Toe-Walking in Children: When It’s Normal, and When to Seek Support
As a parent, noticing your child walking on their tiptoes can spark both curiosity and concern. Toe-walking is actually a fairly common part of early development—but depending on your child’s age, frequency, and the why behind it, it may point to something that deserves a closer look. Let’s break down what’s typical, what may be a musculoskeletal issue best suited for a pediatric physical therapist, and when it could be a sensory-seeking behavior that an occupational therapist can help with.
When Toe-Walking Is a Normal Part of Development
Many toddlers experiment with toe-walking as they first learn to walk. It can happen on and off as they explore balance, new movement patterns, and their growing sense of body control. If your child is under age 2 or a recent walker and occasionally pops up on their toes but also walks flat-footed, this is usually a normal stage of motor development.
As long as your child can walk with their feet flat and is hitting other gross motor milestones—like running, climbing, and squatting—occasional toe-walking is nothing to worry about.
When Toe-Walking Might Signal a Musculoskeletal Issue
If toe-walking continues past age 2 (or after several months of independent walking), happens all the time, or your child is unable to place their heels flat on the ground, it may indicate a musculoskeletal issue. Common reasons include:
Tight calf muscles or Achilles tendon that make it physically difficult to put heels down.
Structural differences in the bones or joints of the feet or legs.
Habitual toe-walking where the pattern has become ingrained and is limiting mobility.
In these cases, a pediatric physical therapy evaluation is recommended. A PT can assess muscle length, joint mobility, gait pattern, and overall gross motor skills. They’ll often recommend stretches, strengthening exercises, and play-based activities to help restore a full range of motion and prevent long-term issues.
When Toe-Walking Might Be Sensory-Seeking
For some children, toe-walking isn’t about muscle tightness at all—it’s about sensory input. Walking on the toes can provide extra pressure and movement sensations that feel regulating for a child’s nervous system. This is especially common in children who are sensory seekers, or those with differences in how they process sensory information.
Signs toe-walking might be sensory-driven include:
Your child can walk flat-footed but prefers to walk on their toes.
Toe-walking happens more in exciting, stimulating, or unpredictable environments.
Your child also shows other sensory-seeking behaviors (jumping, crashing, spinning, touching everything).
In this case, an occupational therapy evaluation may be helpful. An OT can look at the bigger picture of your child’s sensory processing, help determine if toe-walking is part of a sensory-seeking pattern, and guide your family in strategies to meet sensory needs in more functional ways. Toe-walking alone as a sensory seeking pattern is not always a concern.
When to Talk to Your Pediatrician
It’s always a good idea to bring up toe-walking at your child’s next pediatric checkup, especially if:
Your child is over 2 (or has been walking independently for several months) and still toe-walking frequently.
Toe-walking is constant and heels rarely touch the floor.
You notice muscle stiffness, tripping, or pain.
You suspect it may be linked to sensory needs.
Your pediatrician can help guide you toward PT, OT, or a developmental evaluation if needed.
Final Thoughts
Toe-walking isn’t always a red flag—sometimes it’s just a normal stage of toddler exploration. But when it lingers or interferes with your child’s ability to move comfortably, it’s worth exploring further. Pediatric PTs and OTs both play important roles in supporting children, depending on whether the root cause is musculoskeletal or sensory. Determining if the behavior is sensory-based does not necessarily mean that toe-walking needs to be remedied, but rather that there could be a larger sensory “picture” to look at.
If you’re concerned about your child’s toe-walking, know that you don’t have to figure it out alone. Support is available, and early intervention can make a meaningful difference.
