Tippy Toes

Toe walking is the failure of the heel to initially contact the floor while walking. There are a variety of reasons for this, but if there is no medical reason for it, then it is called idiopathic toe walking. Below are potential causes of toe walking:

Tactile

• Too much input so lift heel up

• Too little input so decrease surface area

Proprioceptive

• Bouncing toe walking, lean on people, resist new activities

Vestibular

• Falls and decreased tone (inaccurate input leads to inaccurate response)

Visual

• Dizzy, can’t look back and forth while walking

• Balance difficulties

• Poor muscle tone

To start, your physical therapist will stretch any tight muscles. While this is important, it is likely not the cause of the toe walking, so your PT needs to address the sensory dysfunction or balance impairments. Some interventions may include balance beams, walking on different textures, jumping rope, swinging, scooter board, visual tracking and more.

In previous years, it has been thought that toe walking was normal until the age of 3, but recent research has suggested that treatment shouldn’t wait this long. Children begin to walk at the age of 1 and average >2,000 steps/day and >15 falls/hour when learning this new skill because practice makes permanent. In order to change this pattern, we need to be stopping it sooner.

Here are details on when you should seek PT treatment:

• Start to see ankle tightness

• Foot, ankle, knee, or back pain

• Toe walking >50% of the time or it is increasing in frequency

• Frequent falls or poor balance

• Fatigue with walking

If you or anyone that you know have concerns about toe walking, feel free to call TOPS at 651-455-0561 to speak with a physical therapist.