My child toe walks
What causes it and should I be concerned?
Maybe you’ve noticed your child on their toes as he or she learns to stand or your child walking on the balls of their feet. Have you wondered if it was normal? Whether or not they’re going to be a prima ballerina? Let’s talk about toe walking, some of its causes and what you should be aware of as a parent.
When first learning to walk, it’s normal for children to walk on their toes or the balls of their feet. By 18 to 24 months, children should be able to walk flat on their feet. If toe walking persists, it can cause excessive muscle tightness, pain and weakness. As a result, children may have difficulty running, increased falls and decreased coordination. It may also be a cause for concern for a parent or teacher.
Toe walking can have several causes:
1.Hypersensitivity – children with hypersensitivity dislike the feeling of certain sensations such as walking barefoot. To avoid textures they dislike, they may walk on their toes.
2.Hyposensitivity – children with hyposensitivity have a difficult time receiving sensory input. They may walk on their toes to compress the bones at the ankle joint and help the brain figure out where their body is in space (proprioception).
3.Positional – if your baby spent a lot of time on their toes in a walker or bouncer, they may have developed muscle tightness. This may cause your child to continue to walk on their toes as he or she gets older.
4.Underlying neurological problem – this may cause increased muscle tone or weakness that leads to toe walking compensation. Children diagnosed with cerebral palsy, muscular dystrophy or autism are more likely to walk on their toes.
5.Idiopathic – this means there is an unknown cause. Your child may have developed a habit that led to muscle tightness or shortening or it may be hereditary.
When should you be worried about your children’s toe walking?
1. If they are unable to put their foot in a flat position when standing or walking. This indicates muscle tightness or a shortened muscle in your child’s calves.
2.If they only walk on their toes on certain surfaces or when their shoes are off. Your child may have trouble tolerating certain sensations and rise up on his or her toes to minimize contact with that surface.
3.If they suddenly start to walk on their toes or if they have changes in their bowel and bladder function, they may have an underlying condition causing the toe walking.
4.If they frequently fall or have trouble running and always walk on their toes.
5.If they are older than 3 and/or you notice any of the above problems.
Talk to your child’s physician if you notice any of the above issues or are concerned about his or her toe walking. The doctor may monitor your children’s walking; refer you to a specialist or physical therapist for further examination.
Jean O'Mara is an advanced physical therapist at Cook Children's. Physical therapy at Cook Children's focuses on large motor and functional skils to enhance development, restore function and prevent disability from pediatric conditions, illness or injury. Cook Children's has Rehabilition Services in locations in Fort Worth, Hurst and most recently in Mansfield.