Toe walking is when your child continues to walk on their tiptoes beyond age 3. It does not cause them pain, but walking on the balls of their feet can sometimes be related to certain conditions.
At Banner Children’s, our caring team can help. Learn how toe walking may affect your child, symptoms to watch for and available treatment options.
Toe walking is a gait pattern where your child walks on their toes or balls of their feet without their heels touching the ground. They will often stand with their feet flat on the ground but will walk or run on their toes.
Toe walking can be temporary or ongoing and may happen in one or both feet.
Walking on tiptoes is relatively common in toddlers as they get their balance. However, they usually begin to walk in a normal heel-to-toe pattern within a few months of learning to walk.
Children who continue to walk on their toes past their toddler years often do it out of habit. However, sometimes it can be related to certain conditions.
In most cases, toe walking in children is idiopathic, meaning there is no known cause. Your child simply may get used to tiptoe walking.
In a small number of cases, however, toe walking can be a sign of other medical conditions, such as:
Most young children who toe walk will have a pattern of walking where their heels do not touch the ground. They will remain on their toes for each step. However, they can walk on their heels when asked to do so.
Toe walking symptoms may also include:
Toe walking usually does not cause any pain or discomfort. If toe walking continues, however, it can cause foot and ankle issues.
The ankle joint can become stiff and the calf muscle and Achilles tendon (heel cord) can shorten. As a result, your child may have balance and falling issues.
This toe pattern can also cause the ball of the foot (forefoot) to widen due to extra weight on that part of the foot, and the heel bone may become smaller or narrower.
Early diagnosis and treatment are important to lower the chance of these problems.
Your child’s health care provider will ask about your child's medical history, including developmental milestones and any family history of toe walking or related conditions.
Your provider will look at your child’s legs, feet and muscle tone. Your child will be asked to walk while the provider watches for any issues. They’ll also check your child’s range of motion in their joints.
If your provider suspects a condition such as autism or cerebral palsy, they may perform some neurological tests. These tests will check your child's nervous system, reflexes and muscle strength.
Usually, imaging tests like X-rays are not necessary to diagnose toe walking, unless there are clear signs of issues in the muscles or joints.
Treatment will depend on what is causing your child’s toe walking. For children between ages 2 to 5, treatment always starts with nonsurgical methods and may include:
Most children will not need surgery. However, if nonsurgical treatments do not work, your child’s provider may recommend surgery to lengthen the muscles or tendons at the back of the lower leg. This procedure is usually done on an outpatient basis.
Early diagnosis is important for toe walking as it helps your child’s health care provider identify and treat any related health concerns for your child, as well as correcting walking and balance problems as your child grows.
Toe walking can affect a child's balance and coordination. If left unaddressed, toe walking may lead to physical limitations when your child runs, jumps, or participates in sports. However, early intervention and treatment can help improve these areas, allowing your child to move freely and with ease.
Your child’s outlook depends on the cause of their toe walking. When a cause is identified, treatment can allow most children to walk, run and play flat-footed.
Contact Banner Children's if you have concerns about your child’s walking pattern. Our team of specialists offer complete care to cover all of your needs. We explain all treatment options to help you choose what’s best for your child.