My child always walks on tiptoes! Is that normal?

Published by : | November 29 2019

A child who stands on tiptoe as soon as he is standing, who moves on tiptoe, who is unable to deposit heels on the ground must be evaluated by a physiotherapist in pediatrics. It is not normal for a child to not be able to drop the heels on the ground, or to deposit them very seldom.

Some children are more likely to walk on tiptoe, including:

  1. Child with motor development problem or speech difficulty.
  2. Cerebral palsy.
  3. Muscular dystrophy.
  4. Vertebral spine anomaly.
  5. Peripheral nerve disease.
  6. Club feet.
  7. Difference in leg length.
  8. Prematurity.
  9. TSA.

There is, however, a diagnosis of exclusion, that is, that cannot be explained by any reason.  This is the idiopathic toe walking! This diagnosis is usually posed when the child still walks on tiptoe after 2-3 years old without known etiology.  However, this child has been duly assessed and any medical causes that may explain this walking pattern have been ruled out.

As part of this discussion, we will focus on the different causes that can explain the tiptoe gait (equine), non-idiopathic, and which, in most cases, can be improved through exercises (stretching and muscle reinforcement).

First of all, the physiotherapy assessment has several elements including evaluating the muscular flexibility of your child’s calves.  If a stiffness is present, stretching exercises will be recommended and will be taught to you. Moreover, as the child tends to fix himself on his tiptoes, it is very common to see muscle weakness at the lower limbs, sensory-motor problems and balance disorders.

You can also see a delay in some motor acquisitions.

It is important to understand that walking on tiptoe can have impacts on your child’s musculoskeletal system and have long-term consequences, such as:

  1. Hypoplasia of Calcaneus.
  2. Shortening of the Achilles tendon (especially in periods of growth).
  3. Pain.
  4. Muscular imbalance (under-utilization of certain leg muscle groups).
  5. Increase in the frequency of ankle injuries.


What should I do if my child walks on tiptoe?

A pediatric physiotherapy assessment is recommended to know the cause behind the walk on tiptoes. The physiotherapist will be able to accompany you and direct you to the right approach to help your child adopt an optimal walking pattern.

In any case, you must not minimize the problem and believe that this “bad habit” will cease on its own!


Happy to help your child walk on the right foot!

Julie Lamarre

Physiothérapeute en pédiatrie More from same author

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