While toe walking is normal for periods during early walking, toe walking that persists greater than six months from mastery of walking could cause issues as a child develops. We don’t know why some children persist with toe walking.
Often, a child will have shortening of their heel cords, because they don’t stretch out when they walk. This tightness increases as a child grows. To compensate, they may turn their feet out, and start to stand and walk with their heels down.
If a child walks on their toes, it can lead to changes in their foot structure due to abnormal forces from landing on their forefoot. This in combination with heel cord tightness can lead to foot and knee pain as an adult.
Children can also have some abdominal weakness from walking on their toes from having their weight line more forward and stiff with walking. This increases lumbar lordosis, and increases the the risk of back pain as an adult.
When a child walks on their toes, their stride length is short and they have more difficulty keeping up with their peers as other children lengthen their strides with development. There is also increasing tightness of the hamstring muscles as they are not being stretched like they are with heel contact walking.
Due to these reasons, addressing toe walking as early as possible will assist your child to have better walking and decrease the risk of complications. A physical therapist can assist you to develop a plan to help stretch and strengthen your child’s muscles and facilitate a more normal walking pattern. If you have concerns about your child’s walking, ask your child’s pediatrician for a referral to a pediatric physical therapist.
Eileen McMahon, M.S.P.T., is a physical therapist at MidMichigan Health.