Toe Walking in Children

A common question parents have for their pediatrician’s and therapists regards toe walking in children. While toddlers look extra cute prancing around on their tippy toes like the next prima ballerina, many parents are concerned when their child walks on their tip toes. Toe walking is common and often is nothing to be worried about. However, how does a parent know whether to be concerned about toe walking?

Toe walking is extremely common in early walkers. For most children, there is no reason why they prefer to walk on their toes. The majority of toe walkers will resolve on their own without intervention. Most toe-walkers begin to normalize their gait pattern after two years old. If a child continues to toe walk after two, intervention may be considered.

What Causes Toe Walking?
Toe walking is most often strictly out of preference and habit. If a child is toe walking and all other causes are ruled out, physical therapists will need to work with the child to create a new habit of walking in a normal gait pattern. Occasionally, there can be potential underlying causes for toe walking. Neurological diseases such as cerebral palsy and muscular dystrophy can cause children to toe walk as they do not have the active flexion of the ankle. Children with autism are often toe walkers due to the same disruption in the vestibular system that causes them to seek sensory input from swinging or rocking.

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