I often see children in clinic who struggle to walk with the feet flat and find it easier to walk on their tip toes without any contact with the floor with their heels. This is very common and will usually resolve once a child starts walking more and starts school, however sometimes it doesn’t resolve, and this is when it cause a child pain or problems as they get older.


Most of the time the exact cause is not known but can be cause by:
 Muscle tightness in the calf and joint stiffness
 In older children it can be a habit or because the muscles and tendons in their calves
have slowly become tight over time.

Treatment for persistent tip toeing may involve a period of casting to help stretch these muscles and tendons to help them walk with a flat foot, and referral options can be discussed by your Osteopath through the examination.

However, in some children the cause can be a neurological issue such as Cerebral palsy or Muscular dystrophy however this will be shown on neurological examination as they may have additional signs and symptoms.

Symptoms of tip toe walking
 Pain in their feet or/and knees
 Tightness in their legs when walking
 Walking on their tip toes can cause problems as they get older such as pain when
they exercise, muscle length differences, there biomechanics may alter as they grow
causing pain and mobility in their feet.
 Most children who walk on their toes can put their feet flat, but it can feel sore and
uncomfortable, but may say their feet hurt if they wear different types of shoes
more tight fitted shoes or when they are participating in sports.


But how can osteopathy help?
Osteopathy can be beneficial for paediatric toe walking to help reduce their symptoms unless it is caused from a neurological condition but if you have any concerns speak to your Osteopath. Treatment may include your osteopath doing some gentle massage on your child’s legs and feet and helping the mobility of their feet and legs.

When a child walks on their toes it can lead to muscle imbalance, alter how they walk and can lead to pain and that is why your osteopath will first look at how your child walks and how their hips, knees and ankles move and treatment will focus on all these areas.