Why Does my Physical Therapist Want my Child to Stop Tip-Toeing? Toe walking is a walking pattern where the child will go up on their toes when walking. This is a common walking pattern that is evaluated and treated in physical therapy with kids of all ages. It can happen with every step the child takes or can occur intermittently. There are multiple reasons why your child could be walking on their toes, but here are the big 4 reasons why we physical therapists don’t want your child to continue to walk on their toes.
When a child walks on their toes, it places the ankle in a certain position that can cause calf tightness. When these muscles are tight, your shin cannot move forward, which is needed when squatting and walking. This leads to your kiddo positioning their body differently, such as their toes rotated outwards or a more rounded back to squat or walk. In these different positions, muscles that should be used are turned off and the wrong muscles are used. This can cause injury.
2. Muscle Activation and Posture:
Due to the position of their body when a child toe walks, certain muscles are not at the proper length to activate to their full potential. Most of the time, these kiddos may have an increased low back curvature, meaning their abdominals and gluteal muscles are not turned on. These are important muscles that help with good posture when stationary and moving. Below there are two pictures. The one on the left shows normal back and pelvis position. This allows all the muscles to work together. The picture on the right shows a typical position of someone who walks on their toes due to a different shift in balance and muscle activation.
3. Walking Efficiency
Our bodies are designed to be able to walk for long periods of time. One way we do this is by having the heel of our foot hit the ground first when we take a step. Your body will use momentum and stored energy in your muscles to help move your leg forward. With kiddos that toe walk, the heel will not touch the ground first or sometimes not at all, causing a shorter step length. This can lead to having certain muscles being active the whole time when they should be resting and storing energy. Your body now has to work harder to walk a certain distance. These kiddos might complain of being tired after walking even 10 minutes.
Most common places kiddos that toe walk will complain of pain is in their foot, calf, leg or back. Toe walkers tend to have poor standing posture, as mentioned before. Their body might be relying on different structures, such as ligaments, instead of their muscles to keep their balance. Your kiddo might want to rest more or be less active to stop the pain, which can cause more problems later on.
These are all big reasons why your physical therapist would want your kiddo to stop toe walking. If you noticed your kiddo has just started toe walking or has been for a while, our physical therapy team can help your family with providing exercises and coming up with a game plan to help your child! Call TEAM 4 Kids to schedule a PT evaluation!
Ashley Batistich, PT, DPT