Toe Walking in Children

Most children learn to walk between 12-15 months of age with their feet flat on the ground.  Some children who are first learning to walk may walk up on their toes or on the balls of their feet.  This typically disappears within 3-6 months of regular walking.  Habitual toe walking occurs with children who continue to toe walk beyond the toddler years (after age 2).  By age 3, there should not be any residual toe walking.  Some parents think it is “cute,” but if it persists, it needs to be watched and addressed.  Left untreated, children can end up with tight leg muscles, balance and coordination difficulties and walking problems.  Early treatment by a Pediatric Physical Therapist can reduce and prevent toe walking.

At Physical Therapy 4 Kids, toe walking is one of the more frequent diagnoses treated here with tremendous success.

Causes of Toe Walking:

  • Idiopathic/Habitual Toe Walking – persistence of toe walking for no known reason
  • Shortened Heelcords (Achilles tendons) – this is the tendon that connects the lower leg muscle to the heel bone, preventing the heel from touching the ground
  • Cerebral Palsy – increased tone due to a neurological condition can cause an impairment of the child’s muscle tone or posture
  • Muscular Dystrophy – with genetic conditions like muscular dystrophy, muscle fibers are prone to damage and weaken over a period of time causing the child to rise up on their toes.
  • Autism – children diagnosed with autism may demonstrate toe walking
  • Sensory Processing Disorders – children may have sensory issues and do not like the feeling of their feet touching the surface so they rise up on their toes to avoid their heels touching an uncomfortable surface.  They also may not like the sensation of socks, shoes or bare feet.
  • Vestibular System Dysfunction – the brain may be giving the child a wrong signal on where their body is in space or how to move properly

Signs of Toe Walking

  • Walks up on tip toes
  • Able to stand on flat feet when concentrating but then rises up on toes when they start to move
  • Walks with knees straight
  • Balance sup on their toes when standing still
  • Able to keep up with other children even though they are up on their toes
  • May have a family history of toe walking

Complications of Toe Walking  

  • Walking difficulties
  • Increased risk of falling
  • Balance and coordination difficulties
  • Pain in the hips, knees or ankles
  • Difficulty climbing up or down stairs
  • Decreased core strength and postural issues
  • Social stigma

Treatment for Toe Walking

Early Referral from the Pediatrician for Physical Therapy

  • Specific stretching and strengthening exercises
  • Range of motion exercises
  • Balance and coordination training
  • Walking training on different surfaces 
  • Walking on their heels
  • Sensory stimulation program to desensitize feet
  • Braces, splints or inserts to keep heels flat on floor
  • Specific shoe recommendations or heel lifts or wedges

At Physical Therapy 4 Kids, we make our treatment sessions FUN!!!  We use imagination and creativity along with our therapeutic skills to put an end to Toe Walking.


Call 914-421-9392

Evaluations scheduled within 24-28 hours

Home Optimization for Stay-at-Home Parents

Updated on April 9th, 2019
Before you became a stay-at-home parent, you may have felt that caring for your kids at home would be a fulfilling and enriching life. As true as that maybe now that you are with your children full-time, you may also find that life as a stay-at-home parent can also be chaotic, unpredictable, and even stressful. It’s common for expectations of what it means to be a stay-at-home parent to not always match up with reality.
Like with any job, being a stay-at-home parent has its ups and its downs. One of the most effective and efficient ways to sustain those ups is to optimize your home for healthy, happy parenting. That means not just setting up a home that supports your kids with entertainment and education, but supports you — the parent — as well. In this guide, you will discover how to optimize your home and, as a result, save your sanity by:
  • Waking up before the kids
  • Getting the day organized
  • Encouraging your kids to help with tasks
  • Getting some R&R for yourself
  • Working from home

Getting up on your own schedule, as opposed to being woken up by your children, can help you start a day that is more productive, even if that just means enjoying a cup of coffee on your back porch listening to the birds sing. Taking time to situate your personal needs, like showering, sending emails, or doing some yoga, before the kids start to rise will help you find some peace before the chaos begins.

Click here for the best part of this article!

Idiopathic Toe Walking and ADHD

Toe Walking

Article source: Your Therapy Source

Recent research examined the relationship between idiopathic toe walking and ADHD. Idiopathic toe walking was defined as a gait pattern with no contact between the heels and the ground in children older than three years. The study included 312 children diagnosed with ADHD, with a normal neurological examination, with no alterations in MRI scan, cognitive disorder, or autism. A complete medical history and goniometric measurements were obtained for each of the participants (mean age 11 years old, 73.7% boys). The participants were classified according to ADHD subtypes:

  • 53.8% had ADHD combined subtype
  • 44.9% had inattentive ADHD
  • 1.3% had hyperactive ADHD

The results of the study on idiopathic toe walking and ADHD indicated the following:

  • Idiopathic toe walking was observed in 20.8% of patients, mostly in the combined subtype.
  • Achilles shortening was present in 49.2% of the participants with idiopathic toe walking.
  • Idiopathic toe walking was associated with sociability disorders, an absence of pain in legs, and a family history of toe walking.
  • 11% of the participants had visited a doctor for toe walking.

The researchers concluded that children with ADHD have an increase in idiopathic toe walking and Achilles shortening, especially if they presented with a social communication disorder or a family history of toe walking. It is helpful when idiopathic toe walking is diagnosed early to begin effective treatments.

For more information, visit Your Therapy Source.

 Idiopathic Toe Walking and ADHD is something we can treat so give us a call, 914-421-9392, or visit our website at


Torticollis & Plagiocephaly

What is Torticollis & Plagiocephaly?

Torticollis is defined as a muscular tightness in the muscles on one side of the neck.

The Sternocleidomastoid muscle is most commonly affected. Muscles on the opposite side of the affected side may become weak due to the abnormal head posture. The most optimal time to begin Physical Therapy for Torticollis is between 2 weeks to 2 months of age. However, we evaluate babies at any age when a head tilt is observed. Early diagnosis and treatment is the key to success.

With Right Torticollis, the baby’s head will typically look tilted toward the right shoulder and rotated toward the left shoulder.

With Left Torticollis, the baby’s head will typically look tilted toward the left shoulder and rotated toward the right shoulder.

Plagiocephaly is defined as an abnormal head shape or flat head syndrome.

Plagiocephaly is characterized by a flattening on the back of the skull or on one side of the skull. It can occur before or after birth and can be due to abnormal positioning in utero, prematurity, or from lying on the back or on one side of the head for too long after birth due to decreased tummy time. This condition can also be caused by the overuse of a car seat, stroller, bouncer seat, or swing. There is often some facial asymmetry seen. An abnormal head shape continuing beyond six weeks of age should be evaluated.

We have developed and teach a specially developed Torticollis Protocol. Parents are given a comprehensive home exercise program including handouts. Instructions are given for stretching, strengthening, and positioning during carrying, feeding, and playing activities. Parents are encouraged to take pictures and videotape sessions for home carryover.

The purpose and goals of early Physical Therapy treatment for Torticollis are to:

  • Stretch the involved muscles of the neck
  • Strengthen the weakened/opposite muscles of the neck
  • Promote proper and symmetrical development of the baby
  • Promote age-appropriate developmental activities

Early recognition and treatment are important to facilitate proper elongation of the muscles and achieve the above-mentioned goals. The earlier we evaluate and treat these babies, the faster the positive results.