Tip Toe or Toe Walk? The Lowdown on Toe Walking-Is It Normal?

Authored By: Sarah Kleinman, PT, DPT, Physical Therapist at The Village Therapy Place

What is toe walking?

Toe walking is observed when a child walks on the balls of his feet and his heels do not contact the ground while walking. Toe walking may present like walking on tip toes. However, toe walking is more persistent and can be a sign or symptom of something bigger going on with a child.

Why does toe walking happen?

Toe walking can occur for a variety of reasons and can be determined under the guidance of a pediatrician, specialist, physical therapist and/or occupational therapist.

Toe walking can be idiopathic in nature. Idiopathic toe-walking means there is no known reason; the child does not have any other medical diagnosis that would cause the child to walk this way.

A few potential factors that may contribute to toe-walking include:

  • difficulty with processing sensory information through a child’s feet and/or legs

  • muscular tightness and/or weakness

  • poor bony alignment

  • nervous system involvement.

Toe walking can also be associated with several diagnoses including cerebral palsy, muscular dystrophies, autism spectrum disorder, and global developmental delay.

When is toe walking a concern?

While toe walking under the age of 3 can be considered a typical gait deviation, toe walking should not occur the majority of the time. If toe walking is present frequently in a pre walker or new walker, a consultation with a physical therapist can help to assess the cause. The physical therapist will provide strategies to address the issues contributing to the toe walking and prevent the toe walking from becoming a habit. Additionally, the physical therapist will also screen for any orthopedic or neurologic concerns that may be causing the toe walking.

Once a child has been walking for a few months, if she is walking on her toes the majority of the time, this is not a typical variation. Toe walking that persists past 3-years-old will often require longer and more intensive treatments.

Who We Are:

We are The Village Therapy Place, a multidisciplinary pediatric therapy center located in Wyckoff, NJ- in Bergen County. We aim to provide integrative, neurodevelopmental, individualized, pediatric therapy in a warm, fun, and collaborative environment. 

We offer pediatric services that include physical therapy, speech therapy, occupational therapy, feeding therapy, and DIR Floortime.  

 At The Village Therapy Place, we utilize current and evidence-based treatment techniques to help treat your child during his PT, OT, speech therapy, feeding therapy and DIR Floortime session. These include sensory integration, reflex integration, therapeutic listening, Kinesiotape, craniosacral therapy, NDT, BrainGym, feeding therapy, PROMPT, to name a few. 

Our expert pediatric therapists offer a variety of treatment options, including 30/45/60 minute sessions, group classes, at home sessions and virtual therapy to best suit your child’s needs. 

 The pediatric physical therapists, occupational therapists & speech therapists at The Village Therapy Place are in constant contact with a child's caregivers to facilitate lasting change. 

Call us today at (201) 201-8220 or email us at office@thevillagetherapyplace.com to speak with a pediatric expert who will help your child thrive!