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Two-Year-Old Walks on Her Tiptoes
Q: My child is two years old and almost always walks on her tiptoes. She has been seen by a physical therapist who said she is okay but has a tight muscle tone. I've tried all kinds of shoes. I want to know if she will eventually walk normally. Is this something to be concerned about?
A: It is actually very common for toddlers to walk on their tip toes. For some children, it is just a habit and for other children, it is due to the fact that their muscles, particularly the Achilles tendon and the calf muscle in the back of the leg, are a little bit "tight." This means that the muscle does not stretch as much as it does in other children and therefore it makes it harder for the child to actually put the heel flat on the floor. The best management of this is to do physical therapy and gradual stretching to loosen up the tightness of that muscle. Rarely, children with severe tightness will need casting or surgery to help correct the problem. For children who walk on their toes out of habit, they'll usually start to put their heels flat as they get a little older and are involved in a wider range of activities such as running, climbing, jumping, etc., that force them to put the heel flat on the floor.
I would also recommend that you check with your pediatrician to make sure her developmental skills are all on target for her age. There have been some medical reports suggesting that there might be a higher incidence of language delays in children who toe walk.
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Shari Nethersole is a physician at Children's Hospital, Boston, and an instructor in Pediatrics at Harvard Medical School. She graduated from Yale University and Harvard Medical School, and did her internship and residency at Children's Hospital, Boston. As a pediatrician, she tries to work with parents to identify and address their concerns.