How can I help my child stop toe walking?

First, let's start by stating that there could be several reasons a child may child walk on his toes. For the sake of this post, let's assume that your child does not have a neurological condition and there is no known reason that your child started toe walking (idiopathic toe walking). Please note, if your child recently learned to walk (within 6 months or less) briefly walking on the toes is not considered abnormal. However, if your child is older than 3 years old this is considered abnormal and is something that should not be brushed off or ignored. Your gut instinct is probably right!

Now, let's discuss the things you can begin to implement immediately.

1. Talk to your child's pediatrician. Discuss your concerns and ask for a referral for physical therapy and/or an orthopedic doctor so that your child's feet and ankles can be examined.

2. Begin gentle ROM (range of motion) stretches to your child's heel cords. This should become a part of the daily routine... (maybe after his evening bath when he is winding down for the night). It is important to keep these muscles and tendons flexible in order to prevent these structures from shortening and becoming painful for the child to walk with his heels down. Allow your child to sit or lay with the legs out straight. Take your hand and gently flex the ankle to move the forefoot towards his body. Attempt to hold this stretch for 20-30 seconds at a time.

3. This may seem like a "no-brainer", but don't be afraid to remind you child to lower his heels when you notice him walking on his toes.

Now, here are some "Fun" activities you can begin to do with your child while waiting on a referral to physical therapy.

1. Animal walk games: we LOVE bear, crab and duck walk activities

2. Core strengthening games: "superman" and yoga poses are great ways to engage the core. The muscles are oftentimes weaker in children who walk on their toes.

3. Work the arches! Stand on rounded surfaces like 1/2 moon bolsters, pool noodles or picking up marbles or cotton balls with the toes. This makes the foot work in a way opposite to the preferred toe walk position.

4. Challenge the Balance: Start with encouraging standing on one foot (keeping the foot flat, of course), kneeling with one knee raised while tossing a ball or walking backwards on a taped line.

This is in no way an all-inclusive list, but will hopefully get you started with helping your child reduce his tendency to toe walk. These recommendations and physical therapy in general are considered conservative measures. If conservative measures are not successful then other treatment options include but are not limited to taping, strapping, serial casting, Botox injections as well as surgery. These options should be discussed with your child's pediatrician or orthopedist.

**Other things to consider: does my child seem to difficulty focusing and is he noticed to stand or walk on his toes when he is less focused; does my child walk on his toes in response to varying floor surfaces in the home (ex: walks on toes on bathroom tile but not in the bedroom where the floor is carpeted); does my child exhibit other tendencies like: does not respond to name being call, dislikes certain textures, has trouble with change, does not seem to maintain eye contact or may have difficulty interact with other children. If you notice any of these, again trust your instincts...don't hesitate to discuss these observations with your child's doctor or physical therapist. You are your child's BEST advocate!!