How Can Physiotherapy Help with Toe Walking?
Does your child always seem to walk on their tiptoes?
You might be wondering, why does my child walk on their toes? Or should I be concerned? Many children go through a phase of toe walking, but if it persists, it’s important to understand why. As experienced paediatric physiotherapists, we’re here to explain what toe walking is, why it happens, and how Unbreakable Physiotherapy in Moorabbin can help.
What Is Toe Walking?
Toe walking occurs when a child walks on the balls of their feet without letting their heels touch the ground. Many young children do this occasionally, but when it becomes a habit, it should be assessed to determine the cause.
Why Does Toe Walking Happen?
In most cases, toe walking occurs without a clear reason. This is known as Idiopathic Toe Walking (ITW). While “idiopathic” might sound intimidating, it simply means that the cause is unknown, but the behaviour itself is well-recognised.
To confirm that your child’s toe walking is idiopathic, we first need to rule out any underlying sinister pathology. This process, called a “diagnosis of exclusion,” involves clinical assessment and, when necessary, collaboration with your doctor.
Most children naturally outgrow toe walking by the age of seven or eight when they become too heavy to sustain the habit. However, in some cases, toe walking has an underlying cause. This is referred to as Non-Idiopathic or Pathological Toe Walking, which is often linked to neurological or developmental conditions, sensory processing differences, or tightness in the calf muscles. It can sometimes be difficult to determine whether tight calf muscles are the cause of toe walking or a result of it.
How Can Physiotherapy Help with Toe Walking?
If left untreated, persistent toe walking can cause structural changes, which may eventually require medical intervention, including surgery. Over time, we often see children develop feet that are wider at the toes and narrower at the heel—a shape that resembles a Dorito. This can make it difficult to find properly fitting shoes and may lead to discomfort or self-consciousness.
Some children may require interventions such as calf muscle lengthening surgery or Botox injections to help relax overly tight muscles. However, physiotherapy can play a key role in preventing the need for such measures.
At Unbreakable Physiotherapy in Moorabbin, we use a comprehensive approach to help children with toe walking, aiming to prevent musculoskeletal complications and improve overall mobility. Our treatment plans may include:
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Stretching and strengthening exercises to improve calf flexibility
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Gait training to encourage a heel-to-toe walking pattern
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Sensory integration for children with sensory processing differences
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Bracing or orthotics when necessary to support proper foot positioning
When Should You Get Help for Toe Walking?
If your child is still walking on their toes past two to three years old, has tight calf muscles, or struggles to put their heels down at any age, a physiotherapy assessment is a great step forward. Early intervention can help prevent long-term issues with walking, balance, and muscle tightness.
In most cases, there’s no need for lengthy wait times or complicated referral pathways from your GP or local health service. We can help you right here at Unbreakable Physiotherapy at our Moorabbin clinic.
Book an Appointment for Toe Walking Today
If you’re concerned about your child’s walking, we’re here to help. Our paediatric physiotherapists at Unbreakable Physiotherapy can assess your child and create a personalised plan to support their movement.
Caserta AJ, Pacey V, Fahey MC, Gray K, Engelbert RHH, Williams CM. Interventions for idiopathic toe walking. Cochrane Database of Systematic Reviews 2019, Issue 10. Art. No.: CD012363. DOI: 10.1002/14651858.CD012363.pub2.
van Kuijk, A.A.A. et al. (2014) ‘Treatment for idiopathic toe walking: a systematic review of the literature’, Journal of Rehabilitation Medicine, 46(10), pp. 945–957. Available at: https://doi.org/10.2340/16501977-1881.