First of all, toe walking is not necessarily a sign of anything bigger going on. A lot of kiddos who are just starting to walk spend a good portion of their time on their toes. This should decrease the more experience they get with walking. So, how long is too long for toe walking?
While every kiddo develops differently, by the age of 3 most kids should not be toe walking. Also, you want to look for any additional signs – such as unsteady feet or ankles. This would show up as frequent falls, “wobbly” appearing feet in standing or feet that look like they roll toward the middle with little to no arch visible. Signs such as these may point to some structural instability in the feet or ankles.
These kiddos often do well with extra supportive shoes or orthotics for their feet. Also, if they are frequently clumsy, fall often, have poor overall awareness of their bodies, or have high or low muscle tone at rest there may be a deeper issue at play.
All of these could be signs of gross motor delay or general difficulty with balance and may warrant the need for further evaluation to determine an underlying physical or developmental cause.
So, all that being said, what is the big deal with toe walking? When toe walking becomes a habit, the body adapts to suit that. What that means is the Achilles tendon on the back of the lower leg can shorten. Shortened tendons lead to the inability to properly use the joints they affect, in this case the ankle.
A person with short Achilles tendons cannot properly elevate their toes in running, clearing steps, or climbing which further delays their gross motor development and makes them more prone to tripping on their own feet.
What if your child is a habitual toe walker? A good place to start is a proper screening by your child’s physician to rule out any medical/orthopedic underlying conditions.
Once all has been cleared, a good next step is physical therapy. What this looks like for a kiddo who toe walks is a program individually designed for your child’s needs that typically includes stretching, balance activities, and strengthening. When utilized together, these all work to lower them back down to their heels to allow proper functional development in the areas of walking, strength, balance, and coordination. The earlier toe walking is addressed, the higher likelihood of preventing the cascade of negative long-term effects.
The pediatric therapists at Our Children’s House have ample experience in dealing with toe walking and are more than capable of designing a program to help a child and their family decrease both toe walking and the negative consequences associated with it. A good place to start would be with your child’s physician.
Mention your concerns about your child’s habitual toe walking to them. If they feel physical therapy is a good idea, Our Children’s House has multiple clinics around the Dallas/Ft. Worth Metroplex that would be happy to provide you and your child services to achieve the outcomes you desire. Click here to find a location near you.
This blog post was contributed by Suzan Gordy, a physical therapist at Our Children House at Grapevine.