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Asked by Noreen Ceraulo ,
My granddaughter Jemma is 17 months old and has been walking for some time. She can and will walk on her entire foot, however she loves to toe walk, and it has my daughter concerned. The pediatrician told her to keep an eye on this as it could be a medical problem. My daughter is concerned, as am I. Your response would help ease our minds. Thank you.
Living Well Expert
Dr. Jennifer Shu
Pediatrician,
Children's Medical Group
Around the time children learn to walk, roughly any time between 8 and 18 months, they often have an unsteady gait, walk with their legs bowed and feet far apart, and sometimes prefer to walk on their tiptoes. The most common reason for walking on tiptoes is simply out of habit and because they CAN do it. Also, the sensation of toe walking may be kind of fun. From the perspective of a child, toe walking can make one feel taller as well as seem like dancing or testing out one's balance.
Toe walking is common up to about 18 months but can last until a child is 2 or 3 years old. Usually the child will stop on his or her own, especially if grown-ups don't draw too much attention to it. It is a good sign if the child's feet and ankles seem flexible when you point them up and down and move them around in all directions. Another reassuring sign is if he or she mostly walks on the entire foot and only occasionally walks on tiptoes. This shows that the feet, ankles, legs and sense of balance most likely are working properly and that the child is probably just choosing to walk on his or her toes at times.
The concern about toe walking is that in some instances, it can be a sign of a nerve or muscle problem in the lower limbs or it may be a problem with the body's vestibular system, which helps with balance and orientation. In these situations, children may be benefit from stretching exercises of the Achilles tendon area (also called the "heel cord"), wearing a special cast, or using an orthotic appliance that can be worn inside the shoes to keep the heel on the ground when the child walks. If there might be a problem with the body's vestibular system, sensory therapy and stimulation may help. Rarely, children may need to have surgery to lengthen tight heel cords that are causing the toe walking.
Your granddaughter's 18-month checkup with her pediatrician is a great time to re-assess her walking. Your pediatrician can let you know whether it would be helpful to check her again before the 2-year checkup and whether anything needs to be done in the meantime. Thank you for writing, and I wish you the best of luck.
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