When your baby is first starting to cruise (walk while holding on to furniture or any other low, stable object) it’s often common to see him or her toe-walking. Toe walking is simply a walking pattern in which a child walks on the balls of their feet; there is no contact between the child's heels and the ground as they move. Most children begin walking at 12 to 15 months of age. When children start to learn how to walk, they try different foot positions, and walking on their toes may be part of this developmental stage. By around the age of two, kids should walk with their feet flat on the ground. By three, children should walk using a heel-toe pattern.
While it is less common, some children do continue to walk on their toes even after taking their first steps independently. Some kids will continue to walk this way for several years, well past toddler-hood. So the question is, when, if ever, should you start to worry about your child’s toe walking.
Why is Toe Walking Ever Problematic?
First of all, let’s talk about some of the rumors you may have heard—toe-walking can be a sign of conditions like autism and cerebral palsy that affect development. While it is true that as many as 41% of autistic children do toe-walk, the fact that your child walks this way DOES NOT mean that your little one is autistic. Five-percent of all kids have toe-walked at some point in their life without any developmental delays (known as idiopathic toe-walking, as a stand alone condition, it is not a good indicator of bigger problems.)
So, when should you start to express concern about your child’s toe-walking? By age 6, most kids will naturally outgrow toe-walking. In general, it is not a cause for concern prior to that age; I do, however, suggest mentioning it to your child’s podiatrist as some toe-walking may be the result of a shortened Achilles tendon. Also, toe-walking can lead to some discomfort for kids, so regular check-ins with your foot doc are appropriate.
Past the age of six, if toe-walking is causing discomfort or concern, treatment options like surgically lengthening the heel cords can be discussed, but I want to emphasize that the majority of the kids I see with this issue will be perfectly fine and will not require serious intervention.
As your child grows, each new stage can bring joy, but also anxiety. If you have concerns about your child’s developing feet, schedule an appointment with your Houston pediatric podiatrist for a comprehensive foot evaluation.