Over recent years there has been an increase in the number of children diagnosed with Idiopathic Toe Walking - what this means is that no real reason has been given as to why a child is walking up on their toes. In reality however, prolonged toe walking is due to a clear reason that must be addressed - it can be due to problems with their sensory, muscular or neurological processing.
With a diagnosis having no clear origin for the movement pattern, this leads to poor outcomes and ongoing occurrence of toe walking which can persist into adulthood. What's important is getting a clear assessment and diagnosis so that the exact reason why your child continues to walk on their toes is addressed and treated accordingly.
Is Toe Walking normal?
There is a window of time when toe walking is normal in children. When children start to cruise (prior to stand alone walking) they often go up on their toes to increase support and stability. Once they hae accomodated and are feeling more stable, the child returns to the flat footed position again. In this stage, it is grown out of and is only phase. Heel strike should be noticed by 18 months of age, with heel to toe walking by the age of 3 years old on average. Other times that toe walking is noted and particularly when it persists beyond this window it is not normal and should be addressed.
What does the research show?
- There is a high incidence of toe walking in children with autism, language and cognitive disorders
- Stretching doesn't work - it does not change the movement pattern which is the problem and children will quickly revert back to original walking strategies with re-occurence of contractures
What treatment works?
- Core strengthening
- Bringing the ground up to the foot (heel wedges, splints)
If untreated there are potential concerns
As you can imagine, untreated toe walking means that kids will continue to walk on their toes and this can certainly persist into adulthood. Potential issues that can arise with unmanaged toe walking includes:
- Knee instability
- Difficulties with footwear fittings
- Increase risk of tripping and falling
- Joint pain particularly in the lower back
- Arthritic and degenerative changes
- Progressive weakness in leg muscles