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Why is My Child Walking on Their Tippy Toes?

Did you know that toe walking causes children to use 53% more energy to walk? Toe walking is characterized by walking on one’s toes, with no contact between the heels and ground. It is very common in children who are learning to walk. Children should outgrow this pattern and begin to walk with a normal heel-toe pattern by age two.

When is toe walking ok?

In the majority of children, toe walking is idiopathic, meaning the exact cause is unknown. When these children are evaluated by a doctor; their tests are normal. Persistent toe walking can be a sign of an underlying condition, such as cerebral palsy, muscular dystrophy or spinal cord abnormalities. Or the heel may not be able to touch the ground due to tight muscles in the calf. If not managed properly, the muscles continue to tighten, progressing the deformity. This can lead to instabilities, abnormalities, problems wearing shoes, and participating in sports that require flat feet for equipment (e.g. hockey skates, roller skates).


If your child is toe walking out of habit, treatment is not necessary. They will outgrow the habit. Your doctor might monitor your child during visits. If a physical problem is contributing to toe walking, treatment options may include:

  • Serial casting: a series of walking casts applied over a period of weeks to help progressively stretch and lengthen the muscles and tendons. 
  • Botox therapy: For certain patients – those with a neurologic abnormality leading to increased muscle tone – an injection may be given to temporarily weaken the calf muscles, allowing the muscles to stretch easier.
  • Surgery: For severe presentations and older children, a surgical procedure to lengthen the Achilles tendon may be recommended to improve the range of motion and function of the foot and ankle.


The key is maintaining the lengthened muscles and joint range of motion via physical therapy and bracing. That is where your local rehabilitation team comes into play! Physical therapy provides stretching and strengthening exercises while ankle-foot orthoses (AFOs) will provide a low-grade stretch encouraging proper ankle alignment when walking.

It is important to understand that toe walking does not indicate an underlying problem for most children. If you are concerned with how your child is meeting developmental milestones or walking, please reach out to our office. We are happy to provide a consultation and answer your questions!

The Team at Custom Orthotics of London
(519) 850-4721 | office@customorthoticsoflondon.com | @cool_bracing


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