Seeking Help with a Child That Walks on His Tip-toes

Updated on April 17, 2008
G.D. asks from Shelby, NC
28 answers

I have a seven year old son that walks on his tip-toes. I need some advice from anyone that has a child that does and what did you do to help correct the problem. He's having
trouble with balancing now. He's been doing this for sometime. I thought he would grow out of it but he hasn't. Any help. For information purposes, we have had all the neurological examinations and testing done. Concluded it's a habit. He doesn't have autism or any other developmental problems. He's s very smart, active and gifted child.

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V.G.

answers from Knoxville on

The only way I could get my son to stop walking on his toes was hard bottom shoes. As soon as he got out of bed he was dressed and his shoes on. They can not bend like tennis shoes do they have to stay stiff. Good Luck

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A.J.

answers from Clarksville on

I taught a girl who's tendons at the back of her ankle weren't long enough. She didn't have a problem at ages 1-4 but then she grew taller... That is when the problem started. Get some tests done by an OT.

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S.D.

answers from Nashville on

I walked on my tip toes as a child. My mother had hoped I would grow up to be a ballerina--no such luck. I eventually outgrew it.

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K.

answers from Charlotte on

Toe walking is not unusual in younger children who are just beginning to walk and otherwise growing and developing normally. However, toe walking after age 3 years should be evaluated by a doctor.

In many cases, toe walking in older children is simply a habit and not a sign of an underlying problem. Doctors refer to this as idiopathic toe walking. But toe walking accompanied by other signs and symptoms may be due to a serious underlying condition, such as autism or cerebral palsy.

Talk to your doctor about your child's toe walking. Your doctor may recommend an evaluation, including a neurological examination and testing for language and other developmental delays. If the results of these exams are normal, your child won't need treatment and will most likely outgrow the toe-walking habit.

check out these links:

http://www.revolutionhealth.com/forums/mental-behavioral-...

http://www.autism-help.org/autism-information.htm

http://hcd2.bupa.co.uk/fact_sheets/html/autism.html

http://parents.berkeley.edu/advice/worries/tiptoes.html

1 mom found this helpful

J.L.

answers from Clarksville on

I agree that the toe walking should be evaluated. However, I would request a referral to an Occupational Therapist or even a Physical Therapist to have them assess your child.

I have personal experience as a toe walker and with a toe walker. I was a toe walker for many years before out growing it. I never underwent any evaluations when I was younger though. Fast forward to when I had my first child. Our son was 24 months old and I took him for a development screeing that was offered by the Army. The therapist noted and commented about his toe walking and recommended that I seek further evaluation for this. She commented that overall his development seemed fine but the toe walking was a huge concern of hers. Well, being that I was a toe walker, I dismissed her concerns and never had an evaluation. When my son started kindergarten he had some mild developmental delays that were though to be an age thing. It wasn't until first grade that he was having the same delays and he was evaluated by the school OT. The testing came back where he had some mild delays with bilateral coordination and hypotonia as well as sensory issues. The sensory integration diagnosis helped to explain a lot with my child's behavior. OT has helped him with his delays and still continues to help him with his sensory integration, as well as provide a resource for me to better help him and his teachers.

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M.L.

answers from Jacksonville on

Hi G., I have a four-year-old daughter that has been in physical therapy with a pediatric therapist for over a year for toe walking. I thought her toe-walking was cute, just soemthing special that she did, until I heard about a 9-year-old boy (I grew up going to church with his mother) who was having surgery on his legs for the same problem. The muscles in the backs of his legs were so tight they had to cut them. I'm not sure what the other details were. I immediately made an appointment with our pediatrician and she said that yes, it is serious -- not life-threatening, but something that you really do need to clear up because it has implications down the road --- like the balance issue that you mentioned, as well as hip and knee problems when they're older. It also affects the way they stand, run, etc. My daughter's calf muscles were so tight and developed that it was obvious to our pediatrician that she was toe-walking. She said it's not awful, but it is something that you want to correct. (Our daughter is happy, energetic and otherwise perfectly happy).

