The Truth About Toe Walking

Posted by: GL Admin Tags: | Categories: Children


Children walking on their toes is not uncommon, however it may be indicative of an underlying issue. While many people think toe-walking is specific to autism, it’s actually commonly related to sensory or muscular issues, and it can have long-term health effects. But there are ways to help your child, and we’ve got all the info you want!

What Is Toe Walking?

Toe walking is the pattern in a which a child coordinates their step to place the foot down first on the ball of the feet. When toe walking occurs contact between the heel and the ground does not occur. A normal step pattern will consist of contact first with the heel to the floor, with the second movement where the foot is rolled forward onto the ball of the feet. As stated, in toe walking, heel contact with the floor is omitted and the step is a solid strike to the floor on the ball of the foot. While there are underlying reasons toe walking can occur, habit can be a reason it continues.

Toe walking can occur for a variety of reasons, however common reasons for toe walking are described below. The first possible reason for toe walking is sensory related. Children can be born hypersensitive to particular textures and/or surfaces on the ground. When walking on a textured surface such as wood floors, gravel or carpeting, they’re more prone to walk on their toes if attempting to avoid uncomfortable textures.

Conversely, children who toe walk may also be seeking extrasensory input. Young ones seeking more sensory input can do so by walking on their toes. During toe walking the knees and ankles are typically locked and muscles have increased tension. In addition, ankles and knees are typically locked. The walking pattern performed during toe walking provides increased sensory input to joints, such as the knees and ankles.

Another primary reason children may toe walk is because of an underlying, undiagnosed illness. Diagnoses like muscular dystrophy are conditions that may spur toe walking in children. With muscular dystrophy, for example, muscle is destroyed and gradually replaced with fat, with the calf muscles typically being the first to suffer. The lack of muscle from a disorder, such as muscular dystrophy, may encourage toe walking because of decreased muscle strength. It is widely asserted that most conditions which result in abnormal increases in muscle tone will result in toe walking, like cerebral palsy.

In addition to the above-mentioned reasons is a third reason. Namely, children may just prefer to walk on their toes. Kids without underlying diagnosis or sensory issues practice what we call idiopathic toe walking. Idiopathic toe walking is a term for children who have been evaluated by a physician and have no identifiable medical reason for toe walking, and it occurs in regular healthy, developing children in both feet. Naturally, some children with idiopathic toe walking can walk flat footed when asked, or they may not walk on their toes at all when wearing shoes. It is most pronounced when walking bare-footed from room to room, or when walking on carpet, tile or grass.

While it doesn’t readily seem dangerous, toe walking can lead to problems over time. Children who regularly toe walk, can develop tight Achilles’ tendons in older age. The excessive tightness developed is known as a contracture. If contracture occurs dropping the heel to the ground may become impossible. Tightened tendons also lead to problems in proper alignment of the feet and legs. The misaligned feet and legs can ultimately contribute to or develop flat arches or outwardly rotated legs when heels are placed on the ground.

But there are solutions!

Much like adults, children can benefit from occupational therapy and physical therapy. Therapy can assist in teaching appropriate walking and stretching patterns to contribute to decreased toe walking. Occupational therapy can also help your child develop sensory processing and integration skills to help mitigate toe walking. The key to helping kids with toe walking is staying persistent and consistent. It can be a long journey, but the joy at the end will make it all worth it. You and your little one can do weight bearing activities on various textured pads or platforms, sensory integration work, or active range of motion activities to help! As your kids shift their weight to stay balanced, they’ll experience an active stretch in their affected muscles, while playing with you!

If you’re wanting more tips and professional help, then find a passionate, dedicated occupational therapist like the staff at Greater Learning LP. We’re here for you and your family in your journey toward healthier living.

Visit or call 210.349.1415 to meet with an occupational therapist and start investing in the future today.

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