By Katie Howell, PT, DPT

Children first learning to walk will sometimes go up onto their tip toes as they experiment with bearing weight through their feet. This can be typical up to about 2 years of age as kids gain strength and balance and their lower body alignment shifts. But how do you know when toe walking is a problem and when to seek therapy?

There are a variety of reasons why a child might be up on their toes. Most often, this is at least initially the result of some sensory concern. Sometimes the bottom of the child’s feet might be very sensitive, and they go up onto their toes when barefoot to avoid touching the ground. This may be the case if your child does not like being barefoot, dislikes surfaces like grass, and/or toe walking changes depending on the floor surface. A child may also toe walk due to a problem with the vestibular system (inner ear balance system), which may cause them to feel insecure when upright, on higher surfaces, and when performing motions like spinning/swinging. Additionally, the grasp reflex in the foot may still be active, causing the child to go up onto his/her toes.

If you notice sensory concerns with your child who toe walks and your child is still very young, it may be best to begin with Occupational Therapy. An Occupational Therapist (OT) can help address any underlying sensory concerns, which will decrease toe walking. If your child is a little older, has lost a lot of ankle range of motion, and can no longer walk with heels striking the ground, it may be best to begin with Physical Therapy. A Physical Therapist (PT) can help your child gain back range of motion, improve strength, and re-teach him/her how to walk with the correct pattern. Additionally, a PT can help pursue getting ankle/foot orthotics if recommended.

If you are at all concerned about your child’s toe walking, please call 208-323-8888 to schedule an evaluation. Our therapists be happy to assess and determine if therapy is appropriate.