Toddler Walking on Their Toes

Bayo Ajibola

When a toddler is learning how to walk many times they will start out on tiptoe. He eventually gets the hang of it and gains balance along the way. After that you will probably know that your toddler is trying to indulge his curiosity if you see him on tiptoe.

Toddlers will perfect their walking and eventually use their whole foot by the time they get to three years. Some will however continue to walk on tiptoe even after three. Health professionals generally say that at this point it will need to get checked out.

Causes of toe walking

There are four main reasons why a child would walk on their toes. It could be a neurological condition such as muscular dystrophy or cerebral palsy causing tightness in the calf muscle. This interferes with how the muscle works and makes it difficult, painful or even impossible to place their heels flat on the ground and walk properly with their whole foot.

It could be an orthopedic condition such as club foot (talipes equinovarus) or calcaneal apophysitis (which is inflammation of the heel’s growth plate). These conditions cause a structural change in the heel and make it painful or impossible to get the heel to the ground.

There are those that just prefer to keep their heels up yet they can walk properly. You may find that these also have developmental delays. They may take a while achieving milestones and different ritualistic behaviors. In such situations it is linked to developmental delays or autism spectrum disorders.

There are also those who have no underlying medical conditions but keep walking on their toes. This is idiopathic, habitual or familial toe walking and it affects five to 12 percent of healthy kids. It is called habitual toe walking because the assumption is that the child formed a habit and hasn’t let it go and familial because some studies have found that it presents in several members of the same family.

Researchers don’t know the causes of idiopathic toe walking yet but they suspect that it may be a genetic issue since it often occurs in several family members. Some studies have also found that issues with motor skills, speech and language delays and challenges with sensory processing like balance are common among children with idiopathic toe walking. The most common sign remains tight calf muscles which make it difficult to walk properly or even play.


This condition can be treated in two ways: conservative and surgical. Conservative treatment involves giving it time, verbal reminders to keep the feet down, heavy shoes, ankle foot orthotics, full-length orthotics, stretching, plaster casts (to stretch the muscles), Botox injections, whole-body vibration and carpet, vinyl or gravel flooring. Surgery is aimed at increasing the length of the Achilles tendon.

Surgery and casts have been found to be effective in increasing the length of the muscles. This is the main thing that makes an instant difference when corrected. It may be difficult to choose one single treatment since they are very many and with varying success rates but you have to try something, right?

There are those that brush this toe walking aside saying that they will eventually outgrow it. This can only hold water if he toddler is less than three years. Doctors agree that if it continues after three years the child definitely needs to get checked.

Consult your doctor before you make any treatment choices. They will be able to advise accordingly and guide you on the right path. If your child is still below three years, keep going for checkups and listening to the doctor’s advice.


Bayo Ajibola

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