Home Page

Toe Walking

Date issued: September 2023

Review date: September 2025

Ref: B-482/KM/Physiotherapy/Toe Walking v2

PDF:  toe walking final September 2023 v2.pdf[pdf] 206KB

What is toe walking?

Toe walking is when a child stands or walks mainly on their toes.

This can be normal when a child learns to walk and they should quickly grow out of it as a toddler. A small number of children will continue to toe walk as they get older.

What problems may occur?

Children might have no symptoms other than walking on their toes.

Children may:

  • Experience pain or discomfort

  • Be more wobbly on their feet

  • Have a tendency to walk fast or run

  • Fall over more frequently

What causes it?

Habit

Children may get used to walking on their toes, creating a habit. Over time this can cause muscle tightness in their calf muscles.

Weak trunk muscles

Children may walk on their toes to improve their balance if their tummy, back and bottom muscles are weak.

Short calf muscles 

Children may be unable to get their heels to the floor secondary to tightness in the calf muscles. This can sometimes follow a growth spurt but can result from habitual toe walking over longer periods of time.

Autistic spectrum disorders

Toe walking can be associated with autism. It is less likely that physiotherapy management will resolve this form of toe walking long term.

What can I do to help?

Treatment will depend on each child’s presentation. Giving children time to grow out of toe walking is usually the first option.

Prompting

As children get older, try prompting them to walk slowly and practise heel-toe walking.

Calf stretching

If your child’s calves become tight, daily calf stretching can help to ensure your child can still stand with their feet flat to the ground.

Assisted calf stretching:

Have your child lie down with their knee straight. Support the ankle and push the foot upwards. They should feel a stretch in the back of their leg.

Hold for 30 secs

Repeat 4 times each leg

Independent calf stretching:

Place one-foot forwards and one back with both feet facing forwards. Bend your front knee and keep your back knee straight. Keep your heels on the ground and push into the wall.

Hold for 30 secs

Repeat 4 times each leg

Resting Splints

These hold your child’s calf in a stretched position for a longer period of time. They may be advised to wear them at home whilst resting, watching tv and gaming.

Serial Casting

Weekly below knee casts are applied to progressively increase the length of the calf muscles. The aim is to bring the heel down to the floor and enable the child to walk flat. Children may still return to toe walking after intervention (often with future growth spurts) and need further physiotherapy intervention.

Was this page helpful?

Was this page helpful?
Rating

Please answer the question below, this helps us to reduce the number of spam emails that we receive so that we can spend more time responding to genuine enquiries and feedback. Thank you.

*

Our site uses cookies to help give you a better experience. If you choose not to accept these cookies, our site will still work correctly but some content may not display. You can read our cookie policy here

Please choose a setting: