What is toe walking and why do we care?

What is toe walking and why do we care?  

You may have seen children walking around on their toes and just thought they were excited, or a “bouncy” kid, and therefore not a problem. While this may be true some of the time, if a child is doing this all the time it may be more cause for concern.

Toe walking is exactly what it sounds like- a person, most commonly a child, who walks on their toes as opposed to striking the heel during the first part of the gait cycle.   It can be idiopathic, meaning it just happens on its own. Some research is showing that it may be more common in premies due to these babies not maintaining the flexed/curled posture we often see in newborns. It can also occur in children who have low muscle tone as a way to get some stability in their foot and ankle and make up for lack of stability in their abdominals (where everything stabilizes from). Another reason for toe walking is having sensory processing differences. A child may be walking on toes to avoid the sensation of certain shoes or surfaces or because their joints crave the increased compression of bouncing.  Lastly, tightness in the heel cords can cause toe walking.

This is important for many reasons.  Most importantly, we don't want to put abnormal stresses throughout the body. The foot and ankle are the first part of the body to touch the ground- it starts a chain reaction from the floor up to the knees, hips and spine. If we put increased strain through all of these components, they will eventually cause pain and breakdown in one or more body areas. It can also impair balance, cause muscle fatigue and cause social/emotional problems when kids look or function differently from their peers.

There are many ways a physical therapist can help with this. PT’s are experts at examining gait, posture, strength, flexibility and balance to see which of the above reasons may be causing the toe walking. It may be as simple as stretching some muscles and strengthening others.  There are times when serial casting is needed to force the tissues to be stretched for a prolonged period and break habits that have been formed, It is common to use various forms of orthotics including ankle-foot orthoses (AFOs), or carbon fiber inserts. Physical therapists also work to find sensory techniques to help regulate the sensory system.

If you would like to learn more or make an appointment visit mmidocs.com or call 301-694-8311 today. We are here to serve you Monday- Friday and Saturday with convenient hours to fit your needs. We also offer Telemedicine visits. Let us help you live your best life.