Toe walking is common during the developmental stage of a toddler. If walking on the ball of the foot or on tippy toes continues after the age of three, it can create balance disorders and possible ankle and heel cord limitations. This is known as Idiopathic or Habitual Toe Walking (ITW) or Persistent Toe Walking (PTW). While no clear medical evidence exists, persistent toe walking has been identified as a potential early sign of autism or cerebral palsy.

Klaas DeWit, Physical Therapist and parent recognises your concern with the persistent toe walking of your child. Klaas DeWit, PT, has developed an affordable and easy to apply brace that reminds the wearer to use a more natural heel to toe walking pattern.

The “No-Tip-Toe” brace-set (one brace for each foot) costs $39.80 and can be ordered through this website. Sizes are available for children and adults of all ages.

What is toe walking?

Most children begin walking at 12 to 15 months of age. Often, in the early stages of walking, children try different foot positions for walking. Walking up on their toes may be part of this. By around 24 months, they should walk with their feet flat on the ground. By 3 years of age, children should walk with a heel to toe pattern. When a child continues to not use the heels for ambulation, it is called toe walking or ITW.

Toe walking refers to a walking pattern in which a child walks on the balls of his feet and there is no contact between the heels and the ground.

Idiopathic toe walking, sometimes referred to as habitual or behavioral, occurs when a child walks on the balls of his feet. This term applies to toe walking in a child who has been evaluated by a doctor and no medical reason has been identified. Idiopathic toe walking occurs in otherwise healthy and typically developing children. It always occurs in both feet. 

Some children with idiopathic toe walking are able to walk with their feet flat when asked to do so. When these children wear shoes, they might not walk on their toes. Their toe walking is often exaggerated when they walk bare-footed from one room to another or when they walk on surfaces that have increased tactile sensations (carpet, cold tile, grass). These children typically do not have tightness in their Achilles’ tendons (heel cords) early on.

Typical Idiopathic Toe Walking Footprints

Can idiopathic toe walking be treated?

For young children with idiopathic toe walking without Achilles’ tendon contractures, watching and waiting is an option. Some younger children benefit from physical therapy where they are taught how to stretch their legs, feet, toes and muscles. Night-time bracing with plastic orthotics may be helpful. In some cases, idiopathic toe walking may resolve on its own. 

While night time bracing has shown improvement in the ability to place the heels on the ground during walking, it is generally not effective in reminding the patient to actually develop a normal heel to toe walking pattern.

The “No-Tip-Toe” brace provides ongoing reminders to create a subconscious habit of normal walking.