You notice your child rising up on their toes with every step. They bounce across the room like a tiny ballet dancer — and it looks cute at first. But after weeks or months of watching it continue, you start to wonder: is this normal?
Toe walking is common in young children who are learning to walk. Most grow out of it by age two. But when a child keeps walking on their toes past that age, it’s worth looking into. A podiatrist can help work out what’s going on and whether treatment is needed.
When Is Toe Walking Normal?
Babies and toddlers experiment with movement. When children first start walking — between about 10 and 18 months — many spend time up on their toes. This is a normal part of learning to balance and coordinate their legs.
At this stage, the brain and muscles are still figuring out how walking works. Toe walking during these early months is not a red flag. Most children settle into a heel-to-toe gait pattern by the time they turn two.
If your child is under two and walks on their toes some of the time — but can stand flat-footed when still and walks flat when wearing shoes — there’s usually nothing to worry about. Keep an eye on it, and mention it at your next GP or paediatrician visit if it continues.
Why Some Children Keep Walking on Their Toes
When toe walking continues past age two, there’s usually a reason. Sometimes the cause is straightforward. Other times it takes a team of health professionals to work it out. Here are the main causes.
Idiopathic Toe Walking (Habit)
This is the most common diagnosis. “Idiopathic” means there is no clear medical cause — the child has simply developed a habit of walking on their toes. They can walk with their heels down when asked. Their ankle range of motion is normal. They just prefer to walk up on their toes.
Idiopathic toe walking is a diagnosis of exclusion. A podiatrist or paediatrician needs to rule out other causes before settling on this one.
Tight Achilles Tendon or Calf Muscles
Some children develop tightness in the calf muscles (gastrocnemius and soleus) or the Achilles tendon. This limits how far the ankle can bend upward — a movement called dorsiflexion. When the ankle can’t bend enough, the heel struggles to reach the ground during walking.
This tightness can develop because of prolonged toe walking itself. The longer a child walks on their toes, the shorter and tighter the calf muscles become. What started as a habit can turn into a structural limitation. Understanding foot and ankle anatomy helps explain why this happens — the Achilles tendon connects the calf to the heel bone, and it adapts to whatever position it’s held in most often.
Sensory Processing Differences
Some children walk on their toes because they are sensitive to the feeling of the ground under their feet. This is more common in children with sensory processing difficulties or autism spectrum disorder. Walking on the toes reduces the surface area of the foot that touches the ground, which can feel more comfortable for these children.
Neurological Causes
In a small number of cases, toe walking is linked to a neurological condition such as cerebral palsy or muscular dystrophy. These conditions affect muscle tone and control. A child with increased muscle tone (spasticity) in the calves may walk on their toes because the muscles are pulling the foot into a pointed position.
If a podiatrist or GP suspects a neurological cause, they will refer your child to a paediatrician or paediatric neurologist for further assessment.
The Podiatrist’s Role in Toe Walking
Many parents aren’t sure where to start when their child toe walks. GPs often take a “wait and see” approach, which is reasonable for very young children. But if your child is over two and still toe walking most of the time, a podiatrist can provide a thorough lower-limb assessment and get things moving in the right direction.
Podiatrists specialise in how the feet and legs work together during movement. We see toe walking regularly in our children’s podiatry clinics across Sydney and can assess whether the pattern is a simple habit or something that needs further investigation.
The podiatrist’s role is not to replace your GP or paediatrician. It’s to add a layer of specialist assessment focused on gait, muscle function, and foot mechanics. In many cases, podiatrists work alongside other professionals — paediatricians, physiotherapists, and occupational therapists — to give your child the best outcome.
How We Assess Toe Walking
A proper assessment takes about 30 to 45 minutes and covers several areas.
Gait Analysis
We watch your child walk and run — both with shoes and barefoot. We use digital video analysis to record the gait pattern from multiple angles. This lets us slow the footage down and look at exactly what each part of the leg and foot is doing during each step. We’re looking at when (or if) the heel contacts the ground, what the knees and hips are doing, and whether the pattern is the same on both sides.
Ankle Range of Motion
We measure how far the ankle can bend upward with the knee straight and the knee bent. This tells us whether the calf muscles or Achilles tendon have become tight. A child with full range of motion who still toe walks is more likely to have an idiopathic (habitual) pattern. A child with restricted range may need targeted stretching or other treatment.
Muscle Tone and Strength
We check muscle tone throughout the lower limbs. Increased tone on one side, or a pattern of tightness that affects multiple muscle groups, may point toward a neurological cause and prompt a referral.
History and Observation
We ask about developmental milestones, when the toe walking started, whether it’s getting better or worse, and whether your child has any other concerns (sensory sensitivities, coordination issues, speech delays). The full picture matters.
Treatment Options
Treatment depends on the cause, the child’s age, and how long the toe walking has been happening. Here are the main approaches a podiatrist may recommend.
Stretching Programs
If the calf muscles or Achilles tendon are tight, a daily stretching program is the first step. We teach parents and children specific stretches that target the gastrocnemius and soleus muscles. Stretching works best when it’s done every day — not just once a week. It takes time, but it can make a real difference in restoring ankle range of motion.
Footwear Changes
The right shoes can help. Supportive shoes with a firm heel counter make it harder for a child to rise up onto their toes. We may also recommend avoiding certain shoe types — like very flexible slip-ons — that don’t provide enough structure to encourage a heel-to-toe gait.
Orthotics and Heel Lifts
In some cases, custom orthotics or heel lifts can help. A small heel raise inside the shoe takes tension off the Achilles tendon and makes it easier for the child to get their heel down. Orthotics can also address any underlying foot posture issues — like flat feet or overpronation — that may be contributing to the pattern.
Strengthening Exercises
We may prescribe exercises to build strength in the muscles at the front of the shin (tibialis anterior), which pull the foot upward. If these muscles are weak relative to the calves, the foot naturally falls into a toe-down position. Targeted exercises help restore balance between the two muscle groups.
Referral to Other Specialists
If we suspect a neurological or developmental cause, we’ll refer your child to the right specialist. This might be a paediatrician, paediatric neurologist, physiotherapist, or occupational therapist. Toe walking linked to sensory processing difficulties, for example, often benefits from occupational therapy alongside podiatry treatment.
When to See a Specialist
Book an appointment with a podiatrist if your child:
• Is over two years old and still toe walking most of the time
• Cannot put their heels flat on the ground when asked
• Toe walks on one side only
• Complains of pain in the legs, feet, or calves
• Trips or falls more than other children their age
• Has started toe walking after a period of walking normally
• Has other developmental concerns (speech delays, coordination difficulties, sensory sensitivities)
The earlier toe walking is assessed, the easier it is to treat. A child who has been toe walking for years will have tighter calf muscles and a more ingrained habit than one who is caught early. Don’t wait for it to become a bigger problem.
If your child’s GP has told you to “wait and see” but your gut says something isn’t right, trust that instinct. A podiatry assessment is non-invasive and can give you clear answers about what’s happening and what to do next.
Book a Children’s Podiatry Appointment
At ModPod Podiatry, we see children with toe walking at all five of our Sydney clinics — CBD, Mosman, Dee Why, Rose Bay, and North Ryde. Our podiatrists are experienced in paediatric gait assessment and work alongside your child’s other health professionals to get the best result.
If your child is walking on their toes and you’d like a professional opinion, book a children’s podiatry appointment today. We’ll assess your child’s gait, check their ankle range of motion, and put together a clear plan — so you know exactly what’s going on and what to do about it.
