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Toe Walking

Many of the clients I see in my office are referred due to toe walking. Toe walking can be caused by a few different things and it is a sign that something is connected or parts of the brain are being overstimulated.

Reflexes and Toe Walking

There are a couple of reflexes that are highly involved with toe walking is present. The first is Trunk Extension. Trunk Extension is both an archetype movement (develops in utero around 12 weeks gestation) AND a reflex. This gets a little confusing. To simplify things, we will focus on the reflex which should integrate at about 9 months after birth. Trunk Extension helps develop our head-righting reflex which allows us to keep our balance when we change positions. It also develops connections between the brainstem, midbrain, and neocortex. It is associated with social engagement, imagination, and a feeling of being anchored and secure.

If you hold a baby up under its arms and lift it up, its toes will point straight down. This is trunk extension. If it stays active, a child will walk on their toes. Lung capacity is also expanded with trunk extension so if it is active, it may contribute to the development of asthma.


The next reflex associated with toe walking is the tonic labyrinthine reflex, or TLR. The TLR emerges at about 8 weeks in utero and should integrate at about 8 months after birth. The TLR allows a baby to stay in the fetal position during pregnancy and to uncurl after birth It helps integrate our proprioceptive, vestibular, and visual systems; maintain muscle tone; coordinate movement, and more!


The last reflex associated with toe walking is the foot tendon guard reflex, or FTG. This is part of the fight or flight response and signals the body is trying to protect itself from a perceived threat. This threat could be physical, biological, or emotional. If the core is not fully active due to integrated spinal reflexes or foot reflexes (Babinksi, Leg-Cross Flexion-Extension), the brain will perceive the body is unstable and thus activate the FTG.


Biological Causes of Toe Walking


FTG can be activated by imbalances in our biochemistry. Remember, anything the brain perceives as a danger can trigger this response. Some common triggers include:

  • High levels of yeast, bad bacteria, or parasites in the gut

  • Low levels of B vitamins and/or magnesium

  • High levels of glutamates

  • Reactions to certain food dyes and preservatives such as nitrates and MSG

Poor Sensory Processing


OTs or Functional Medical Doctors may point to sensory processing issues as the cause of toe walking. Actually, these are two sides to the same coin. If Trunk Extension, TLR and/or FTG are active, then the midbrain is not connected and/or getting the information it needs in the Thalamus to accurately process sensory information. Hand flapping and vocal stimming, auditory or visual processing issues, and visual tracking challenges would all point to low thalamic function.


What to Do


Some children have multiple factors at play. In order to determine the cause of your child's toe walking, work with a qualified reflex integration specialist and a naturopath who has significant experience working with neurodiverse children. It is rarely just one thing, but a combination of factors that are causing this issue.





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