Toe Walking – Should I be concerned?

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As parents, you likely remember or eagerly anticipate your child’s first steps as they begin their journey from crawling to walking and exploring from a different vantage point. Along with the feeling of excitement, you also likely feel a bit nervous at the probability of his discovering some or many of your prized possessions now at his reach.

Most children begin walking between 12 and 14 months and continue to improve with their mobility and balance in the following months. During this time, there are many subtle changes in foot and body alignment and how the child walks; all of these subtle changes encourage the strengthening of various different muscles at different stages of development.

The next few months of your child’s journey on his feet are crucial to healthy development of bones, muscles, and joints. This will allow the body to handle the various activities common to children such as running, jumping, kicking, riding a bike, and even falling; these activities along with the value of a healthy body will enable your child to continue participating in various physical activities through adolescence and teenage years.
During the age of one and two, a child will demonstrate the typical phase of toe walking but should outgrow this phase by three years of age. This stage could also persist and impede healthy development of muscles, bones, and joints. What are warning signs of a possible problem?

• Walk on toes on both feet more often than with feet flat on floor
• Constantly balancing on their toes
• Can stand on flat feet when prompted
• Walks with straight knees
• Often have a family history of toe walking
• May have tight leg muscles

In some cases toe walking will be resolved on its own but it could persist several years. Many healthcare professionals may recommend allowing it to resolve on its own but is this the best solution for your child? What are the adverse effects if this persists?

• Weak postural muscles as the child grows
• Tight leg muscles
• Weak ankle, leg and postural muscles
• Child may have balance problems, increasing the frequency of falls
• Difficulty keeping up with peers in physical activities as the child grows
• Higher risk for knee and ankle injury when child is older
• Decreased endurance with walking or running long distances

Early intervention, as soon as signs of persistent toe walking are noticed, can help your child move past this stage of development and continue progressing throughout his/her life. If during the toe walking phase you notice excessive time on toes and/or an increase in leg muscle tightness, do not hesitate in contacting a physical therapist or speak with your pediatrician.

A physical therapist can evaluate and assess your child’s needs and provide an individualized treatment plan. This can consist of stretching and strengthening activities along with family education including a home exercise program.

We look forward to assisting you and your child in reaching their maximal potential

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