Have you noticed that your child often walks on their tip toes? There are multiple reasons why a child might toe-walk. Sometimes it can be a trait you commonly see in autism, but is not always limited to just that diagnosis. There may also be different root causes that motivate the toe-walking. For my son who is on the spectrum, his toe-walking is a result of sensory-seeking behaviors. Walking on his tip toes provides him the sensory input he often craves. Unfortunately, it can be very difficult to discourage a sensory-seeker from the toe-walking habit. There are various behavioral approaches we tried for our son that simply did not work. After many consultations with our physical therapist, it was determined that we would have to focus mostly on exercises and shoes for him that counteract the effects of the toe-walking on his ankles. So, why is toe-walking a concern? If it continues consistently for long periods of time, it can damage the ankles and limit the range of mobility in the feet and legs.
In addition to exercises, there are certain types of shoes one can try to help discourage walking on the toes. An Ankle Foot Orthosis (AFO) may even be considered to help support a child who toe walks. These shoes act as a brace to lock the feet into place where they are only able to stand on flat feet.
*Disclaimer: I am not a licensed physical therapist or a medical professional, but rather an autism mom. Please consult your physician before considering the exercises and tips in this post. It is not intended as medical advice. I am sharing this guide more as ideas I have learned over the years from working at home with my son. I can’t guarantee results or that your child will have the same prognosis. These are simply ideas you can experiment with and try at home.
*Affiliate Disclaimer: This post may include affiliate links where I get paid a commission for some recommendations. However, I only bring you resources that I have personally tried or researched, and firmly stand by them. As an Amazon Affiliate, I earn on qualifying purchases.
Exercises for Toe-Walking
The types of exercises that help to counteract the damage of toe walking are the ones that stretch the toes towards the sky rather than the heels in the upward position. Also, exercises that force the feet to remain flat while in a 90 degree angle with a straight leg position. We personally like to play a lot of games like “duck walking,” where I have my son walk on his heels and try to waddle like a duck. Another game we play is the “bear crawl,” where I have my son get down on all fours with his back feet facing forward and flat. Any time you can make a fun game out of these exercises, you will hopefully get more cooperation and longer duration from your child.
Also, anytime you can get kids jumping or climbing, it is beneficial for toe-walkers. Look for opportunities to go to the park and climb slide ladders, rock climbing walls, spider netting or other climbing playground equipment. This gets their feet stretching without them even realizing they’re engaging in physical therapy. Also, trampolines or bounce houses are helpful to encourage jumping. If you don’t have a trampoline at home, consider allowing them to jump on the bed (if you are okay with this). I have times where I let my son jump on our king-size bed on a rainy day and he thinks it is the coolest thing ever.
There are also several products we have purchased to keep at our home as tools for foot exercises. These handy stepping stones you see below (you can find them on Amazon) are great for motor skills and coordination and balance in general. We lay them across the floor and have our son jump and walk across them, while pretending the floor is a swamp that he can’t fall into or touch with his feet. If he falls, the alligators in the swamp can “eat” him. These stones help with toe-walking and promote flat feet as he concentrates on his balance skills. A wobble board is another essential in our house (click on the link below to find the rockerboard we use, available on Amazon). This encourages balance in general, but is excellent for stretching the range of our son’s ankles. He loves to stand on it and play, but it also helps to have him prop his feet on it while doing homework or eating a snack at the table. The key is to keep the heels in the downward position and the toes up.
A scooter board is also a staple in most occupational and physical therapy offices. It is very fun to have for kids at home, as well. There are so many exercises you can do with a scooter to build the core and strengthen muscles, as well as to promote coordination and motor skills. For toe-walking specifically, we have our son sit on the scooter on his bottom and kick off of the ground with his heels. The process of putting the force on the heels encourages strength in the right places (you can find the scooter we use in the Amazon links below). Finally, exercise bands or therabands are an easy product to have on hand for all kinds of strengthening and dexterity exercises. We are especially targeting our son’s arm strength to prepare him fo swimming this summer. But, for toe-walking, we use exercise bands in a specific way. Take the bands and wrap them around the foot on all sides, pulling backwards on the band, so that the feet are lifted with toes perpendicular and pointing straight to the ceiling. (See the picture of my son above for a demonstration of how he prepared to start this exercise). You can find my recommended bands below on Amazon).
Shoes That Discourage Toe-Walking
In addition to exercises, you can also look into shoes that will discourage the toe-walking. Shoes with a very sturdy high top that cover fairly high up the shin over the ankles can sometimes help. However, high tops were still not sturdy enough for our son, who discovered ways to get his heels up out of his shoes when walking. There are also sturdy hiking boots, which we attempted even in the summer. But, those didn’t last long before our son’s trickster toes outsmarted them, as well. Another great tip we received from a physical therapist we consulted was to put little cushions in his shoes. We bought pillow foam insets that we cut to the size of his shoe, then pulled out the sole and placed the cushions inside. These actually did the trick for awhile. The foamy, squishy material sometimes offers the sensory seekers that sensory input they are seeking on their feet. But, our son eventually stopped liking them for whatever reason and started pulling the cushions out.
It was when we finally found some good quality cowboy boots that we found we had a winner. Our son wore his boots all winter and it ended up being the most effective way to keep his feet flat consistently. The tricky part was the hot summer months in Florida. It was harder to have him wear cowboy boots with shorts. If you are willing to invest in a good pair, however, cowboy boots may be the way to go.
Our physical therapist did end up recommending AFOs for him eventually. These special braces acted to keep his feet flat at all times and simply would not allow him to get up on his tip toes. The PT encouraged us to have him wear them even for just 30 minutes a day. We preferred not to send him to school wearing them, since he had some mobility issues in them running around on the playground. He also complained about them hurting his feet a lot. When a toe-walker is so used to being up on their toes all the time, their feet can really start to hurt after staying flat for long periods of time. It can take some time getting used to them. Eventually my son began taking them off on his own and soon outgrew them, anyways. Therefore, we started going back to the exercises as much as possible rather than relying on the AFOs. They may be something you want to consider for your child, however, depending on how much they are up on their tip toes.
This wraps up the series on toe-walking exercises and solutions. Be on the lookout for more like this in the “At-Home Therapy” series where I’ll be addressing other types of skill sets and interventions. Check out more on autism and special needs resources on my Shop page. You can also subscribe to the blog or follow me on Facebook or Instagram for more posts like these in the future. More posts that may interest you: