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What is Toe Walking?

Toe walking is fairly common when a child is beginning to learn how to walk. When a child toe walks they are walking on the balls of their feet with no contact between the ground and their heels. Typically a child will grow out of this and begin walking with a normal heel-to-toe pattern. Overtime, the achilles tendon may shorten which will prevent the child from touching his or her heels to the ground.  If a child continues to toe walk past the age of 2, it’s important to seek medical advice as well as treatment options.


The majority of cases, a child’s toe walking may be “idiopathic” meaning the cause for this is unknown and a child may continue walking on their toes out of habit. In fewer cases, toe walking is secondary to an underlying condition such as: Autism, Cerebral Palsy, Muscular Dystrophy, or other conditions.


Toe walking can be easily diagnosed by a gait analysis with many treatment options available. Treatment options include the following:



  • Physical Therapy – which will consist of stretching the muscles of the child’s lower leg as well as functional activities focusing on maintaining heel contact with the ground.
  • Leg Braces (AFOs) – which is called an Ankle Foot Orthosis. This would be worn daily to help correct the child’s gait pattern as well as provide a small stretch.


  • Serial Casting – this may be done if the child is not progressing with physical therapy or AFOs. This option is more aggressive in which the child would be casted each week to maintain a constant stretch and obtain the intended range of motion.
  • OnabotulinumtoxinA – is an injection into the calf muscles which are sometimes used to help promote a normal gait and help decrease tissue tension.
  • Surgery – If conservative treatments fail, the doctor might recommend surgery to lengthen the muscles or tendons at the back of the lower leg.

If you feel that your child may be demonstrating “toe walking” call today to set up a FREE screening with one of our trained therapists. 586-323-2957

-Brie Glombowski , PTA




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