So doctors might wait to see how the child does without treatment. If the toe walking continues, or if the child has a physical reason for toe walking such as tight muscles or tendons , treatment may include:. If your child is under age 2, your doctor may recommend coming back in a few months to check to see if the toe walking is getting better.
Reviewed by: Abigail S. Helms, PA. Orthopedics at Nemours Children's Health. Larger text size Large text size Regular text size. What Is Toe Walking? If your child's calf muscles are tight, or ankle motion is limited, you will be shown stretches to do at home with them. These stretches should be followed with activities to help them use their muscles in their new lengthened position. These exercises will be necessary and beneficial as long as your child demonstrates a tip toe walking pattern.
The exercises will vary with their age. The most important part of the exercise program is to remember to have fun with your child! Children who walk on their toes can develop tight calf muscles on the backs of their legs and have decreased movement of their ankles. In addition, the muscles on the front of their legs may become weak. If there is tightness and weakness, your child will have difficulty walking on their heels. Early identification of toe walking can help lead to the prevention of these muscle problems.
Wearing shoes may not correct toe walking. However, appropriate foot wear can help your child bring their heels further down. Most children outgrow it. Kids who continue toe walking beyond the toddler years often do so out of habit. As long as your child is growing and developing normally, toe walking is unlikely to be a cause for concern. Toe walking sometimes can result from certain conditions, including cerebral palsy, muscular dystrophy and autism spectrum disorder.
If your child is still toe walking after age 2, talk to your doctor about it. Make an appointment sooner if your child also has tight leg muscles, stiffness in the Achilles tendon or a lack of muscle coordination. Typically, toe walking is a habit that develops when a child learns to walk.
In a few cases, toe walking is caused by an underlying condition, such as:. Conservative treatment includes verbal reminders, stretching, heavy footwear, full-length orthotics, ankle foot orthotics, whole-body vibration , vinyl, carpet or gravel flooring , plaster casts to stretch the calf muscles, and injections of Botox into the calf muscles.
Surgical intervention has primarily focused on lengthening the Achilles tendon. At present, the best evidence supports plaster casts or surgery. Both of these treatments have shown the greatest improvement in the length of the calf muscles.
Yet one longitudinal study found that many children who had been treated with serial casts or surgery still continued to toe-walk for up to 13 years after treatment. Having multiple treatment options with varied success makes it hard for parents to choose the best treatment option.
Researchers agree that keeping calf muscles long enough to easily make heel contact with the ground is important for children who are diagnosed with idiopathic toe walking. There is also agreement that any child who is unable to get their heels to the ground at any time or continues to toe walk after three, should be assessed by a health professional. Do kids grow out of childhood asthma? Nightmares and night terrors in kids: when do they stop being normal?
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