Toe-Walking

Many parents worry about toe-walking. This occurs when children walk only on tip-toes rather than using their entire foot. Often, this is normal as children learn to walk. In otherwise healthy children, toe-walking under age 3 should not be a major concern.

In the setting of other developmental or physical delays, toe walking can be associated with autism or cerebral palsy. Congenital Achilles tendon contracture, and paralytic muscle illnesses like muscular dystrophy can also cause toe-walking.

Idiopathic Toe Walking (ITW) occurs when a child, three and older, continues to walk on their toes without showing any signs of other illness. An estimated 7 to 24 percent of children are affected by ITW.

ITW will typically resolve eventually, however toe-walking for an extended period of time causes the bones and ligaments in the knees, hips, and lower back to operate under increased tension. This can lead to abnormal bone growth or ligaments to be overstretched. These abnormalities leaves children at risk for injury and joint discomfort in the future.

Treatments for ITW include physical therapy to stretch the Achilles tendon and calf muscles as well as splints or leg braces to reinforce a normal gait. Casts and surgical options are also potential treatments if necessary and other treatments fail.