Toe Walking in Children: Causes, Risks, and How Occupational Therapy Can Help
As an occupational therapist, one of the common concerns I see in kids is toe walking. While some children outgrow it, persistent toe walking can have several underlying causes and, if left unaddressed, may lead to complications.
What Causes Toe Walking?
Toe walking can be attributed to several factors:
Muscle Imbalances – Weakness in the muscles that help keep the feet flat, like the calf muscles, can cause children to walk on their toes.
Sensory Needs – Some children may have reduced proprioception (body awareness) and toe walking becomes a way to get extra sensory input.
Habitual Toe Walking – In some cases, it’s simply a habit that has developed over time.
Why It’s Important to Address
Persistent toe walking can lead to:
Muscle shortening or contractures
Foot and ankle pain
Changes in posture and gait, which may affect knees, hips, or lower back
Increased risk of falls or injury
How Occupational Therapy Helps
Occupational therapy can support children with toe walking through fun, engaging activities that address both the physical and sensory aspects of the condition. Here are a couple of ways I work with kids in therapy:
Balance Beam Activities
Encouraging heel-toe walking on a balance beam helps promote a normal gait pattern. I sometimes add a medicine ball to incorporate more sensory input through the hands, encourage grounding, and provide heavy work, which can help regulate the sensory system.Incline and Stretch Activities
Using a bolster or treadmill incline stretches the muscles responsible for keeping the feet flat. I also integrate visual-motor activities, like catching or throwing a ball, to make the exercises fun while supporting coordination and body awareness.
Supporting Your Child at Home
Alongside therapy, simple strategies at home can help reinforce these skills:
Encourage barefoot walking on soft surfaces when safe
Use games that involve balance and coordination
Practice activities that provide proprioceptive input, like climbing stairs or carrying weighted objects
