Toe-walking can be normal, all children will try out walking on their toes during their development. If you see your child walking on their toes less than 25% of the time, chances are they are experimenting with walking on their toes. If your child is walking on their toes the majority of the time but stands flat footed, you can consider them a toe walker. It is important to discuss any concerns with your pediatrician but these explanations will give you some of the most common causes.
- Proprioceptive input: When your joints move, a ligament or tendon is stretched. Receptors in the ligaments and tendons respond to the stretch by sending a message to the brain. Your brain then sends a message to the appropriate muscle to control that movement. If someone has “loose ligaments” sometimes that feedback does not get to the brain in time and the person will stumble or fall before the muscles are activated to prevent it. As a result some children will avoid the stumbling by walking on their toes.
- Tight Muscles: A child may have tightness in their calf muscles (i.e., the Gastroc /Soleus complex). This can happen as a result of keeping their feet plantarflexed (toes pointed) or because the bones are growing faster than the muscles during a growth spurt. If the Gastroc is tight, it pulls the heel upward toward the back of the knee making it difficult to get the heel on the ground, which can make walking challenging. You can stretch the Gastroc and resolve the issue. The hard part is to break the habit of walking on the toes.
- Sensitivity: A child may have sensitive feet. The tactile input from the feet (sensations they feel from the receptors on the bottom of their feet) can be significantly bothersome to certain children making them prefer to walk on their toes to decrease this input. A child with tactile input issues may be up on their toes on some surfaces or when their shoes are off but may be flat footed on other surfaces. However, the child could be up on their toes all the time.