Toe Walking for the Orthopedic Patient

What is toe walking?

Toe walking is when children walk up on their toes and do not place their heels flat on the floor.

Why does my child walk up on their toes?

Some children walk up on their toes when they first begin to walk. If your child is developing normally and meeting developmental milestones on time, but toe walking, they will usually be called an idiopathic toe walker. This means that there is no medical reason your child walks on their toes.

Some children are born with tight heel cords which cause them to toe walk. Other children have a neurological reason for walking up on their toes. Yet another group of children have sensory issues that cause them to walk up on their toes. Your child may be referred to a neurologist or developmental pediatrician for an evaluation to look for an underlying neurologic or sensory cause for toe walking.

Will my child be able to play sports if they toe walk?

Yes, your child may play sports.

What will happen if the toe walking is not treated?

Toe walking can lead to discomfort, ankle injuries, and self-consciousness around classmates and peers. It could be a sign of other underlying problems.

Does toe walking cause pain?

Toe walking is an awkward way to walk and run. Therefore, children may tire more easily and complain of some foot and leg pain.

Is there a treatment for toe walking?

If toe walking does not get better on its own, medical evaluation can help determine the cause and if treatment is necessary.

How is toe walking treated?

The following treatments may be recommended:

• Home stretching exercises to be done daily.

• Physical therapy with daily home stretching.

• Night braces to maintain the stretched position during sleep.

• Serial casting – a walking cast is put on each week to gradually stretch the Achilles tendon.

• In very resistant cases, surgery to lengthen the Achilles tendon.

Will my child need surgery?

Most children are treated without surgery. Surgery may be considered when other treatments are not successful.

Division of Orthopaedics

Weekdays:

215-590-1527 if your cast was placed in our Philadelphia, Princeton or Voorhees sites.

If your cast was placed in our King of Prussia office, call 215-590-6919.

Nights, weekends, and holidays:

Call 215-590-1000 and ask the operator to page the orthopedic resident on call.

Reviewed April 2024 by Beverly Teti, CRNP