Toe Walking In Toddlers

As parents, you won’t forget seeing your child walk for the first time.

Those cute and clumsy, awkward steps remain in your memory. Your child’s confidence steadily grows and soon he or she is running everywhere.

Toddlers are a curious bunch and often spring onto their tippy toes to catch some of the action that’s happening above. According to Liesa Persaud, a Paediatric Physical Therapist, in the first 6 months of independent walking, it is normal for them to spend some time on their toes. If your child is on their toes for longer than 6 months, it is a concern, and you should get it looked at.

There are a number of reasons a child may continue walking on their toes, but often no underlying cause can be found. If your child is a habitual toe walker, you may need to take action rather than play the ‘wait and see’ game.

Here we will share with you a few toe walking treatment options for you to consider.

Toe Walking Causes


Autism and toe walking are often linked. However, they are not one and the same. Your child can be a toe walker without being autistic, and vice versa. There are a variety of reasons toddlers toe walk and understanding your child is key.


Tight Achilles and/or calf muscles can make regular walking uncomfortable. In extreme cases, kids are physically unable to step flat on the ground.


For children who have sensory concerns, tiptoes can be preferable to flat feet. 


Children who are unstable on their feet may feel steadier when on their toes. Children who is hypotonia (low muscle tone) and has pronation (flat feet) are common culprits. 


For some, there’s no apparent reason. This is called idiopathic toe walking.


Potential Problems


Toe walking can lead to a variety of problems if ignored. Potential problems such as:

  • Foot pain
  • Muscle contractures
  • Widening forefoot
  • Poor alignment

Toe Walking Treatment


Is your child complaining of any foot or leg pain, or has been walking for a while but still tiptoes more than half of the time or maybe you are noticing some developmental delays?

If you answered yes to any of these, it may be time to talk to an expert. It is better to take action now than waiting. If toe walking is not treated, it may eventually require surgery.

Below are some non-surgical solutions and treatments for toe walking.

Physical Therapy


A physical therapist will guide your little one through a series of exercises, movements and activities that are designed to address the cause of the toe walking.

Serial Casting


Serial casting involves your child wearing a series of leg casts over a period of time. This provides a gradual stretching of the muscles.

Braces for Toe Walking


This option, which is often paired with physical therapy, is one of a variety of braces for toe walking.

These are custom-made and require a visit to your local orthotist.


AFO Braces for Toe Walking


AFOs are the most common braces for toe walking.

The specifics of the device can vary depending on your child’s needs, but typically they address toe walking by blocking the toes from pointing down. This would help your child to learn to walk flat footed.

However, for greater freedom, you can consider a combination device such as the Surestep Indy 2 Stage. This features an AFO and an SMO, both of which offer their own unique benefits. Some kids begin with an Indy 2 Stage before graduating on to just the SMO portion without needing a whole new device.






SMO Braces for Toe Walking


AFOs are not the only orthotic solution for toe walking.

Surestep created an SMO specifically designed to treat toe walking that is caused by instability, pronation, and/or sensory concerns.

Unlike more restrictive options, the Surestep Toe Walking SMO does not physically prevent your toddler from toe walking. Rising up on your toes is a natural movement that used often, such as walking up the stairs. By not blocking this, your child has more freedom of development and movement.

Instead, the Surestep Toe Walking SMO features an extension in the back. Any time your child stands on his or her toes, that extension pushes into the back of the leg. It does not hurt but it serves as a reminder to come back down.

No matter what is causing your child to toe walk, it can be worthwhile to get an expert opinion if your parental intuition keeps telling you that something is wrong.

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