Paediatric Toe Walking

I am often asked about why children walk up on their tip toes. It’s actually quite common – almost 7 to 30% of children will be toe walkers.

But why? Common causes include cerebral palsy; autism; muscular dystrophy and global developmental delay. But there is also a group of children who walk on their toes for no known reason. They are often referred to as idiopathic toe walkers (idiopathic meaning “no known”) and they often can walk in a heel – toe pattern when asked, but simply prefer to walk up on their toes.

Many children when they first learn to walk will walk on their tip toes for part of the time. This may due to lack of balance; adapting to different floor surfaces and it is actually important for development of their calf muscles – the drivers of walking. When a child is first walking they are often wobbly, with a bow legged appearance. By about 18 months they often have developed a heel – toe gait pattern. But if a child is still continuing to toe walk after 6 months of being on their feet, they should be assessed by a qualified physiotherapist.

But why do they need to be assessed? Toe walking is simply an inefficient walking pattern. Children that walk on their tip toes often take twice as many steps as their peers who don’t. Over time toe walking can lead to changes in the bony alignment of the foot – our feet are designed after all, to be walked on in a heel – toe pattern! Changes may include smaller, narrower heels through lack of weight bearing and a loss of the natural arch of the middle of the foot.

I have had many parents saying they have been told that their child will simply grow out of it! This can have serious long term consequences including: knee instability; more frequent falls, tight calf muscles and even arthritis in later life.

Treatment often involves wearing wedged shoes; taping and exercises and good quality shoes or boots. If you are concerned about your child’s walking, do not hesitate to contact Kate Williams on 0401 840 768.