Toe Walking in Children: When to Seek Professional Help

Parents get excited when their kids first learn to walk. However, that is no longer the case when they find out their child is toe-walking. 

It may seem harmless, but it could be a result of underlying conditions like autism spectrum disorder, muscular dystrophy, and cerebral palsy. So, it’s best to let a doctor assess your child. 

If your child manifests this condition, you’re not alone. There’s no reason to worry, as this post discusses this condition in detail. It will also provide insights on when it’s the right time to talk to a doctor. 

What is Tip Toe Walking?

As the term suggests, it means walking on one’s toes or balls of your feet. Also known as idiopathic toe, this condition is common among children still learning to walk. 

While most children outgrow them, others continue to do so not because of habit but because of other reasons. 

Some parents think that since some kids under the Autism spectrum exhibit this condition, it’s an automatic symptom. However, it’s not the case. It is not a diagnostic criterion for autism and can occur in children without autism as well.

Why Do Kids Walk On Their Toes?

It’s often simply a habit that develops when a child learns to walk. However, in some scenarios, it can be a sign of an underlying condition, including:

Shorter Achilles Tendon

It’s the band of tissue that links the calf muscles to the heel bone. When it’s too short, it can prevent the heel from touching the ground, forcing the child to walk on their toes.

Cerebral Palsy

Neurological disorders can also contribute to tip-toe walking. Cerebral palsy, a condition affecting muscle control and movement, can manifest in various ways, including walking on one’s toes. 

Autism

Similarly, autism spectrum disorders, known for their impact on communication and social interaction, have been linked to this gait abnormality.

Spine Damage

Spinal cord issues, like spina bifida and tethered cord syndrome, can also lead to this walking condition. It can disrupt nerve signals to the legs, resulting in muscle imbalances and abnormal gait patterns. 

Muscular Dystrophy

In some instances, this condition may be an early sign of muscular dystrophy. The latter is a genetic disorder characterized by progressive muscle weakness and degeneration. 

If your child began walking normally but later started walking with their toes, this could be a red flag for muscular dystrophy.

While an idiopathic toe may seem harmless, it's crucial to consult a doctor if it persists. They can assess your child's development, rule out underlying conditions, and recommend necessary interventions. 

Early detection and doctor intervention can significantly improve outcomes and enhance your child's quality of life.

Risk Factors and Complications

Your child may be more predisposed to this habit if this condition runs in your family. While habitual toe walking doesn't have a clear cause, a familial link suggests a potential genetic component. 

Premature birth or a complicated pregnancy may slightly increase the risk of mild cerebral palsy.  The latter can be associated with children who toe walk.

Beyond the toddler years, persistent conditions can pose particular challenges. The altered gait may affect balance and coordination, increasing the risk of trips and falls. 

Furthermore, it can be socially isolating for children. They may experience teasing or exclusion due to their different way of moving. Sometimes, it can even lead to musculoskeletal problems later in life if not addressed.

When Is The Best Time to Talk to a Doctor?

There’s no cause for concern if your kid is tip-toe walking out of habit and if they’re developing and growing normally. However, if after the age of two, they still do so, it’s best to talk to a doctor. 

Children under two still learn to balance, so they toe-walk. After this age, they usually mastered walking and are now running and jumping. Hence, they stop stepping on their toes. 

You should also seek an appointment with your physician if your child experiences any of the following: 

• Problem with muscle coordination

• Achilles tendon stiffness

• Leg muscle tightening 

Is Treatment Necessary? 

Most children aged two who toe walk out of habit will naturally outgrow it by age five. Gentle reminders to walk flat-footed can be helpful during this time.

However, if the toddler walking on their toes is older than five or has a medical condition contributing to their toe-walk habit, treatment might be necessary. The latter aims to prevent long-term complications like muscle or tendon shortening.

Treatment options include:

Physical Therapy

It can involve stretching exercises and activities to improve flexibility, strengthen muscles, and enhance balance and coordination.

Casting Or Bracing

In some cases,  doctors may use casts or braces to help stretch and lengthen muscles in the feet and legs.

Botulinum Toxin Injections

Botulinum toxin injections can temporarily relax muscles, which contributes to this condition's effective management and rehabilitation process.

Surgery

Your doctor may consider this option in severe cases or when other treatment plans for toe walking in children have been unsuccessful.

Always consult with your child's specialist to determine the best course of action for their individual needs.

Help Your Child Walk Confidently — Take the First Step Today!

Prime Foot and Ankle Specialists understand that toe walks can concern parents and children alike. Our team of seasoned podiatrists specializes in diagnosing and treating the underlying causes of this condition. 

We provide tailored solutions to help children walk comfortably and confidently. Our team also educates parents about toe walking, its potential causes, and available care options. 

We also provide ongoing support and guidance to help children achieve their best possible outcomes. 

If you are concerned about your child's toe walks, don't hesitate to contact us. We are here to help your child walk with confidence and comfort.