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Talipes



Club foot – NHS Choices






























































Club foot 

Introduction 

Club foot


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Vanessa and Jon’s daughter was born with club feet. They describe coping with the diagnosis and choosing her treatment, and an expert compares physiotherapy with surgery.

Media last reviewed: 21/10/2013

Next review due: 21/10/2015

Talipes

Club foot is sometimes known as talipes. There are two types of talipes:

  • congenital talipes equinovarus (club foot)
  • talipes calcaneovalgus – where the foot points upwards and outwards

This topic focuses on congenital club foot.

Club foot is a deformity of the foot and ankle that is present at birth (congenital). If it is treated early, the position and function of the foot can be greatly improved.

In a baby born with club foot, the foot points down and inwards with deep inner and heel creases, and the soles of the feet face backwards.

What causes club foot?

In most cases the cause of club foot is unknown. There is evidence of a genetic link, but no other causes have been confirmed.

If you have one child with clubfoot then your risk of having a second child affected is one in 35.

Club foot affects one baby in every 1,000 born in the UK and is one of the most common congenital abnormalities.

Boys are twice as likely to be affected as girls and around half of the children born with club foot will have both feet affected.

Treatment 

Treatment for club foot should ideally start within a week or two of the baby being born, but can still be effective if started much later.

A treatment technique known as the Ponseti method is the main treatment for club foot, which involves your baby’s foot being gently manipulated into position and put in a cast. The gentle manipulation involves gradually stretching out the ligaments and reshaping the bones of the foot, until the foot is in a normal position.

This is repeated weekly for an average of five weeks, but shouldn’t take longer than eight weeks. 

After this series of casts, it is likely your baby will need a small, quick procedure called an Achilles tendon tenotomy, usually performed under local anaesthetic. This allows the foot a more normal range of movement. The tendon takes two to three weeks to heal in a plaster.

After this, your baby will need to wear special boots attached to a bar. These are only worn full time for the first three months, then overnight until your child is at least four years old. During the day, your child can wear normal footwear and should start to walk and run at the same time as any other child.

Although the Ponseti method can be a time-consuming process to go through, it is not painful and in around 95% of cases it is an effective method of treating babies with club foot. It is important to stick to the treatment, particularly the use of the boots and bar, to prevent club foot re-occurring.

Your child’s condition will be regularly reviewed in case they have a relapse and require further treatment.

Evidence shows that effective treatment with the Ponseti method can ensure a child with clubfoot will have pain-free, normal looking feet that function well.

However, there are a small number of children with clubfoot that cannot be fully treated with the Ponseti Method. This can be due to other underlying conditions which make treatment more challenging. Some children will require further surgery which have a less successful outcome.

Read more about treating club foot.

Page last reviewed: 04/02/2013

Next review due: 04/02/2015

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Comments

The 39 comments posted are personal views. Any information they give has not been checked and may not be accurate.

Bev Griffiths said on 03 August 2014

I was born with a left club foot, I had surgery to alter the position of the foot. To use the word “corrected” is so inaccurate – surgery only cosmetically alters the foot. I have a 1″ leg length discrepency and a small stubby foot and over the years due to bad biomechanics I have to live with chronic lower back pain, occasional neck pain, Sacro -Iliac joint pain radiating down my leg and not forgetting a painful club foot. This deformity is so under studied , it’s only fellow club footers that really understand what pain we experience and what we have to live with on a daily basis.
I agree totally with Cam Lonely regarding the fact that us pre -Ponseti Talipes suffers should be recognised with having a painful deformity in which we have to live with daily for the rest of our lives . This information should be highlighted if the Government are basing their disability claims on the information on this site

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Petecob said on 15 June 2014

I was born Talipese in 1963, i had ankle rebuild, bones fused, tendon stretch’s, my first opperation was when i was 5 yrs old, I’ve had a bone graft taken from same leg,
I get constant pain but different types of pain in different parts of my foot,
underneath feels like i have been walking down the road bare foot and always feels hot and aore, top of my foot where some bones where fused is really tight,
the tendon is sore aswell most of the time,
my heal feels like a sharp pain, sometimes as if something inside wants to poke out,
My leg feels like the bone is bowing outwards.
I’m now at the point where im sick of asking for creams, tablets, gels and all the rst, and now im under a new doctor we have started again, as he wants to see what is what………. I can i have my foot and lower leg removed ( i know this sounds extreme but i have thought about this over atleast 20 years, im now 51 and wish the bloody thing was not there ) Someone please give me some interesting advice or help, as its sending me up the wall, im sick of going to my doctors, i just dont like going out and walking on it, im tired of my foot/leg

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roxannemoran said on 09 June 2014

I was born in the early 80s, left foot affected. From what my Mum has told me I had physio until I was approx 5 (no operation). Always remember my built up shoes. From approx aged 13 I have experienced pain in my left calf if I walk in flat shoes or bare feet. I can only describe the pain as a burn – like a knife in my leg. It has stopped me doing things over the years and I can’t walk far without pain. I have to wear heels to overcome this. If I walk more than a few minutes I get a throbbing lump in my left calf. For the last 20 years no one has explained this to me. I’ve simply been told to "work through the pain" (which is easier said than done) without X-rays etc or any diagnosis. Anyway, 20 years later (mid 30s) I finally had an ultrasound on my leg. It turns out I’ve been living with a muscle hernia for 20 years because my affected leg is shorter. Can anyone relate to this? Anyone had repair surgery? Advice to parents with babies with talipes – keep all your records. I recently had a baby and luckily his feet are ok. X

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Cam lonely said on 26 May 2014

I was born in the early 80s with quite a severe club foot, I had surgery when a few months old, 5 years old and when I was 28. I had the usual splints and orthopaedic boots. I’ve been in and out of physio for years which never seems to help really.

