Undertsanding Toe walking

Have you noticed a child walking on toes instead of on the whole feet? Toe walking is a not a new concept and is something most children tend to do before the age of two years. They tend to walk on their toes without touching the ground with their heels.

However, in some cases, the child may continue walking on toes even after 2 years of age. This could be either be just out of habit or may also be indicative of some medical conditions.

It is advisable to consult a doctor in case the child persistently walks on the toes and also has some other signs such as stiff leg muscles, stiff Achilles tendon or lack of muscle coordination.

Causes & Impact

Toe walking could simply be something the child does out of habit however, there are some medical conditions associated with it.

1. Achilles tendon- It connects the lower leg muscles to the back of the heel bone and if it is shorter, walking with the heel on the ground becomes difficulty.

2. Cerebral palsy- When muscle controlling part of brain is not developing properly, walking can become challenging leading to toe walking.

3. Muscular dystrophy- This genetic disease makes muscle fibers weak and can also be a cause of toe walking.

4. Autism- In some children tow walking has been found to have a link with autism spectrum disorders.

We spoke to Dr Kinjal Chandra, an expert occupational therapist about toe walking.

Toe walking is common in children learning to walk but if persists beyond 5 years of age then it can indicate neurological immaturity. Of the kids that I see in the clinic at least 30 to 40 % of kids on Autism spectrum indulge in toe walking. When sensory intergration is used as a frame of reference with major focus on a hypersensitive tactile system is made, along with Wilbarger’s protocol with a good sensory diet follow-up at home, toe walking gradually mellows down. Dr Kinjal Chandra, Founder Pehel Pediatric Therapy Centre

Toe walking can cause the child to fall often and lose balance. As the child grows, the habit or walking trait can also have an impact on social life.

Treatment

Toe walking out of habit needs no treatment but parents can remind the child to walk properly and break the habit overtime. For toe walking due to underlying medical conditions, parents can seek relevant treatment options after consulting experts. It is advisable to get a proper diagnoses from doctors.

Kavita Shetty, a mother of child with autism shared her experience.

” My girl used to walk normally after she started walking . We noticed her walking on toes for the first time when she turned 2 and half. We did show this concern to her pediatrician but we couldn’t pin point the reason. But as her therapy started we understood that this might be because of tactile sensitivity. Over a period of time as the therapy continues her toe walking has reduced with fewer incidences of her doing it again. And even if that happens , she immediately stops if we ask her to. ” Kavita Shetty, parent

Surgery or non-surgical methods such as therapy, walking casts, braces, Botox therapy can be used depending on the condition and causes.

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