My recommendations are to go to a pediatric therapist if you can, because he'll more than likely be going for a while -- maybe once or twice a month, maybe even once a week for a while -- so it's helpful that the therapy is geared toward a child and presented in the form of games. Some exercises you can do at home are to have him walk on his heels -- we say "lets walk on our teddy bear heels" -- for a while like its a game. Or, the two of you can walk backward in the yard. Or, you can have him stand on a three-ring binder, with his toes and the ball of his foot at the thicker end, while he's doing something like coloring or play-doh at the table. Try having him stand on one foot without touching the other foot to the floor. At therapy, they had my daughter do exercises that addressed flexibility, which was her bigger issue, as well as balance. They'll measure the "range" of his foot each visit so they can chart his progress. There are things they can try, as well, like taping their foot or putting fillers in their shoes or trying special shoes.

Therapy helped our daughter a lot -- and we never called it therapy. We called it "play school," since my older daughter was in "preschool" at the time. Her "range" improved a lot and we met our goals just before Christmas, and then I enrolled her in a gymnastics class to further help her flexibility. She loves it, and it has helped her flexibility so much. Now she's doing somersaults and lately she's been able to walk down the stairs from one step to another, like we all do normally. I never noticed it until a therapist pointed it out, but before therapy, she would get both feet on a step, then move to the next step, putting both feet on that step, before moving on (like younger children do). We still go back to the therapist periodically to have her range measured. The therapist said that sometimes during growth spurts their muscles tighten and they revert back to toe walking.

As for the cause of toe walking in otherwise healthy children, I've been told by several doctors and therapists as well as research I found on the Internet that they don't really know why some children walk on their toes. One therapist asked me if she had spent much time in a walker or a saucer when she was a baby, which she didn't. She said that sometimes if the walker or saucer -- which she said therapists don't recomend -- is positioned to high off the ground, the child can only touch it on their toes and that gets the habit started.

This is probably more than you wanted or needed....Good luck to you and your son.

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M.T.

answers from Nashville on

Is the one that is tippy toing, 7 yrs old?
My sister was told that her son may be autistic and that was one of the signs, however, that is only a minor sign... there are many others and if your son is 7 you would surely know that by now.
Another suggestion is that you said you did all the neurological tests and they were fine.... have you thought about maybe he has a muscle in his leg that is tight and not allowing him to walk flat foot? Try stretching out his calf muscle by doing some stretcing exercises and stretch is ham string out and then massage it for him and then stretch it out again.... then sit back and observe how he is walking after you do all of that.
It could possibly be habbit.
The only other thing that I would know to tell you is get some really tight, stiff shoes.

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S.K.

answers from Goldsboro on

Hello, G.~

This has been on my heart for several days, and I have to respond to you.

You absolutely need to have this child tested for Muscular Dystrophy. If they say they have done it, ask them to rerun the test. He is showing classic symptoms of the disease. The earlier it is diagnosed, the more you can do for him. PLEASE do not wait.

My family has Dushenne's Dystrophy, which means it is carried from the mom and passed to the son. there are many other forms of the disease. I was blessed that my son did not have it, but have had plenty of cousins and uncles who did. Check out the MDA website for more information. They have come a long way in medicine for helping these patients.

Please let me know what you find out. God bless.

Love,
S.

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G.S.

answers from Charlotte on

I've walked on my toes for as long as I can remember, and I still do this on occasion when I am barefoot. I have very healthy calves. I also noticed that I don't like to feel the dirty floor under my feet and that is part of the reason I do it. If it isn't hurting him, don't worry about it. My parents would sometimes talk about it and I remember feeling conscious about it from time to time and would try to walk on my whole foot, but inevitably I started walking on my toes again. My sister is 17 and still does this too.

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B.H.

answers from Louisville on

G.,

Our six year old son is a toe walker. It has been determined that it is a sensory issue with him. But longterm effects can be detrimental to his heel cords and hips according to the doctors. He wears shoe inserts and sleeps in AFO's (braces) to correct his walk and stretch his cords. He also has regular visits with an orthopedic doctor and years of physical therapy. We've also tried botox and casting which seemed to help alot but was short-lived. We may try it again to release some of the tightness and maybe retrain his muscles now that he is older. Whatever you are comfortable in doing to stretch your son's heel cords (therapy, exercises, AFO's, botox and casting) to prevent surgery. Good luck.

