Physio 101: Toe Walking in Children and Adults
Toe walking occurs when a person walks on the balls of their feet, or “tip toes,” rather than walking using their whole foot. When the cause of this abnormal gait (walking pattern) is unknown, we refer to it as idiopathic toe walking.
This condition is relatively common in small children and should resolve itself by ages 2 to 3 years old. However, in some cases it will not.
Toe walking is sometimes caused by muscle tightness (particularly in the calf), joint stiffness, problems in gait development, growth spurts, or genetic/neurological conditions. It will often lead to pain in the feet and lower legs and tightness in lower extremity muscles while walking and sitting. While less common, the same symptoms occur in adults who experience this condition. Muscle tightness in the calf is the most common symptom of toe walking.
If your child’s case of toe walking does not resolve itself naturally, it can cause problems later on in life, such as painful biomechanical issues, shortened muscles, and increased risk of ankle injury. In order to prevent these larger issues from happening, it’s best to professionally address toe walking if it’s still occurring after two to three years of age. If this is the case for your young one, seeing a physiotherapist can help.
While toe walking typically affects children, it can sometimes affect adults.
In some cases, an adult carried this abnormal gait through to adulthood after corrective measures were ineffective in childhood. In other cases, the toe walking may be due to various foot conditions, such as a calluses, corns, or a loss of sensation in the feet.
The impact of toe walking in the long term is the same. You may find your calf and other muscles tightening and walking with a flat foot may become difficult and result in cramping, particularly over extended periods of time.
If you toe walk most of the time, you may have problems wearing shoes comfortably or engaging in recreational activities that require special footwear, such as roller skates. You may also find you fall more easily.
There are a variety of exercises that can be performed by both children and adults to reduce the symptoms of toe walking and help to re-establish a normal gait.
It is recommended that your child have an assessment with a physiotherapist if toe walking has persisted after the age of three. If you choose to work with one of our licenced physiotherapists, you or your child will be individually assessed and provided with exercises(play-based for children), advice, and other tools that are tailored to your specific needs.
If you are not ready to see one of our professionals, we recommend trying these exercises to help stretch and strengthen the lower legs.
In a standing position, hold on to a table, chair, or wall for support and step one leg back behind you. Keep the heel of the back leg on the floor and the toes pointing forwards. Bend the front knee, moving your body forwards, until you feel a stretch in the back of the calf.Make sure your heel does not come off the floor and your back knee does not bend. Hold this gentle stretch for 30 seconds to a minute. Perform 3 times on each leg, 2 times a day.
Stand on one leg close to a wall or countertop. Try to balance as still as you can. Hold this position for as long as possible. Do not allow the other leg to rest on the stance leg. Try to hold this pose for 30 seconds without hand support. Do this 3 times on each leg once a day. As this gets easier hold for longer times or try standing on a pillow. (Make sure you have something close by to grab on to that will not move if you feel like you may lose you balance—like a countertop!)
Stand up straight and lift your toes off the floor as high as you can. Walk forwards, balancing on your heels only, keeping your toes up. Walk across your room and back like this 10 times, taking breaks as needed. Perform once per day.
None of these exercises should be painful. If you feel pain while attempting, stop and contact your physiotherapist to ensure they are being performed correctly.
Before we dive into a physiotherapy regimen, we’ll perform a thorough assessment of your or your child’s legs and feet. Here, we’ll evaluate activities such as walking, running, jumping, and getting on and off of the floor. We’ll look at the range of motion and decide whether or not additional support is needed. At Capture Therapeutics, we have a Licenced Pedorthist on staff, and if other specialists are needed, we liaise directly with your family doctor to have referrals sent.
Physiotherapy for toe walking involves retraining the muscles for a normal gait pattern. We’ll strengthen musculature around the hips and legs to make controlled movements and shift weight comfortably and properly as steps are taken. We’ll focus on balance, stretching, and strengthening the muscles to increase the range of motion at the ankle, increasing the size of steps, and stimulating nerve pathways by breaking the gait cycle down into more manageable chunks and practicing repetition.
Your physiotherapist may also feel it’s appropriate to add hydrotherapy as part of the rehabilitation process. With hydrotherapy, exercises are performed in warm water, helping to relax the body as you engage with each movement. This can ease any pain you or your child may have with walking on flat feet as the water provides buoyancy. It also improves circulation in your legs as you work through your regimen.
Get started with one of our dedicated physiotherapists today by calling 1-833-U-R-HEARDor booking an appointment with our online booking tool here. Our therapists are comfortable working with people of all ages, developmental levels, and special needs. No matter where you’re at, whether you’re a parent of a child suffering or you’re an adult suffering with this condition, we look forward to helping you and your family overcome the frustrations of toe walking and getting you back on your feet as soon as possible.