Q: Why does our 2-year-old insist on walking on his toes?
A: When learning to walk, toddlers quickly discover that they have more control over their balance with their weight shifted slightly forward toward the balls of their feet.
Then, when they lose their balance, they can more easily fall forward and use their arms and hands to break their falls.
In the first few years of life, toddlers become experts at balancing (and falling) and they often rely on toe walking. Toe walking is normal for young children and shouldn’t cause concern unless a kid is unable to stand flat-footed at all.
Gentle exercises to stretch kids’ Achilles tendons can help ensure that tight muscles aren’t causing the toe walking.
Additionally, a hard-soled shoe that doesn’t allow much flexibility in the mid-foot area, can help minimize toe walking.
If you notice asymmetry with toe walking or a limp on one side compared to the other, you should discuss it with your child’s doctor.
Rarely, toe walkers may need help beyond stretching exercises or physical therapy, but when they do, casting their feet and ankles at 90 degrees may be recommended.
Even more rare are patients who need a surgical solution to manage their toe walking. Children who don’t outgrow toe walking by age 5 should also be referred back to their doctor for intervention. Neurodevelopmental evaluations should be considered in these cases.
Ask the Pediatrician column featuring Dr. Gigi Chawla, the Chief of General Pediatrics at Children’s Minnesota.
