Ideopathic Toe Walking (ITW) is when children walk on their toes for no known reason. We do not know why children with ITW walk on their toes. Physicians diagnose ITW by ruling out other diagnosis.

Toe walking usually starts when walking or soon after walking starts.

Children with ITW may:

  • Fall or stumble
  • Complain of pain in the foot or leg
  • Have tightness in the calf muscles in the back of the leg
  • Have difficulty with jumping, running and hopping
  • Have a history if injury in the ankles
  • Have language delays


Early evaluation by physical therapist can prevent delay in movement skills and injury. The evaluation will consist of a review of your child’s medical and family history. The PT will do a physical examination of your child’s legs and measure movement and strength. The therapist will also watch your child walk, jump, run, etc. The child should wear loose comfortable pants or shorts to the evaluation.


Physical Therapy treatment may include:

  • Stretching the ankle and leg
  • Strengthening exercises for the leg and foot balance
  • Coordination exercises
  • Taping the leg muscles
  • Providing verbal feedback
  • Neuromuscular electrical stimulation
  • Manual therapy
  • Ankle joint mobilizations
  • Splints
  • Braces
  • Walking training
  • Treadmill training
  • Shoe modifications
  • Serial casting
  • Home exercises programs.

It is integral to the success of treatment that you do the home exercises as directed by the therapist.

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