What are the symptoms of toe walking?
The main and most noticeable symptom of toe walking is your child walks on their toes and balls of their feet. When asked to walk in a regular, flat-footed pattern, most young children can do so. But if your child continues to walk on their toes, you may also notice:
- Decreased balance and coordination.
- Frequent falls.
- Problems wearing shoes.
- Difficulty participating in sports or other recreational activities.
- Complaints of pain.
- Difficulty heel walking (walking with their toes up in the air).
- Tightness in their heel cords.
Why do kids walk on their toes?
In most cases, persistent toe walking is an idiopathic condition. That means the cause is unknown.
A shortened Achilles tendon (equinus deformity) may cause toe walking. Your calf muscles merge at the base of your calf, where they turn into your Achilles tendon. Your Achilles tendon then joins your heel bone. When you use your calf muscles, your Achilles tendon pulls on your heel.
In some kids who toe walk, this muscle-tendon combination may have been shorter at birth. (This isn’t typical unless your child has a club foot or other congenital bone deformity.) It may also shorten over time. This can prevent your child from touching their heels to the ground and walking flat-footed, which is problematic and abnormal.
Some older children who toe walk may be doing it out of habit. They may also be doing it because the muscles and tendons in their calves have tightened over time. This makes it painful to walk in a heel-to-toe manner (normal gait mechanics).
In very rare cases, toe walking may be a sign of an underlying medical condition. These conditions may include:
- A brain disorder, such as cerebral palsy.
- A muscle or nerve disorder, such as muscular dystrophy.
- A spinal cord abnormality.
- Autism spectrum disorder (ASD).
Toe walking with autism
Toe walking happens more frequently in children with autism spectrum disorder than in children who don’t have ASD. One large study found that 9% of children on the spectrum were toe walkers. The same study found that less than 0.5% of children without an autism diagnosis were toe walkers.
The causes for this increased rate are unclear because there’s no direct link between autism and toe walking. It may be that tightened heel muscles restrict the range of movement in your child’s ankles.
Toe walking with autism may also be sensory-related. Many children with autism have a dysfunctional vestibular system. The vestibular system is responsible for providing your brain with feedback about motion, position and spatial orientation. It may be responsible for toe walking. Scientists need to do more research to understand how sensory processing may cause toe walking in children with autism.
Toe walking in adults
Some people walk on their toes into adulthood. They may have tried to correct their toe walking as a child but never outgrew it or treatment was ineffective.
Other times, walking on your toes as an adult begins for unknown reasons. Certain health conditions affecting your feet can sometimes cause toe walking. Corns, calluses and peripheral neuropathy may all cause toe walking.
