Toe Walking in Children: what parents should know
By Natalie Sadek
Toe walking is a common concern we see in pediatric physiotherapy. Understanding why a child walks on their toes is the first step toward helping them move more comfortably and confidently.
What Is Toe Walking?
Toe walking refers to a walking pattern where a child consistently walks on their toes or the balls of their feet, without their heels touching the ground.
Toe walking can happen for many different reasons. Some common causes include:
Tight Calf Muscles: Shortened or tight calf muscles can limit ankle movement, making it difficult for a child to place their heels down during walking.
Neurological Conditions: Conditions such as cerebral palsy (CP) can affect muscle tone, strength, and coordination, which may result in toe walking.
Autism Spectrum Disorder (ASD): Toe walking is more commonly observed in children with ASD and may be related to sensory processing differences or motor planning challenges.
Increased or Decreased Sensation in the Feet:
Sensory hypersensitivity: Some children avoid heel contact because certain textures or pressure feel uncomfortable.
Sensory hyposensitivity: Other children seek extra sensory input and may walk on their toes to increase feedback from the ground.
Common Myths About Toe Walking
“They’ll just grow out of it.” While some children do stop toe walking on their own, persistent toe walking may indicate an underlying issue.
“Toe walking is always neurological.” Toe walking is not always caused by a neurological condition. Many children toe walk due to muscle tightness, sensory differences, or learned movement patterns.
“Nothing can be done unless braces or surgery are needed.” In many cases, physiotherapy alone can significantly improve toe walking especially when started early by addressing strength, flexibility, sensory processing, and movement patterns.
How Can Physiotherapy Help?
Step 1: Comprehensive Assessment
A physiotherapist will:
Take a detailed history, including pregnancy, birth, milestones, and daily routines
Observe the child during play, which often reveals patterns that aren’t obvious during structured testing
Perform objective assessments (such as range of motion and strength) to guide diagnosis and treatment
Step 2: Addressing the Root Cause
When appropriate, treatment focuses on the underlying cause of toe walking (except in primarily neurological cases, where the focus is on optimizing function).
Physiotherapy may include:
Guided play activities that naturally encourage heel contact
Strengthening weak muscles that support healthy walking patterns
Stretching tight muscles, particularly in the calves
Sensory-based strategies to help children with hyper- or hyposensitivity
Movement retraining to build healthier, more efficient patterns
Book a Pediatric Physiotherapy Assessment
If you’re concerned about your child’s walking pattern, a pediatric physiotherapy assessment can provide clarity, reassurance, and a clear plan forward. Our physiotherapists use play-based, child-friendly approaches to understand your child’s unique needs and support healthy movement development.
Contact us today to book an assessment in our East or West end clinics with out pediatric physiotherapists, Alexia or Natalie.