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Keeping you, not your baby, on your toes

Updated: Jun 22

What you need to know about Toe Walking


What is Toe Walking?

Toe walking or walking on tippy toes is referred to as walking on the toes without letting other parts of the foot touch the floor.


From normal to abnormal

Toe Walking is considered normal up until the age of two. During the first learning phase of walking, babies tend to walk on their toes. This helps babies to start the process of walking. By putting the tips of their feet on the ground and avoiding the heels from touching the floor, babies learn to balance their gate. However, should toe-walking continue beyond two years, this may be detrimental for your child.


What Causes Your Baby Toe Walk?

The following can be the causes behind your baby’s toe walking.



Health-related Causes:

  1. Normal developmental phase of walking: when your baby is learning to walk, toe walking helps the baby balance his/her position while walking, which is normal up until two years of age.

  2. Any disorder that influences movement or muscle development can be a cause of toe walking.

  3. Disrupted muscle tone or posture caused by any injury can increase the risk of toe walking.

  4. Abnormal development in any part of your baby’s brain linked with body movement can result in toe walking.

  5. Tight calf muscles (lower leg muscles) can result in toe walking.

  6. A tight Achilles tendon (the tendon that connects calf muscles to the heel) may also cause toe walking.

Lifestyle Causes:

  1. Your baby can keep on toe walking if you force him to walk when he is not yet ready.

  2. Use of poorly designed seating products and incorrect height adjustments.

How can Incorrect Walking Assisting Product Use Contribute to Toe Walking?

If positioning in a baby walker forces the baby to walk on their toes, this may reinforce toe walking as a habit. If babies are forced to walk on their toes for an extended time, it may lead to tight calf muscles or shortened Achilles's tendons. While putting your baby in a walker, jumper, or activity center, make sure his/her ball and heal of their feet touch the ground. This enables healthy development of gate and balance with their feet flat on the ground when learning to walk.


Symptoms of Toe Walking

The most common symptom of toe walking is an abnormal gait with an increased tendency to fall due to decreased coordination between the leg muscles and the brain. If your baby shows signs of an abnormal gait which includes them pushing themselves up onto the ball of their feet, keeping their heels off the ground, and difficulty maintaining their balance, then this is likely to be toe walking.



Being a Parent, How to Deal with it in the First Place?

Ensure you identify and address the lifestyle causes:


  • Let your baby decide when they want to learn to walk – some babies start earlier and some later. Don’t use walking aids until the recommended age and developmental milestones have been reached. Please consult reputable sources and product manuals to assist with this information.

  • Ensure the seating products you use allow correct feet placement and height adjustment to prevent toe-walking and correct postural development


If you are concerned that toe-walking is abnormal in your baby, then you need to seek professional help in determining the cause. The cause, as stated, could be health-related or lifestyle related. Note that a lifestyle related cause could become a health-related cause if left too long.


Usually, your first port of call will be your family doctor, or paediatrician. They should be able to determine the cause or refer you to another member of the healthcare team to assist with this and the treatment plan.


Final Takeaway!

If you notice your baby walking on his toes when he/she is older than two years, don’t wait until he/she developed the habit of walking on his/her toes. Consult your Healthcare practitioner for guidance. This condition is mostly easy to treat when identified in the early stages of development. Taking the advice that your doctor provides and doing the different activities and exercises can help your baby walk on his heels along with his toes.


References

Sala, Debra A; Shulman, Lisa H; Kennedy, Rose F; Grant, Alfred D; Chu, Mary Lynn Y (1999). Idiopathic toe-walking: a review. Developmental Medicine & Child Neurology, 41(12), 846–848. doi:10.1017/s0012162299001681

Oetgen, M. E.; Peden, S. (2012). Idiopathic Toe Walking. Journal of the American Academy of Orthopaedic Surgeons, 20(5), 292–300. doi:10.5435/jaaos-20-05-292

Lisa H. Shulman; Debra A. Sala; Mary Lynn Y. Chu; Patricia R. McCaul; Bonnie J. Sandler (1997). Developmental implications of idiopathic toe walking. , 130(4), 0–546. doi:10.1016/s0022-3476(97)70236-1


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