Toe Walking

What is toe walking?  

Toe walking is when kids favor walking on the balls of their feet without heel contact. It’s a common immature walking pattern among new walkers, toddlers, and children with neurological involvement including cerebral palsy. It typically takes ~3 months of independent walking for your little one to adopt a mature walking pattern. Read on to learn more about toe walking, when it becomes a concern, negative effects to toe walking, and exercises to help! 

When is toe walking a concern? 

  • Your child walks on their toes 80% of the day of more 

  • After 4 weeks of consistent toe walking  

  • Your little one is over 2 years old 

  • Loss of motion where your child is unable to walk or stand with their foot flat, heels touching the floor 

What are negative effects to toe walking? 

  • Back, knee, and/or ankle pain  

  • Withdrawal from physical activity and participation in play due to the pain  

  • Foot deformities  

  • Inability to complete and perform gross motor skills such as jumping, stairs, or squatting 

  • Heel cord tightness and/or loss of motor function can result with absent input from the heel with gait 

So.. Now What?  

Initiating therapy at older ages (4+ years) or after 6 months of consistent use of toe walking requires more invasive interventions such as ankle orthotics – so early intervention is key!  

Exercises to Help:  

1.) Backward walking is a great exercise to encourage shifting weight to the heels and lifting the toes. Your child can pull a string toy around the house or pull a laundry basket around the room. For added challenge, add some toys or weighted objects into the bucket for your older kiddo to increase resistance. 

2.) Walking up inclines. The perfect place to do this is at the playground. Have your child walk up slides or hills to help stretch the calve muscles and heel cord while strengthening other muscles in the legs. Standing on an incline or rolled towel while singing songs or playing catch is a great way to incorporate stretching of the calve muscles in one place as well.  

3.) Single leg balance promotes shifting of their weight to the heels and engages unused muscles in the front of the ankle that helps to promote heel-toe walking pattern. Use of stairs for step ups or stepping over or in and out of a bucket are great obstacles on the floor to incorporate single leg balance at home.  

4.)  Squatting activities are a great way to shift their weight to the heels and strengthen the muscles responsible for achieving heel contact with walking. If they are unable to achieve foot flat in a squatting position, place their heels on a rolled towel or wedge to bring the floor up to their heels for increased input and awareness through their heels. Then decrease the incline as they gain more range of motion through their ankles. 

5.) Strengthening their core muscles is another helpful exercise to assist with their postural control in standing and walking activities to facilitate their weight onto the heels. Crab walks, superman pose, and overhead reaching are all great ways to engage their core! 

Emily Brandt