Toe Walking . . . Should I Be Concerned?
Many parents notice their children walking on tiptoes and often wonder about the reasons behind this behavior and whether it should be a cause for concern. There are several reasons why children might adopt this walking style, and I’d like to highlight a few common ones:
Exploration of Balance: Some children enjoy experimenting with weight shifting and balance. They may explore with walking and balance with how high they can lift themselves onto their toes before losing their balance or regaining it just in time.
Tactile Sensitivities: Other children may have sensitivities to certain textures and walk on their tiptoes to avoid unpleasant sensations. For them, surfaces like grass might feel sharp, while sand can feel abrasive.
Spatial Awareness: Some children struggle with understanding their body’s position in space and may go up on their tiptoes to receive additional feedback for their nervous system.
Visual Compensatory Strategy: A child may walk on tiptoes as a way to compensate for visual deficits.
State of Fight or Flight: Toe walking can be a sign of a heightened state of arousal, which can also include faster body movements, a child in an excited or over-whelmed state and decreased ability to stay regulated and organized.
Suggestions for toe walking:
Desensitization Strategies
Gradual exposure to different textures and pressures helps with tactile sensitivities.
Providing a child with proprioceptive input (heavy work, deep pressure) through massage, weighted items, carrying heavy items, large gross motor muscle movements, etc. can help calm the child’s nervous system.
Aims to enable children to place their entire foot on the ground comfortably.
Fight or Flight State
Provide organizing and calming strategies to support a more regulated state.
Body Awareness Activities
Tiptoe walking can be a feedback mechanism for children with high sensory thresholds.
Activities to support improved body awareness and improve sensory processing include: massage, joint compressions, and weighted items; play activities such as climbing, jumping, pushing and carrying heavy items.
Assess for Primitive Reflexes
Several primitive reflexes can be associated with toe walking include Babinski and Tonic Labyrinthine reflexes.
Some insights into Toe Walking
While many children enjoy bouncers and jumpers, it's important to be cautious. These devices can hinder development and encourage tiptoe walking. Children who use jumpers or walkers might also develop tight heel cords from their habitual weight-bearing on the front of their feet potentially leading to shortened heel cords that may require therapy, orthotics, or surgery. The solution is simple: avoid putting your child in equipment that promotes this alignment.
Vision, balance and feedback through our muscles (proprioception) play a crucial role in body awareness. If a child is struggling in these areas, they may resort to tiptoe walking to better understand their bodies.
How can OT help?
Occupational therapy can be a valuable resource for children who walk on tiptoes, helping to improve alignment and address underlying factors while providing supportive play. Occupational therapy can also address visual processing, spatial awareness, sensory processing (including sensory sensitivity) and related balance issues. If needed, your therapist will investigate the reasons behind the behavior and develop a tailored plan, including ongoing therapy and home programs to support both the child and their family.
Contact us for more information: www.kidskillstherapy.com