How many of you have kids that walk on their toes? This can be normal for children still learning to walk, but should be gone by the time they are 2-3 years old. If your child is 3 or older and is still walking on their toes, I would recommend speaking to your pediatrician about seeing a PT for the issue.
Issues Caused by Toe Walking
If a child continues to walk on their toes, it can lead to a shortening of the Achilles tendon and calf muscles as they grow, making it even more difficult for them to correct later in life.
If the toe walking persists until they are 5-6 years old, it can also lead to a hardening of the joints in the feet in the wrong position. I have a current patient that this has happened to. He is 7 years old and the joints in his foot do not move the way they were intended, making him run incorrectly.
When children continue to walk on their toes and if it is not corrected with parent help or with PT, surgery is performed. I am not a surgeon and therefore won’t get into the specifics. However, my advice is to avoid surgery at any cost!
Here are some activities and exercises you as parents can perform with your children to improve their walking style.
Stretches
Parent stretching calves: 1st picture: Have child’s legs straight and push feet so the toes go back towards their nose. 2nd picture: Bend child’s knee and perform same stretch. These subtle differences stretch 2 different muscles of the calves.
Standing Calf stretch: Have child place feet about 1-2 feet away from the wall. Put their hands on the wall. Now instruct them to put their nose to the wall while keep their heels flat on floor.
During these two stretches, the child should feel a “pulling” in the calves or back of the lower leg. Usually, I recommend hold stretches for 30 seconds. But for young children performing the stretches for 10-15 seconds 5-10 times will be sufficient.
Walking activities:
Stepping over a hurdle or object with heel-toe pattern: when they step over the hurdle, have them put their foot down heel first then on the toes.
Tandem walking: have them walk about 10 feet with the heels touching the toes on each step.
Heel walking: have the child walk about 10 feet with their toes lifted up.
Usually when giving these exercises to a child, I have them perform 2-3 laps of each one.
Other exercises:
Single Leg Stance: 5 times holding about 10 seconds. Have child try to balance on one foot. This will force them to stand flat footed.
Lifting up objects with feet: about 10 times on each foot. Have the child lift their toes in the air, put an object on the foot, and have them put the object into a container.
First Day of PT
On the child’s first day of PT, I will perform an evaluation and determine which exercises need to be performed. I will also give the families “homework”. This homework is a home exercise program and should not take more than 15 minutes to perform. The above exercises and stretches are some of the exercises I will give to parents. I ask that the exercises be performed at least one time a day.
It is also important for you as a parent to continuously remind your child to walk with their feet flat instead of on their toes.
Most children will be seeing results within 1-2 months of coming to see me. But understand that by the time they are needing PT help, it may take longer. So, you should see your child walking better within that same time frame if the exercises are being performed regularly (once a day).
And once your child is not needing you to remind them about walking with their feet flat then they will no longer need to perform the exercises.