Toe walking—when a child walks on the balls of their feet without their heels touching the ground—is common in early walkers. For many toddlers, it’s part of exploring new movement patterns. However, if toe walking continues beyond age two or occurs without ever walking heel-toe in those early walking days, it may be time to consult a pediatric physical therapist.
How Pediatric Physical Therapy Can Help
A physical therapist will assess a child’s muscle flexibility, motor coordination, balance, and sensory responses of the whole body, and treatment may include: stretching and strengthening exercises, balance and coordination activities, sensory and primitive reflex integration strategies, gait training, and collaboration with other specialists (occupational therapist, developmental optometrist, orthotist, etc.) if needed. Because toe walking does not usually have one single cause, treatment is rarely solely focused on the feet and a trained pediatric physical therapist will incorporate activities and recommendations from several angles.
Activities To Try At Home
While we recommend reaching out to a trained provider if toe walking is a concern, here are 5 activities your child can do at home while you’re lining up a professional consultation.
- Squats: Encourage your child to perform deep squats on flat and squishy surfaces (couch cushions, pillows, etc.). While keeping their heel in contact with the floor, your child will get a passive stretch and work on strengthening their ankles, legs, and hips at the same time!
- Stairs: If you watch closely, going up and down the stairs are great ways to stretch and strengthen the ankles. On the way up stairs, encourage your child to lift their toes as they clear the step as a way to strengthen their front ankle muscles. On the way down stairs, suggest they focus on keeping their heel on the step above as long as possible to give a gentle stretch.
- Bear Crawls: This movement combines coordination, strengthening and stretching all in one! It’s a total body exercise that improves strength to the trunk, upper body, and lower body, while also stretching the lower body. Give them a challenge to bear crawl on couch cushions or even up hills!
- Walking with Swim Flippers: Swim flippers are more than just pool toys! Walking in these at home can strengthen the front ankle muscles and encourage your child to walk with their heels in contact with the floor.
- Scooter Board: This is one of my favorite activities, and the kids too! Remember those scooter boards from gym class - yes, I am talking about those (although a skateboard will work too). Have your child sit on the scooter board and pull themselves forward by digging their heels into the floor. This strengthens the front ankle muscles, provides a gentle stretch, and is so fun!
When To Seek Help
If your child consistently toe walks past the age of two, has difficulty walking flat-footed, or you notice muscle tightness, coordination challenges, or sensory concerns, early evaluation is key. With timely intervention, many children can develop a typical walking pattern and avoid long-term complications. And, if you are local to the Dallas area, reach out - we'd love to be a resource for you!
