Toe walking in children

Overview

Toe walking, commonly seen in early walkers, usually resolves on its own as children mature. However, if it persists beyond toddlerhood, it may become habitual. Generally, as long as a child is progressing normally in growth and development, toe walking is typically not worrisome. Yet, in some cases, it may be associated with conditions like cerebral palsy, muscular dystrophy, or autism spectrum disorder.

Symptoms

Toe walking, characterized by walking on the toes or ball of the foot, should prompt a discussion with a doctor if observed in children beyond the age of 2. It is advisable to seek medical attention sooner if additional symptoms such as tight leg muscles, Achilles tendon stiffness, or lack of muscle coordination are present.

Causes

Toe walking typically develops as a habit when a child learns to walk. However, in some cases, it may be caused by underlying conditions such as:

• Short achilles tendon: This tendon, connecting lower leg muscles to the back of the heel bone, may be too short, preventing the heel from touching the ground.
• Autism: Toe walking has been associated with autism spectrum disorders, impacting a child’s communication and social interaction abilities.
• Muscular dystrophy: In this genetic disease where muscle fibers are prone to damage and weaken over time, toe walking may occur, especially if the child initially walked normally.
• Cerebral palsy: A disorder affecting movement, muscle tone, or posture due to injury or abnormal development in parts of the immature brain controlling muscle function can lead to toe walking.

Risk factors

Habitual toe walking, referred to as idiopathic toe walking, can occasionally have a familial tendency.