When children start to walk they often start by walking on their tiptoes. When they continue to do so beyond the age of two or three years old this can understandably be of significant concern and worry for you as a parent. It’s not often clear as to whether or not this is something to be very worried about. It’s important to know that in the majority of cases walking on tiptoes does not mean that there is any other problem with your child.
Tip toe walking is a pattern of walking when a child walks on the balls of their feet without bringing their heels to the ground.
It is a common form of walking when children are first learning to walk. However, most children will have grown out of this by the time they reached 2 ½ years old.
For the children that continue to walk on the tiptoes of this age, most of them will still not have any underlying problem of concern. There are some conditions that are associated with walking on tiptoes, and if a child persists in walking on their toes then it is important that these conditions are considered and excluded as a cause of the tiptoes walking. However it is rare for tiptoe walking to be associated with these underlying problems
The vast majority of cases will be “idiopathic”; which means that no underlying cause is identified.
Conditions that are associated with tiptoes can be as neuromuscular or behavioural. Tip toe walking can be associated with cerebral palsy, muscular dystrophy, or with autism and attention deficit hyperactivity disorder. Therefore, it is important that if a child persistently walks on their toes and continues to do so beyond the age of four years old that they are assessed. Remembering that the majority of cases will still not have any significant underlying cause.