Toe Walking: when should I be concerned?
What is toe walking?
Toe walking is when children favour walking on their balls (front part) of their feet, without heel contact with the ground. It is a common habit when children first learn to walk, but most grow out of it after a few weeks.
Early intervention for toe walking is key! Starting therapy at older ages often requires more invasive and expensive intervention such as casting.
Understanding the Causes
Toe walking in toddlers can be attributed to physiological, neurological, sensory or musculoskeletal factors. In some cases, toe walking is idiopathic (ie not linked to any medical conditions). Consulting with a healthcare professional can help determine the cause and provide appropriate guidance.
When should I be concerned?
After your baby initially learns to pull up to stand, they are often up on their toes - this is normal behaviour! They stand on their toes and curl their toes to find stability in early standing. However as they practise standing and become more confident, it should decrease quickly over a few weeks to a flat foot stance.
Toe walking more than 50% of the time is not typical!
Seek advice if:
Your child is over 2 years old and toe walks greater than 50% of the time.
Your child is under 2 and continues to toe walk more than 50% of the time, 4 weeks after starting to walk
If toe walking significantly affects your child's balance, coordination, and causes frequent tripping or falling.
If your child displays delays or difficulties in other motor skills, such as jumping, running, or climbing stairs, along with toe walking
Strategies to Promote a Flat Foot Stance:
Encouraging Barefoot Walking: Allow your child to walk barefoot on different surfaces, such as grass or sand, to promote natural foot and ankle movement. This sensory experience can enhance their awareness of their feet and encourage a more natural walking pattern.
Footwear: Ensure your child wears appropriate footwear that provides proper support and encourages a heel-to-toe gait. Avoid shoes that are too rigid or have elevated heels, as they can contribute to toe walking.
Assisted Squats: Assist your child in performing squats by gently supporting their underarms or holding their hands. Guide them through the squatting motion while encouraging them to keep their feet flat on the ground. Gradually reduce the amount of assistance as your child gains confidence and strength.
Use Props: Incorporate props, such as a small stool or stack of cushions, to support your child's heels during squats. This reduces the demand on ankle flexibility, making it easier for them to achieve a flat foot stance. Over time, gradually lower the height of the prop to encourage independent squatting.
Final thoughts:
Encouraging a flat foot stance in toddlers requires patience, consistency, and an understanding of the underlying causes making them stand or walk on their toes. Prolonged toe walking can lead to tight foot muscles, altered foot posture and leg development and pain – both in feet and back
If your child’s tip toe walking persists or baby is having difficulty with standing or stepping, contact us to have a paediatric physiotherapist assess your child in the comfort of your own home.