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Clubfoot

Clubfoot, or talipes equinovarus, affects roughly 150,000 to 200,000 children each year. Every year, almost 11,000 children are born with clubfoot in Southern Africa, around 2,000 in South Africa. Boys are twice as likely to develop it. Clubfoot is the most common musculoskeletal birth deformity.

It is a congenital condition, meaning that it is present at birth. It may affect one or both feet, and about 50 percent of cases are bilateral. In most cases, the cause of clubfoot is unknown (idiopathic), but there may be a genetic component since it can run in families.

Clubfoot causes the foot to turn inward and point downward. Shortened tendons and ligaments on the inside of the lower leg restrict outward movement and cause the foot to turn inward. A tight Achilles tendon causes the foot to point downward. Most children born with clubfoot do not have missing bones, muscles, or connective tissue. Babies with clubfoot aren’t usually in pain, but if not treated, clubfoot can become painful and make walking difficult.

Clubfoot can be easily identified at birth since the foot will be twisted inwards and rigid. In some cases, the diagnosis is made before birth during a routine ultrasound. If you suspect your child may suffer from clubfoot, talk to a doctor who is experienced in diagnosing this condition.

Clubfoot is usually treated within a week or two of your baby’s birth.  The Ponseti method is the main treatment for clubfoot.  This involves gently manipulating your baby’s foot into a better position, then putting it into a cast from the toes to the thigh, to hold the foot in position.  The process is repeated every week for about 5 to 8 weeks.  Casting and manipulation are done very gently, so your baby should not experience any pain.

Once the foot has been corrected, your baby must wear special boots attached to each other by a bar.  The boots should be worn for 23 hours a day for the first 3 months, then only during nap times and at night until the child is 4 or 5 years old. All other times, regular footwear may be worn.

How can physiotherapy help?

Paediatric physiotherapists have the expertise and clinical training to provide early treatment to children with symptoms of Clubfoot.  We will provide your child with a comprehensive assessment and the best possible level of care during the treatment process.

Our aim is to assist your child’s walking biomechanics in order to encourage your child to walk as efficiently as possible.  We aim to prevent pain in the future, maintain your child’s muscle and tissue flexibility, and prevent any weaknesses in the lower extremities and core developing.

Stretching exercises are designed to help maintain the length of the tissues in your child’s foot.