Talipes equinovarus, also called clubfoot, affects around one in 1,000 babies, according to the American Academy of Orthopaedic Surgeons. A baby with talipes equinovarus may have one or both feet twisted in the wrong position. The cause is unknown, but babies are twice as likely to be born with the deformity if one of their parents or siblings has it. Consult your physician about exercises before performing them on your child.
Talipes Equinovarus
Talipes equinovarus is a serious deformity that causes the entire foot to rotate inward with the toes pointing up and the heel pointing in. The two types of talipes equinovarus are positional and structural. If your baby's foot is of normal size and the condition is positional, exercises can usually manipulate the foot into the correct position. Exercises are less likely to work if the problem is structural. A baby with structural talipes equinovarus has smaller feet and thinner-than-usual calf muscles. Exercises may work if performed promptly when the baby is young and her tissues are soft.
Ponseti Method
The Ponseti method uses exercises, casts and splints to manipulate and hold the affected foot in the correct position. A specialist turns the sole of the foot to face up and then stretches the foot outward in a horizontal manner, called abduction, while pressing against the outside of the talus bone in the ankle to keep it from rotating. The exercises stretch the ligaments that connect the bones of the foot and ankle to improve the positional relationship between the talus to the heel. A cast then holds the foot in the better position. Treatment may take six weeks.
French Functional Method
The French functional physical therapy method is the other nonsurgical option commonly used for talipes equinovarus. The method requires daily stretching exercises, massage and mobilization exercises to move the foot into an increasingly better position; tape holds the foot in each improved position until replaced by a molded plastic splint. A physical therapist begins the exercises and then teaches parents how to continue the exercises, taping and splinting at home. If you use this method, you must perform the routine at home until your child reaches 2 years of age.
Surgery
Physical therapy exercises do not work for every child. Doctors generally suggest surgery to straighten the foot after children reach 6 months of age if exercises are unsuccessful. Surgery for talipes equinovarus lengthens the heel cord -- which is the Achilles tendon -- and fix the position of the front and back part of the foot. Correcting the foot with surgery before your child begins to walk prevents significant delays in his development. Exercises to increase range of motion are part of the recovery process; these exercises begin generally about six to eight weeks following surgery when the cast is taken off.
