Have you noticed that your child is walking on her tiptoes? It’s certainly not an uncommon sight, but it is one you’ll want to watch if it goes on past age 3.
It is natural for toddlers 18 months and older to experiment with toe-walking as they learn to walk and run. However, if they continue to toe-walk on the balls of their feet past age 3 and no underlying diagnoses exist, the behavior will need to be addressed. Called idiopathic toe walking, this condition can cause a child’s calf muscles to shorten making it more challenging to walk flat-footed.
Why do children walk on their toes?
The three most common reasons children tip-toe or walk on their toes include:
Sensory Processing Difficulties
Children with sensory processing difficulties may walk on their toes for two reasons due to hypersensitivity to floor textures and surfaces or desire for increased sensory input and feeling within the joints.
Underlying Medical Conditions
Underlying medical conditions like cerebral palsy or muscular dystrophy may be another reason a child walks on the balls of her feet. These medical conditions cause an abnormal increase in muscle tone, which can lead to toe-walking.
A child may toe-walk simply because she prefers to walk on her toes. And, if done continuously, toe-walking or tip-toeing can cause her calf muscles to shorten making it more difficult to walk normally.
How do I help my child stop toe-walking?
If your child’s continuous toe-walking concerns you, please contact your pediatrician to schedule an appointment for further consideration. Your doctor may refer you to a licensed pediatric physical therapist to evaluate your child’s muscles and strength by assessing her leg muscles and ankle movements.
The physical therapist may recommend an at-home exercise program targeting the calf and front leg muscles. The ultimate goal will be for your daughter to walk using a heel-to-toe pattern rather than choosing her tiptoes.
Some common stretching exercises physical therapists may recommend for toe-walkers include:
Ask your daughter to lie on her back with her knees straight. One at a time, bring her feet up towards her head while bending her ankle.
Have your daughter put her hands on a wall with her feet pointed toward the same wall. One foot should be behind the other with the front leg bent. Instruct her to lean into the wall keeping her back leg straight. Both of her heels should remain on the floor while she stretches.
Long Sit Stretches
Ask your daughter to sit with both legs straight out in front of her while wrapping a towel around both of her feet. She should hold the towel at both ends and pull the towel back towards her body while keeping her knees flat and back straight.
Heel Drop Stretches
Have your daughter stand on a step. While keeping one foot planted firmly on the step, ask her to place one foot halfway on the step and drop her heel to feel a stretch in her calf muscle.
Please note, while simple to execute, these exercises should be initiated under the guidance of a physical therapist who will demonstrate the correct stretch positioning, the number of repetitions needed and the appropriate amount of time to hold the stretch.