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N.G.

answers from Fayetteville on

My friend has a son who did that when he was a toddler, but he grew out of it. We dubbed him "Tippy." Don't stress, it'll pass! But if you want to try something, I hope this doesn't sound mean or anything. Remember the story of the Princess and the Pea? Why not put something very small into the tip of his shoes? It may discourage him if it's slightly uncomfortable.

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M.E.

answers from Lexington on

i've heard of older kids walking on top toes because of a problem with their achiles tendon(sp). some times it is too sort or very tight and causes it to be very uncomfortable for the person to stand flat footed. physical therepy can usually loosen the tendon and sometimes as a last resort, surgery is needed to correct the problem. have your son evaluted by his ped or youi might have to take him to a podiatrist or some other specialist to figure out what is going on...and by the way...have you ever just asked your son why he does it? maybe he feels taller or something. it could very well be "just a habit." "habits" can be broken with perserverence and patience, but actually physical or neuorlogical problems needs precise care.

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L.R.

answers from Raleigh on

Check out
Emerge, A Child's Place
in both Chapel Hill and Durham (two offices) -

They are amazing and can help him out through OT sessions and can also evaluate him in case there are other issues that may be associated with this that you may not even notice:)
Best of Luck!

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N.M.

answers from Clarksville on

Walking on tip toe can be a characteristic of an autism spectrum disorder. My son, for example was diagnoised with Aspergar's. Many of the signs were very mild until school age. Tip toe walking, hand flapping, spinning, lack of direct eye contact, speech delays and many others can be signs of a possible problem. Of course, I know nothing more of your little one than the tip toeing, but just thought I'd throw it out there. N.

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M.D.

answers from Fayetteville on

Hello G., my daughter was a toe walker from 1yrs old, she is now 8. she did not have any neurological problems either and has had therapy, braces everything. well i took her to an orthopeadic, they said she had "idopathy toewalking" which means they dont know why she does it. well she got to where she couldnt even stand on her feet flat without it hurting cause her muscles were so tight and her balance was starting to get bad so they did surgery. she had something called a Bi Lateral Gastrocneumsis Resession (i might have spelled it wrong). basically they made a small incision on her legs, and fixed everything inside. she has been in casts for 3 weeks now and is walking on her feet. so my guess would be to take your son to an orthopeadic and see what they tell you. Good luck, and let me know what they say.

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J.H.

answers from Clarksville on

Ask if you can talk to the physical therapist and his school. They work with these problems on a regular basis.

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A.M.

answers from Memphis on

Dear G.,

First, I can tell from the tone of your request that this is a great concern to you. Please don't panic.
I am 31 years old and I can still walk, literally, on the tops of my feet. Yes you read it correctly. I can curl my toes under my foot and walk across everything from the grass to the hardwood. I started walking that way.
Although my mother found humor in it at first, then found concern when I didn't find the bottoms of my feet, I did eventually figure it out.

Gymnastics helped with my balance issues and I loved the extra cirricular activity. Dance helped me learn how to control the issue. All of this without me realizing that it was correcting the "problem". Of course, I didn't stay in either activity for long, a few years or so, and I was on to something else, but the balance and the grace have stayed with me.

Please know that there is nothing "abnormal" about your son. In fact, I am finding out that this is pretty common. He may be "double jointed" in his feet, which could be a great benefit to him in dance or gymnastics. Another idea is to put him into a more active sport if dance and gymnastics doesn't appeal to him. Try soccer or a lighter contact sport so he will be forced to wear shoes that keep his feet flat to the ground. Either way he will be training his feet (unknowingly) to do what they were menat to do for him!

I hope this helps.
By the way, my 3 year old daughter also walks on the tips of her toes....the very tips....just like a ballerina. We have put her in Ju Jitsu and dance. She loves it!!

