AskThePedipod
Farokh Wadia
What is Tip toe walking?
Mr Farokh Wadia, Consultant Paediatric Orthopaedic Surgeon
1 August 2026
Walking on the toes, common in toddlers and usually harmless, but worth checking if it persists.
What is tip toe walking?
Tip toe walking is walking on the balls of the feet without the heels making normal contact with the ground. It is common and often completely normal in toddlers who are learning to walk. When it persists beyond around the age of three, or when a child always walks this way, it sometimes needs assessment to look for an underlying cause such as a tight calf (Achilles) tendon or a neurological condition.
Signs and symptoms
• Persistent walking on the toes
• Difficulty placing the heels flat on the ground
• Tightness in the calf
• In some children, no other symptoms at all
How is it diagnosed?
A careful history and examination are the most important steps, including assessment of muscle tone, the tightness of the calf tendon, and the child’s general development. Most children with idiopathic toe walking (where no underlying cause is found) are otherwise developing normally. Where there are other concerns, further assessment may be arranged.
Treatment options
Many children grow out of toe walking. Where treatment is helpful, options include physiotherapy and stretching, a period of casting to gradually lengthen a tight tendon, and, for a persistently tight tendon that does not respond to other measures, a surgical lengthening procedure.
Outlook
The outlook is very good, particularly for idiopathic toe walking, which usually resolves with simple measures.
When to seek advice
If your child toe walks all the time, cannot bring their heels to the floor, or if you have any concern about how they are developing.
This information is for general guidance only and is not a substitute for a consultation with Mr Wadia. If you are worried about your child, please seek medical advice.
FAQs
Is tip toe walking normal for a young child?
Yes, tip toe walking is entirely normal and common in toddlers up to the age of three as they learn to walk and develop balance. However, if a child continues to walk on their toes past their third birthday, or if they are unable to physically drop their heels flat to the floor when standing, it requires a professional orthopedic assessment to rule out underlying muscle tightness or neurological conditions.
When to seek a specialist pediatric assessment:
Persistent habit: Walking on the toes most of the time after reaching three years of age.
Physical stiffness: An inability to flat-foot stand or a tight Achilles tendon that limits normal ankle movement.
Asymmetry: Toe walking that occurs on only one leg while the other leg walks flat.
Developmental signs: Accompanied by other delays in coordination, speech, or motor milestones.