Walking on Toes

Did you ever get concerned about your little toddler walking around on his tiptoes all the time?

We used to wonder. We had one super toe walker, one non-toe walker, and one sort of in the middle. Now that we are on our fourth toddler, I have pretty much come to realize that toe walking is developmental and related to 1) self-stimulation and 2) muscle development. So you want a little, but too much or too little is a small sign that there might be a problem.

For my super toe-walker, we got a little concerned because he hit a phase where he was walking on his toes almost all the time. Compared to my medium toe-walker, my super- would walk around on his toes by default. And he didn’t grow out of it very much. My medium toe-walker went through a short phase where he seemed to be walking around on his toes a lot (as if he were excited to discover it). But a couple months later, he was only doing it when he was bored or really excited or needing to reach something. My super toe-walker had to be retaught to walk flat-footed and then constantly reminded in order to do it. Later he would go through phases where we’d have to remind him again for a time. He turned out to have a number of language issues as well as trouble imagining, self-directing, and knowing the rules of social convention.

Obviously the toe-walking didn’t CAUSE those problems, but it was a sign that he was overstimulated, possibly relating to his inability to converse or play in a higher-level way. But, he did acquire good muscle tone!

Another one of my good friends had a super-toe walker and he turned out to have an overstimulation problem, part of a sensory disintegration problem. But he had other hyper behavior, and was an unusually high-need child, whereas my own super toe walker was not. My child was high-need compared to my other children, but by three years old he was not still running all over the place all the time, getting into stuff, making weird animal noises, etc! (BTW I think tiptoe walking is especially common for boys because of higher levels of energy, stimulation needs.)

On the other hand, my non-toe walker didn’t discover the phase at all. I can’t recall seeing him walk around on his toes much… maybe he didn’t at all. He is now my sensory-disordered kid who has very low muscle tone, trouble reaching or extending his body, slight balance problems, and a hyposensitive (understimulation) problem.

Obviously the toe-walking (lack of it) didn’t cause that either, but it was a sign.

So look for a balance. Somewhere around 15-30 months the toe-walking starts, and it can seem a little overboard or strange… especially for boys because it looks kind of silly or even girly. It will stay strong for awhile but should begin to abate over the next year. Directed activity is sometimes the remedy if you sense your child is overstimulated.  If you sense that the toe-walking is becoming stronger, like the child’s default pattern—and especially if other unusual symptoms accompany the tiptoes (repetitive movements with the fingers/hands, or perhaps talking to oneself), then get it checked out by an occupational therapist. Early Intervention can catch it if the child is under 3, but I wouldn’t necessarily call for professional help before the child was 3 years old unless other symptoms were present and disturbing. And on the other hand, if you don’t see tiptoe walking at all by the time the child is four, consider encouraging it or beginning leg muscle exercises to work on muscle tone and balancing skills.

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14 thoughts on “Walking on Toes

  1. Pingback: Tippy Toes « Bottoms Up!

  2. That’s a really interesting article. I was Googling toe-walking because I was really worried about my little boy (16 months) who has started to do partial toe-walking – sometimes he just does it with one foot, sometimes just odd steps. It looks very strange! We were very pleased to see that, when he started walking, he had very solid flat feet as his older sister has walked virutally ‘en pointe’ since her first steps. She’s been checked out by docs and physios and she’s fine – and, as you said, she’s got fab muscle tone! – but, having read your article, it really ties in with her energetic, full-on, demanding personality. (She’s nearly 4 now and her dance teachers adore her!) I was worried that he seemed to be ‘regressing’ into toe-walking, especially as toe walking was what led to my friend’s son’s being diagnosed with Muscular Dystrophy. I had a look at the Echolalia article too – your pages are really informative and just what a hyper-worrier like me needs! I’m going to check everything here before I even start to worry in future! Thanks.

