Idiopathic Toe Walking

Is toddler toe walking a cause for concern?

By Beth M. Iovinelli, RN, BSN, IBCLC

Q: My toddler is walking on his toes a lot. Our pediatrician says this is very common, but is requesting he see a physical therapist. What causes "toe walking" and when should we be worried?

A: Up until the age of 3, this kind of behavior can be considered "normal" as children are learning to walk and do a fair amount of experimenting.

What begins as a fun way to get around can turn into a habit, though, and a cause of concern for many parents. This habitual tippy-toe walking is referred to as idiopathic toe walking.

There are instances, however, when toe walking may have a physical cause. The most common cause of toe walking (aside from habit) is having a tight or short Achilles tendon. The Achilles is the tendon located just above the heel and it enables you to point and flex you foot.

Other things that may contribute to toe walking include, but are not limited to:

• Muscular dystrophy
• Spinal cord abnormality
• Cerebral palsy (especially if your baby was born prematurely)
• Learning disorders

If you notice your child walking like this, play some games with him to try to encourage him to walk flat footed. Try having him copy you and exaggerate your heel-toe walking. Make it fun and hopefully he will grow out of the habit!

Your pediatrician may refer you to a physical therapist, who will evaluate your child. If everything appears to be normal, the PT may simply suggest more games and activities to encourage "normal" walking. If the tendon is indeed tight, stretching exercise will be suggested.

Don't hesitate to speak with your pediatrician about any concerns you might have.

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