By Heather Cruz, SPT Graduate Student
Toe Walking and Exercises to Try at Home
Toe walking is defined as walking on the balls of the feet or on the toes, where the heel never contacts the ground. This is a typical pattern of walking as children are learning this skill and usually develop a normal gait pattern by 2 to 3 years of age.
Toe walking is often associated with neurological disorders including Autism, Cerebral Palsy, Duchenne Muscular Dystrophy, and language delays, but can also be idiopathic. There are three common reasons for this, increased muscle tone or tightness, protective reflexes that are still intact, or sensory seeking/avoiding behaviors.
Sometimes toe walking is inconsistent and might only occur on certain surfaces (i.e. carpet or grass) or at seemingly random times throughout the day. This might be happening out of habit or a sensory avoiding behavior. If you are noticing that your child never seems to walk with their heels on the ground and they are past the age of 3, this may be a sign that conservative treatments are required and you should seek a referral from your pediatrician for a PT evaluation. The physical therapist will conduct a thorough evaluation and provide a treatment plan to improve gait mechanics.
Conservative treatment options include strengthen and stretch muscles in the legs orthotics or night splints, changing footwear, serial casting, gait retraining to help promote a more normal gait pattern, and Botox injections in the tightened muscle area.
Strengthening:
Bear Crawls
Place puzzle or game pieces on one side of the room and have them walk like a bear to go put it on the puzzle or game board.
Duck Walks
Have your child race you or another kiddo while walking on their heels to see who can get to the finish line first.
Pushing a Toy Across the Floor
Use a large toy car or a box and have your child push the object to the other side of the room to see how fast they can do it.
Pillow Scoots
Sitting on a large pillow or stuffed animal, have your child scoot themselves around the room. Try to have them use their heels to scoot themselves forward.
Active Range of Motion:
Stepping Down off a Step
Using a step stool or the bottom step of your stairs, have your child step down making sure they land with a flat foot.
Walking Backwards
Have your child race you or another kiddo and see who can get to the finish line first while walking backwards. Make sure their feet stay flat on the ground.
Stretches:
Calf/Hamstring Stretch
Have your child place both hands on a wall and stagger their feet, making sure that their heels stay on the ground, and hold for a few seconds on each side. OR have them with their feet on the wall and legs straight playing with a toy, holding for a few seconds.
If you believe your child is presenting with signs of toe walking without resolution please seek out a referral to physical therapy from your pediatrician and try out these exercises in the mean time. We would love to hear your thoughts on what exercises worked best for your family!
