Reducing Tip-Toe Walking Behavior

By: Judy Benz Duncan, Occupational Therapist

Most children, when they are learning to walk and develop their coordination skills, typically do walk on their tip-toes, or forefoot. This is a common behavior and is an expected stage of development with children.

For children who seem to continually be walking on their tip-toes, and do not seem to develop into walking using their whole foot, it can become a concern.

Sustained and prolonged walking on their tip-toes can pose difficulty with dynamic balance changes and stability, as well as allowing the Achilles tendons to shorten.

Some strategies and activities that you can try to get your child to walk with their feet flat on the floor include:

Check with your pediatrician for a podiatry consult to determine if there are structural issues or need for special shoes, inserts, or bracing

Keep track of when your child does the majority of toe-walking – is it most noticeable when barefoot, with certain shoes, when tired, when over-stimulated? Do they toe-walk with both feet equally, or does it seem they only toe-walk primarily on one foot?

Provide lots of deep pressure input (like a foot massage, stretching) to your child’s feet, especially before and after putting on shoes, at bath time, and if you are able, when you notice them displaying this behavior

Foot massages can include deep push/release, rubbing briskly on the soles of their feet, applying lotion with deep massaging motions

Encourage your child to walk barefoot over a variety of textures (grass, carpet, bubble wrap, sand at the beach/park or sandbox)

Encourage jumping on a trampoline (supervised for safety)

Try ankle / foot stretching exercises on a daily basis to maintain your child's tendon lengths. Ask your child’s services providers / podiatrist / pediatrician for instruction in technique and for specific exercises to prevent an injury to the joint/ tendon / muscles.

Look for good footwear that supports the ankle and foot well

Sometimes wearing crocs or other slip on shoes make it almost impossible to walk on their tip-toes and still keep those types of shoes on their feet

Give additional proprioceptive feedback by use of ankle weights (not all the time, but at specific times during the day); soft ankle weights are fairly easy to find online or at a sports store

Play active games like twister where keeping their foot flat helps them to play the game without falling over, and also gives some good stretch at the ankles while changing their positions

Other games and activities that can help with movement patterns, placing their whole foot on the ground, and giving good body awareness input includes:

o   Hopscotch

o   Jumping rope

o   Shuttle-cock

o   Walking on a low balance beam

o   Stepping from one rubbery tactile disc to the next

o   Skipping

o   Walking heel-to-toe on a taped line

o   Follow foot print walking pattern making sure their whole foot connects with the paper or vinyl footprints on the floor

o   Push whole foot into the sand (at beach, sand box, play sand) as they walk leaving a “whole foot” trail

o   Stamp (or stomp) on feathers, leaves, paper cut-outs

What other activities can you come up with?

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