4 Exercises for Toe Walkers You Can Do at Home
Is Toe Walking Normal?
“Toe walking” is referred to as a condition where a person walks on their toes without placing weight on their heel. As children start to learn how to walk, standing or cruising on the balls of their feet is common. Failure of a person’s heel to contact the floor results in a toe to toe walking pattern. This is considered part of normal development up until 2 years old, where they should start to adopt a normal walking pattern.
According to a study done in Sweden of more than 1,400 children, over half of the toe walking kids stopped on their own by the age of 5 (Children’s MD, 2015). If the child is still toe walking by then, it could be caused by habitual patterns or other underlying reasons such as neurological or sensory disorders per John Hopkins' website ( n.d.).However, the earlier your child recieves intervention, the better outcome your child may have.
Toe walking for long periods of time will cause the Achilles tendon to tighten, making it difficult to return to a heel-toe gait pattern. In some cases, toe walking requires therapy intervention including but not limited to: ice/heat modalities, self and active stretching, exercises focusing on the anterior compartment of lower extremities, and manual therapy. Stretching of the calf or Achilles tendon and exercises that dorsiflex the foot (pulling toes toward the shin bone) will help increase range of motion of the ankle joint.
Here are some exercises you can try at home:
1. Stretching calves or Achilles tendons: Parents can stretch their kids passively by laying the child down and pushing the foot upwards toward the shin for a stretch. Another way to stretch the calves is to stand on a wedge or any incline while playing a game for a few minutes to create a prolonged stretch. For older kids, a standing “runner’s” calf stretch will work or standing at the edge of a step and lowering the heels down while keeping the toes on the step.
You can encourage your child to strengthen their anterior compartment by placing a soft bean bag on the dorsum (top) of their foot and place the bean bag into a container.
You can also do work on range of motion by tapping their heel on cones and squatting with the wedge under heels.
2. Sit-to-stands or squatting: Parents can incorporate a game while their child transitions from sitting to standing repeatedly. For example, put puzzle pieces on a chair, board on a table, and every time they stand up, put a puzzle piece in. The lower the chair, the bigger stretch it will be for the Achilles tendons. Squatting for toys also helps with ankle mobility: the deeper the squat, the bigger the stretch.
How squatting is usually performed in toe-walkers:
Squatting with wedge UNDER both Heels
Wedge in FRONT to get an active stretch while squatting
The wedge under both feet during a squat will give them input and feel a surface under their heel, which they most likely do not achieve while walking.
3. Retro ambulation: Walking backwards creates the largest ankle joint power during mid-stance phase (Kim et al., 2014). If ankle dorsiflexion is lacking, they can tend to shuffle backwards; therefore, make sure your child is touching their toes backwards first and shifting weight to heel, allowing toes to lift off the ground, before taking the next step backwards.
4. Heel walking: This is an easy activity to do around the house, but will be difficult if the Anterior Tibialis (the muscle that helps bring the toes towards the shin) is weak. Taking steps forward by balancing on the heels only helps strengthen the muscles needed to lift the foot upwards.
No one knows your child more than you do! Try to make these exercises fun by incorporating these movements in games your child loves like squatting for their favorite toy or making them squat before shooting a basketball. Think of all the exercises you do with your child not as “exercises” but as functional play!
If you are concerned with your child's toe walking, it can be mentioned to your Primary Care Doctor to be referred to physical therapy.
Angeli Calaunan works at our Optimal Therapy an Affiliated Company in South Las Vegas located on Windmill and 215.
To schedule an appointment call 702-564-6712 or click here to see a list of our locations.
Robyn Reyes works at our Optimal Therapy an Affiliated Company in Northwest Las Vegas located on Cheyenne and Durango.
To schedule an appointment call 702-209-0069 or click here to see a list of our locations.
Angeli Calaunan was born in Jersey City, NJ and raised here in Las Vegas, NV. She attended Desert Oasis High School where she graduated in 2010. She attended Carrington College to become a Physical Therapist Assistant in 2016.
Angeli has gained experience in early childhood intervention in the home-health setting, skilled nursing facilities, outpatient pediatrics and outpatient orthopedics settings. She has worked in the pediatric setting since receiving her license. She enjoys treating patients of all ages but has the love for treating babies, toddlers, and children with neurological disorders. Angeli is always open to new perspectives and believes everyone has something great to offer and teach her!
Angeli and her husband, Aaron, have been together since high school. They have three children together: Avery, Asher and Aryana. In her spare time, she loves spending the day outdoors with her family, like hiking and sightseeing new places. Angeli is also a major foodie and loves trying new foods from all different cultures!
Robyn Reyes was born in Bronx, New York. Shortly after, she moved with her family to Las Vegas, Nevada. After graduating high school, Robyn started to work towards a Pastry degree at the College of Southern Nevada (CSN). She gained experience working as a baker but realized that she enjoyed it more as a hobby.
Robyn has been familiar with the Physical Therapy field ever since a little girl because both of her parents are PTs. Robyn’s determination to help others and sincere passion for working with children, motivated her to graduate with an Associate Degree in Physical Therapy as a Physical Therapy Assistant (PTA), from Carrington College.
From the first time she helped a non-ambulatory toddler walk independently, Robyn was confident in her career choice. With years of knowledge and experience in treating a wide variety of pediatric disorders, Robyn is looking forward to helping all the kiddos she can. In her spare time, Robyn enjoys playing soccer, going to concerts, and ANYTHING DISNEY!
Children’s MD. (2015, October 22). Toe Walking: Should you be concerned? . Retrieved from https://childrensmd.org/browse-by-age-group/toddler-pre-school/toe-walking-should-you-be-concerned
Kim, Youngho & Lee, Minhyun & Son, Jongsang & Kim, Jungyoon & Hwang, Seonhong. (2011). Gait Mechanism of the Backward Walking. Retrieved from https://www.researchgate.net/publication/238854471_GAIT_MECHANISM_OF_THE_BACKWARD_WALKING