When children first learn to stand they often push up onto their toes as they have not yet learned what muscles to turn on and which to turn off. They turn on everything to get up against gravity into standing whilst building up their leg strength. With practice over the first few months of pulling to stand, they should learn to stand and step with their heels down and feet flat. Within six months of independent walking (walking completely on their own) their walking pattern should mature to look like ours, heel to toe pattern. Some children continue to walk on their toes for no reason and others due to changes in their muscle activity caused by neurological problems. Prolonged toe walking can make their calf muscles tight but also weak. This makes learning to balance, run, jump and hop difficult for your child. Prolonged toe walking can also make structural changes to your child’s feet affecting their shoe choices in the future. Preventing the calf muscle from getting short (tight) is very important, as late management requires serial casting to stretch the muscle out. Which is not much fun for anyone.
How can Physio help?
We will assess your child to determine the reason they are continuing to toe walk, assess their muscle function and overall functional ability (balance, coordination, sensation) that all contribute to ongoing toe walking. Following their assessment, we will teach your child exercise, activities and stretches that will improve their walking.
Please don’t take the ‘just wait and see’ approach as it can take longer to unpick these changes than to treat in the early years before strong habits and muscle changes occur.