Toe walking is a common gait abnormality, especially in children learning to walk. It is a pattern of walking where a child walks on the balls of their feet and their heels do not touch the ground.

Many children outgrow toe walking, while some continue to do so out of habit. In very rare cases, continuing to toe walk past age 2 could be a sign of an underlying medical condition. Some children begin toe walking later in life. This is often caused by pain in the muscles or Achilles tendon.

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What are the signs and symptoms of toe walking?

Toe walking is walking on the toes and balls of the feet. The exact cause of toe walking is unknown. In a small number of cases, toe walking can be a sign of underlying medical conditions.

What causes toe walking?

  • Inherited trait
  • Tight muscles
  • Short Achilles tendon
  • Neurological disorders
  • Neurodivergence (i.e., autism or ADHD)

How is toe walking diagnosed?

Toe walking is noted when a child walks on their toes and balls of their feet. Doctors may examine your child to check for underlying conditions or injuries. This may include a physical exam and a neurological exam.

How is toe walking treated?

In most cases, treatment is not needed after a diagnosis.

However, treatment may be necessary if an underlying condition causes your child’s toe walking. Non-surgical treatment options include:

  • Serial casting
  • Bracing
  • Botox therapy

Surgery is only necessary in more severe cases where walking flat-footed is not possible. Doctors at Connecticut Children’s can determine the right plan to treat your child’s toe walking.