Tip Toe Walking

What Is Tip Toe Walking?

Tip toe walking refers to walking on your toes or balls of feet, without putting any weight through the heel.

This is very common under the age of 3, with most children outgrowing this and adopting a normal walking pattern.

If a child continues to toe walk after 3 they should be assessed by a podiatrist.

Habitual or idiopathic, where the cause is unknown. The child is physically capable to stand flat footed, but prefers to walk on their toes.
Congenitally short or contracted Achilles Tendon.
Muscle spasticity (i.e Cerebral Palsy). Reflexes are increased and walking may be delayed.
Paralytic muscle disease (i.e Duchene Muscular Dystrophy). There will usually be large calf muscles and signs of muscle weakness. A serum blood test for a specific muscle enzyme level assists diagnosis.
Autism, as persistent toe walking may be an early sign of this condition.
Hypersensitivity or sensory complications.

Walking on the balls and toes of the feet, rather than heel first.
May complain about problems wearing shoes or participating in sports or recreational activities.

Depending on the cause of the toe walking, treatment may vary considerably.
Monitoring for idiopathic toe walking to see if the child “outgrows” the condition.
Passive stretching and calf massage
Desensitisation with increased sensory feedback to the heels of the feet.
Heel raises in the shoe that progressively reduce with a stretching regime and increased sensory feedback.
Carbon fibre plates inside the shoe to prevent toe walking in severe habitual cases.
Night splints, AFO braces or serial casting may be necessary, if there is a reduction in calf range of motion.
Botox therapy is used in severe cases to paralyse the calf muscles to prevent resistance to stretching, most often used with serial casting.
Surgical lengthening of the Achilles tendon may be necessary if conservative treatment fails. This is normally day surgery and done in conjunction with serial casting for 6 weeks and bracing.
Referral to a specialist for serious neuro-muscular disorders causing toe walking.

We will thoroughly assess your child’s gait, range of motion and neurological status to determine the underlying cause of their toe walking.

Well Heeled Podiatry has a range of treatment options depending on the reason your child is adopting this particular walking style.