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Why does my 3-year-old only walk on his toes?
Q: My son will be 3 in August, and he continues to walk on his toes. Every day I encourage him to walk with his feet, but he only takes one step and returns to his toes. Any suggestions? Thank you.
A: Elaine, it’s good that you’re concerned about your son’s physical development and his walking on his toes. From 1 to 2 years of age, it’s common for toddlers to walk on their toes, but most children outgrow it by the time they’re 3. Your son’s continued walking on his toes could be a normal part of his learning to walk, or it could be a sign of another developmental, neurological, muscular or orthopedic condition.

It’s helpful to know more about your son’s overall development. Were there any complications during the pregnancy or delivery? Was he born prematurely? How has the rest of his development been so far: his hand coordination, speech, social interactions, etc.? Other than the walking on his toes, is his development typical of an almost 3-year-old: for example, does he feed and dress himself, talk and play with other children and adults, speak in three-word sentences, answer simple questions, and follow simple directions? Does he have any other behaviours that you’re concerned about?

It’s best to make sure your son gets a thorough assessment by the pediatrician. The doctor should do a full developmental and neurological assessment, and also pay special attention to your son’s feet, ankles, legs and hips, and the way he stands and walks. Ask the doctor whether it might be helpful to request an additional assessment by a developmental or orthopedic specialist and the local school district. These assessments will determine whether developmental services, physical therapy, or other services might be helpful for your son.
Karen Sokal-Gutierrez M.D., M.P.H. Pediatrician