Developmental Milestones – Idiopathic Toe Walking

Watching your baby learn to walk is an exciting time. You might notice that your baby’s walking pattern does not look like that of an adult, they may walk in a “funny” way. One variation you may see when your baby is trying to walk, is them walking on their toes. Toe walking is fairly common when a child is beginning to walk and most children tend to outgrow this by the time they are two years old. In some children, toe walking can persist beyond this expected age range and this is referred to as idiopathic toe walking.

What is Idiopathic toe walking?
Idiopathic toe walking is a term used to describe the condition in which children walk with a bilateral toe-toe pattern. That is, they walk consistently on their toes without putting their heels down. It is a diagnosis made when all other possible causes of toe walking have been ruled out. If not corrected, toe walking can lead to problems when children get older such as pain in the foot or leg when walking, limping and frequent falling. One of the biggest problems it can cause is tight calf muscles which means less movement in the ankle joint.

Why does this happen?
In developing children, consistent heel strike, or stepping heel first occurs by 18 months old or about 22 weeks after beginning to walk by themselves. However, some children will continue to toe walk, this may be caused by an underlying condition, such as:
• Cerebral palsy
• Neuromuscular disorders
• Autism

Toe walking tends to be more common in children who are male or who have a family history of toe walking.

When to see a medical professional?
Generally, if your child continues to walk on their toes after the age of two it is important to talk to your GP, paediatrician or physiotherapist. Make an appointment sooner if the toe walking is accompanied by tight leg muscles, stiffness in the ankle, lack of muscle coordination or if you notice a difference between both sides.

What can physiotherapy do?
Physiotherapists can help you in the assessment and treatment of toe walking. It can involve prescription of an exercise program incorporating stretches of the calf muscles, strengthening and balance exercises. If needed, a physiotherapist may also provide your child with splints, casts or orthotics.

Check out this video below to hear what some paediatricians have to say about toe walking as they answer some common questions on toe walking:

Please feel free to contact our practice if you have any questions or want to book an appointment with one of our experienced paediatric physiotherapists.


  • Management of idiopathic toe walking, Anderson et al (2011)
  • Eastwood, D. M.; Dennett, X.; Shield, L. K.; and Dickens, D. R.: Muscle abnormalities in idiopathic toe-walkers. J Pediatr Orthop B, 6(3): 215-8, 1997,
  • Treatment For Idiopathic Toe Walking: A Systematic Review Of The Literature, Van Kuijk et al, 2014