  3. Hello!
    I am a Christian mom too. I have two children, ages 2 and 3. My daughter was a super toe-walker. She was the worst case the children’s hospital here in Austin, Texas, had ever seen. She was not able to put her heels flat – even if we forced her foot with our hands. In this case, there is a real problem. The chidren’s hospital casted both her legs, and after three weeks, took them off. She has never toe-walked again. After being scared to death by various occupational and physical therapists that she had Autism, Sensory Integration Disorder, etc., the Neurologists at the hospital confirmed that she has mild Cerebral Palsy. For us, it was a big relief, although I have to admit, I’m still hypermindful of her development. Just wanted to add that in case anyone else is seeing what we did. It should also be noted that there are other more rare physical explanations when there is an extreme case of toe-walking.

  4. We have a super toe walker. He is now 6. He has been in PT for 2 years. Not much help. He can walk flat if he wants to. He does have sensory issues. Some he has outgrown. Shirt tags, certain foods, water tempeture seems hotter to him. Went to a MD today who prescribed casting. I am encouraged by Jennifer’s post. They also suggested the possibility of Botox in the calf to help in relaxing the muscle. Has anybody had experience with the Botox?
    Thanks, Mark

  5. Six is still young, especially for boys who sometimes need a year or two more in the developmental areas. Assuming that your son doesn’t have cerebral palsy like Jennifer, or some other syndrome (which is worth checking out), I think there is little harm in letting him outgrow it on his own without drastic measures (casting, Botox). It is better to try and convince him that it is worth trying to walk flat (intrinsic motivation) than forcing him to (externally). If he puts forth the effort, it will work longer than medical intervention.

  6. I, personally, walked on my toes until I was 12, non stop. Yet I’ve never had any disabilities. I could walk flat foot if I wanted to, but it was just a habit to walk on my toes all the time, and I didn’t stop until I was 12 and kids made fun of me, when I forced myself to break the habit. I still walk on my toes when I’m barefoot. I have no physical or mental disabilities, I’m just a normal girl who walks on her toes much more than most people. Just because a kid walks on their toes more often than normal isn’t a definite sign something is wrong. Just something that should be kept in mind.

  7. Toe-walking can also reflect vestibular or visual processing issues – a way to counterbalance what the person is perceiving in their visual-spatial field. It is more common in autism, but people without autism can also have vestibular and visual issues as well.

  8. Sensory Processing Disorder (SPD) can include the following areas: visual processing, vestibular processing, auditory processing, tactile processing, proprioceptive (body) processing, and olfactory processing (all are your 6, not 5, senses). A person can be hypo- or hyper- sensitive in one or more of these areas and it is not uncommon to see both extremes in the same family. If your child’s ability to function on a daily basis is impacted (you may be making adjustments for the child without even realizing it), then it warrants therapy. Early Intervention will resolve issues now so they don’t come out in other ways (academically/socially), later—-A Pediatric Speech-Language Pathologist with 10 years+ experience.

  9. I was a “super toe-walker” as a child. I learned to walk on my toes and never walked flat-footed. My pediatrician considered cutting my Achilles (this was quite a while ago!), but didn’t because I could flex my feet. I was probably around 12 or 13 when I made an effort to stop walking on my toes in public because I was made fun of.

    I never had any mental or physical disabilities. I excelled in gymnastics and ballet always did fine in school. I have 4 siblings, all very close in age, and, because I grew up in the midst of chaos, seem to tolerate “over-stimulation” better than most people.

    I know it’s hard, but try not to read too much into toe-walking.

  10. My son is 4. He’s very articulate and active. He’s also a tippy toe walker which drives me crazy. I try telling him over and over but he just can’t seem to get it right.

  11. This is a very different analysis on tip-toe walking, compared to all other stuff I’ve read. Does it only come from observation, or is it also based on theoretical research? I have a 19 mo toddler that is walking on tip toes around 30% of the time. In all other fields he seems to be falling within normal. I’ve read a lot of articles connecting toe walking to autism and I’ve been over concerned. Thanks for the article anyway. 🙂

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