Toe Walking: What Every Parent Should Know

If your toddler is starting to walk, you may have noticed they balance on the balls of their feet, rather than placing their heels flat on the ground. This walking pattern, called toe walking, may seem unusual, but it’s often a normal part of growth and development. 

Most children grow out of the behavior by age 2 or 3, but in some cases, it lasts longer. When that happens, parents often wonder if it could mean something bigger about their child’s health.

At Prime Foot and Ankle Care, experienced podiatrist Nrupa Shah, DPM, works with parents in South Brunswick, North Brunswick, Kendall Park, Franklin Park, Princeton, and Plainsboro, New Jersey, to identify and treat the causes of toe walking. 

Read on to learn why some kids walk on their toes, when parents should call a specialist, and what treatments can help.

Why do some kids walk on their toes?

Walking on the toes or balls of the feet is very common in children who are learning to walk. This happens for various reasons, including:

Tight calf muscles or Achilles tendon

Many children have tight calf muscles or Achilles tendons (Achilles tendonitis), especially during growth spurts. These issues can make it uncomfortable to walk flat-footed, causing them to walk on their toes.

Sensory issues

Some children find toe walking more comfortable, while others are sensitive to floor textures. Both of these factors can contribute to the walking pattern.

Habitual or idiopathic toe walking

Most toe walking is idiopathic, meaning there’s no underlying cause. In many cases, children simply grow out of it over time.

Neurological or developmental conditions

Certain medical conditions, such as cerebral palsy, muscular dystrophy, and autism spectrum disorder, lead to toe walking. However, just because your child walks on their toes doesn’t necessarily mean they have a serious medical condition.

When to see a specialist about toe walking

Most toe walking is harmless and improves over time, but it’s important to see a podiatrist if your child:

• Regularly trips, falls, or has other balance issues
• Continues toe walking after age 3
• Experiences stiffness, pain, or has difficulty keeping up with friends
• Can’t put their heels down, even when asked

You should also have your child evaluated if your family has a history of neuromuscular disorders, such as muscular dystrophy. Prompt treatment can prevent the issue from worsening and help maintain healthy mobility.

How toe walking is diagnosed

Dr. Shah reviews your child’s medical history, asks about their symptoms, and performs an exam. She also conducts a gait assessment, which evaluates your child’s range of motion, balance, and muscle flexibility.

These steps are often enough to identify the cause of toe walking. She may also refer you to a neurologist or imaging facility for additional tests, especially if a neurological issue is suspected.

This process helps rule out underlying causes and guides the treatment plan.

Toe walking treatment: What to expect

Dr. Shah takes a conservative, integrated approach to treating toe walking. Treatment depends on symptom severity and the underlying cause. Dr. Shah may recommend:

• Physical therapy to improve balance and strength
• Night splints or custom orthotics to support proper foot position
• Serial casting to gradually stretch tight muscles or tendons and improve mobility
• Botox® to weaken calf muscles and improve range of motion
• Surgery if nonsurgical treatments don’t improve symptoms

Most children respond well to a combination of nonsurgical treatments. Dr. Shah monitors progress through regular checkups and adjusts your child’s care plan as needed. 

We can help your child move more comfortably

If your toddler is 3 or older and regularly toe walks, contact us today about pediatric foot and ankle care. Most cases aren’t serious, but it’s important to have them screened for peace of mind. Call the Prime Foot and Ankle Care office or book an appointment online.