There are many causes for why children walk on their toes. According to the Mayo Clinic, many children toe walk before the age of two as they are first starting to walk. If a child continues to toe walk after two years of age it could be idiopathic toe walking, which is another way to say it has become a habit. If there is no improvement before the age of three consult with your child's doctor. Habitual toe walking can be damaging and runs the risk of muscle shortening if not treated. There are exercises you can do to discourage toe walking.
One common problem to watch out for in toe-walkers, is a short tendon, which in the lower leg links the leg muscle to the back of the heel bone. Physiotherapy can work to lengthen and strengthen the muscles and tendons. The exercises begin with stretching and strengthening. Gait training uses treadmills and shoe orthotics to increase alignment and ankle foot orthotics to help correct muscle balance. Many of the exercises help train the brain to recognise a normal gait of heel-toe movement.
The therapist also works with the parents to give home exercises.
Stretching and Strengthening Exercises
Many exercises need to be followed out at home to keep a steady progress. One exercise is to have the child lean forward against the wall with feet together and pointed straight while a parent steadies the child. A progressive stretch is accomplished by increasing the distance from the wall.
Using a small block helps your child to stand with a forefoot elevated on the block so that the heel may drop downward. Help steady the child and add a gentle pressure to the stretching process.
Create an inclined plane. Let your child walk up the plane on their toes. Then turn back and walk down using the calf muscles.
Idiopathic Toe Walking
If your child continues, out of habit, to toe walk it is important to gently discourage it. The younger the better. Buy shoes for your child that light up or make a squeak sound when the heel is pressed down. Play a game with your child that every time the squeak or light goes off praise and reward. Instruct your child to stand with arms out in front as if he is hugging a huge teddy bear. Then have him lean back on his heels. The shoes will light up or squeak. Do not let him bend his knees or at the waist. You may need to help him balance. Play a game with him to see how many lights and squeaks he can get.
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- "Paediatric Primary Care (Burns, Pediatric Primary Care)"; Catherine E. Burns PhD RN CPNP FAAN, Ardys M. Dunn PhD RN PNP, Margaret A. Brady PhD RN CPNP, and Nancy Barber Starr MS RN CPNP; 2008
- "Atlas of Pediatric Physical Diagnosis: Text with Online Access (Zitelli, Atlas of Pediatric Physical Diagnosis)"; Basil J. Zitelli and Holly W. Davis MD; 2007
- "Mayo Clinic Family Health Book"; Mayo Clinic; 2009