropriate alignment.

1. Have your child sit on a children’s sized chair or stool.
2. Place your hands below their knees, providing a moderate, constant pressure downwards as a cue to keep their heels on the floor.
3. Have your child practice standing up while keeping their heels on the ground.
4. Make this exercise fun by playing a game of high five, blowing bubbles, reaching for objects, working in front of a mirror or singing songs.