Why is my child walking on their toes?

We all know or have seen someone who walks on their toes, but what happens when its your child who is doing it? What can you do to fix this phenomenon?

Is toe walking in children normal?

It is VERY IMPORTANT to note that toe walking is normal and should not cause concern in children younger than 2 years. Around 2 years, children should begin to develop a more mature gait pattern in which they strike the floor with their heel first. A fully mature gait pattern with reciprocal arm swing and appropriate pelvic rotation develops around 5 years.

Why is my 2 year old still toe walking?

Children may walk on their toes for a number of reasons; poor sensory modulation, visual impairments, muscle tightness, and increased muscle tone are some of the most common reasons. Now let me explain:

Sensory Modulation and Toe Walking

The bottom of our feet have tons of nerve endings. Many people who have difficulty with sensory processing, don’t like getting tactile input from the rear of their feet, so they keep their heels up while walking.

Visual Impairments and Toe Walking

Patients with visual impairments may walk on their toes because they are having trouble with depth perception or visual convergence. For patients with visual impairments I first refer out to a pediatric ophthalmologist.

Heel Cord Tightness and Toe Walking

Tight heel cords are simply tight calf muscles. Some patients are born with tight heel cords, some patients develop tight heel cords because of increased muscle tone or spasticity secondary to a neurological condition, and some patients develop tight heel cords as a secondary result of toe walking that was primarily caused by another reason.

Muscle Tone and Toe Walking

Central Nervous System Dysfunction that causes increased muscle tone or spasticity may result in extension throughout the entire leg - knee extension and ankle plantar flexion (pointing the foot/toes). This is common in children with Cerebral Palsy or pediatric stroke.

Muscle Weakness and Toe Walking

Muscular weakness at the core or anterior tibialis may result in toe walking. This weakness may be caused by hypotonia, inherited muscular dystrophies, or just plain weakness. Depending on the cause, an appropriate strengthening program is necessary develop a typical gait pattern.

Disclaimer: The information in this post is based on professional opinion and evidence based research. This should not replace a doctor’s opinion. Please consult your pediatrician or other healthcare provider.