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K.L.

answers from Charlotte on

Do not accept their answer that it is a habit! I did the same thing as a 4-5 year old. At age 14 I was diagnoised with CMT (Charcot-Marie-Tooth). It is a form of Muscular Dystrophy. It is also known as Peroneal Muscular Atrophy. It can cause foot deformities and muscle weekness but is not fatal. I am now 38 years old and still active. I do wear leg braces and had several surgeries throughout my childhood. The first surgery I had at age 4 was a heal cord release. My heal cord was so tight that it made it nearly immpossible for me to put my heal flat on the floor. One of the other signs besides walking on toes and poor balance is high foot arches and small calves. CMT can be diagnosed by nerve conduction tests and also by genetic testing. For more information go to www.mdausa.org . You can pull up the different diseases that fall under Muscular Dystrophy and find out more about them. You can also look up your local MDA office who can help you get with doctors and the local Muscular Dystrophy clinics. There is an MDA clinic at Carolina Medical Center in Charlotte and also in Winston-Salem at Baptist Hospital. Please check it out. My parents used to tell me all the time to stop walking on my toes but I physically couldn't. Get him checked out for CMT. Good luck and if you have any other questions about it please feel free to send me an e-mail.

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T.C.

answers from Nashville on

YOu need to get him to an pediatric orthopedist specialist now! Vanderbilt has the #1 ranking Ped Orthopedist in Tennessee! He will probably go through a series of cast that will correct his achilles tendon which is now tight! Don't wait any longer..call your pediatrician and get him to the ortho docs!

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A.H.

answers from Chattanooga on

My cousin did this when she was younger, and ended up having to wear inserts in her shoes and having physical therapy for a while. the problem with allowing this to continue is their Achilles tendon will tighten and make it painful and difficult for them to stand flat footed. the best bet is to ask the pediatrician for a podiatrist refferal if you need one if not try a few in the area that see children.

Good luck.

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J.H.

answers from Lexington on

is this a pretty new thing? did he start out walking normal but just start doing this? i don't want to alarm you, but you might want to look into "tethered spinal cord"... this is a condition that may not show up for a while, and as i remember, that might be one manifestation. it might be (and hopefully is!) something much less drastic, but that just struck me. my niece was just diagnosed with one, and i had never heard of it, so i did some research... either way, let us know!
good luck,
J.

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H.K.

answers from Huntington on

Hi G.! I agree with what some of these other ladies are saying about the achilles tendon being tight. When I was a kid I knew a boy who walked on his toes and he ended up having surgery to correct it. He walked normally after that.

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K.D.

answers from Raleigh on

I just want to throw one other possibility out there. Everybody has given you great advice and one or more of them might be right.

But I went to a talk many years ago by Kelly Dorfman where she said toe walking could be a sign of an essential fatty acid deficiency.

What luck, I found someone's notes to that talk online:

http://www.autisminfo.com/dorfman.htm

Here is the part I was talking about:

She talked about essential fatty acid deficiency, some symptoms of which are: wax buildup in ears, restlessness, "permanent gooseflesh", "Albert Einstein
hair", toe walking, and excessive thirst. She recommends Total EFA by Health From the Sun, flaxseed oil, and Efalex Focus as replacements for the missing fatty acids. She says they rancidify quickly, so we should taste them every
other week to be sure they are still good.

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L.B.

answers from Atlanta on

G.,

My brother was and still is a toe walker. He even runs on his toes. He is now 22 years old and he still walks on his toes. He has played all sports through school and never had any issues. He has great leg and calf muscles because of it too. I don't see any issue with it at all.

L.

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V.S.

answers from Charlotte on

he may have to see a physical therapist my father is one...he goes from sc to nc if you'd like his info let me know...

Magnolia Medical Group 1-###-###-####

His name is Victor Cortina

Tell him you got his # from his daughter ... My name is V.

Good luck

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B.H.

answers from Greenville on

My son did this since he was walking he is turning 9 soon and still occasionally does this. The only problem I have found is toe walkers seem to be fast runners. He is slowly grown out of it and we notice it rarely. The doctor had our son walk up the slide from the bottom up (going up the wrong way).

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B.L.

answers from Memphis on

I have no personal experience with toe-walking, but I've heard....it's fairly normal for a child three years old and under; however, you should have your child checked out by an orthoepedic surgeon. He may have some underlying problem that you don't know about.

Good luck, G..

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K.D.

answers from Knoxville on

I am a dance education specialist and I have had many children enroll in dance to correct neuro/muscular habits like this one. Dance classes really do help.... lots of boys take dance, it doesn;t have to be ballet. Look at modern, hip hop, or african, where the emphasis is down into the floor. Perhaps gymnastics could help as well.

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