A guide for parents about toe walking (walking on tip-toes)

Why is my child toe walking?

Many children walk on tip-toes. This is a normal part of their development. It is more common in boys and it can sometimes be seen in several family members.

When does it occur?

It is common for children aged between 10 and 18 months to walk on tip-toes when they are learning to walk as it helps with their balance. Some children continue this up to the age of six or seven, where it usually resolves naturally. However, a small number of children may continue to walk this way as they get older.

Does it cause pain?

Walking on tip-toes does not usually cause any pain or discomfort and it does not result in any type of deformity. However, it may lead to tightening of the calf muscles and shortening of the Achilles tendon, which can lead to your child being unable to put their heel to the ground. Children are able to walk, run and jump on their toes without any problems.

What causes it?

The cause of toe walking is unknown and is possibly due to habit from a young age. This can be identified if your child is able to put their heel to the ground when standing. Sometimes children can walk with their heel to the ground for short periods if asked to. In this case simple calf-stretching exercises are required to help prevent the calf muscle from tightening. A heel raise insole may be provided to encourage your child to place their heel on the ground, the height of which will be gradually reduced over time.

How is it treated?

In a very small number of cases tip-toe walking can be due to underlying causes such as congenital tightness of muscle, neurological or development issues. In these cases it may be necessary to provide treatment such as physiotherapy and bespoke footwear or insoles. In severe cases it may be necessary to provide botox injections, casting or surgery.