I wasn’t able to do sports when I was younger nor can I now, I can’t run about and play sports with my son and I can’t walk more than 20 minutes without sharp pain though my foot at every step, my feet are also quite flat which makes me feel like I’ve been on them for 12 hours. The following day the pain will be a dull ache all day and I have to stay off it. My Achilles’ tendon feels hard and hot to the touch and is very tender and painful most of the time. It makes going out quite miserable at times and I become impatient and irritable. I can’t drive a manual car anymore and have to drive automatic.

I have 3 very unsightly scars on my leg, my foot is a size and a half smaller and I have very little calf muscle on my leg. I’ve learned to get over these insecurities through the years but I live in constant pain and always walk with a limp.

I thick the Ponseti method is great and only wished is was available for me when I was a child. But for us who were born with club foot pre Ponseti we do live in pain and it is a constant problem. This article should recognise pre Ponseti talipes and the problems people have in later life especially if the government is basing disability claims on the information here.

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jojo lisa said on 18 April 2014

Hi. I was born with a severe clubfoot in 1978 and had 4 operations. I had to wear the usual boots, splints, cast ect. My right foot is smaller then my left and my right leg is smaller then my left also have limited muscle in my right calf. I had bone removed from my right hip to try and make my ankle joint look more rounded. I was a ‘normal’ child, played sports, climbed trees ect. However, by the time I reached 20 I was diagnosed with arthritus in my ankle. As I have got older, I experience pain in my lower and upper back, hips, knees, ankle, foot and toes. I have been back and forth to the g.p and hospital to no avail. It makes me feel like they think i am making it up, but reading what some of you have put has made me realise that I am not going crazy.

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Jesshoniston said on 07 April 2014

I was born in 1993 with both feet affected by club foot. I had surgery on both feet and I am now left with unsightly scars and odd sized feet (left foot is a size 7 and right foot is a size 5) and my second and 3rd toe on my left foot are joined together kind of like webbed.
I quite often have pain in my spine and ankles and believe it’s due to my club feet. I’ve seen Physios and doctors who don’t do anything about this.
Just wondering if anyone has children or themselves affected by this and know of anything I could do.

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Leos mummy 2012 said on 02 January 2014

Hi, I would just like to put anyone’s mind at rest who have just found out their baby has talipes. We found out at our 20 week scan that our baby had bilateral talipes, we were sent for another scan where they confirmed, we were taken into a side room and told that as it is a chromosome defect there were chances of other problems like Down syndrome even though our risk factor was 1:6600. We were offered an amniocentesis but declined.
Nearly 21 weeks later we had a beautiful baby boy. He was given extra checks at the hospital as we requested and apart from his special little feet he was completely normal and healthy 🙂
At 12 days old he went for his first casts and then every week they moved his feet a bit more and casted again. At 7 weeks he had his akiliies snipped which he was a little bit grumpy but with the help of Calpol he was fine. A few more weeks in casts and he was put into his boots and bars for 23 hours a day.
3 months later and he just wears them at night. He sat up at 5 months and crawled at 9 months just like all his friends even earlier then some!
He is now 14 months and has just started walking 😉 we are so proud of him!
Hope this helps as I remember how we felt when we found out. Our not so little boy now is so happy and clever and extremely tolerant to what he has been through. It’s made him who he is and I wouldn’t have him any other way.

Good luck x

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Lanny95 said on 08 December 2013

Hi, i was born with clubfoot and have dealt with it for 18 years. And i was wondering if there are any operations i can continue to have once my foot as stopped developing? Iv had a pin put in to straighten my fourth toe but it failed now in suffering with more pain and wish to know my options? If anyone has advice, thanks ??

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rmcconnell12 said on 07 October 2013

I had my left foot corrected when I was a baby and had to wear shoes with a bar between them to straighten my feet. I am now 26 and for the past 5 years I have had pain in my lower back, right hip and right leg going all the way into my foot and I have been told by a few people it has been caused by my left leg been shorter and weaker due to having the club foot and me putting more weight on my right side all of these years. I am on a lot of pain killers and still in a lot of pain just waiting to see the consultants again to see what is going to happen.

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dgg said on 11 September 2013

My son was born with congenital bilateral tallipes in 1999. He had corrective surgery a number of times and spent a fair while in casts in his early months and years and continues to wear a splint on one leg to this day.
He is now approaching his 14th birthday and wants to take his friends to Fort William to ride the World Cup Downhill Mountain Bike track (again) as his birthday treat.
He has grown up as an active youngster and is now probably one of the fittest pupils in his year at school. He trains 3 to 4 times a week with the local bike club and recently came 8th in the Scottish Mountain Bike Championships. His younger brother – who does not have Tallipes – is now 12, also mountain bikes but is no-where near as fast.
At school no-one bats an eyelid at his splint – its just part of who he is.
He has participated in numerous other sports including football, badminton, skiing, climbing etc. and seems totally at ease with the condition. In sports where fast feet are required he is at a disadvantage but participates for fun. No real study to back this up but I am convinced that his high level of activity has helped him to strengthen what muscle he has below the knee and increase his flexibility – natural and enjoyable physio.
Other than being a teenager he has no other issues;-)
I hope this encourages those of you who might be early in the journey.

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5asidemum said on 02 May 2013

I just wanted to leave a comment to hopefully give some comfort to anyone who has recently discovered that their baby has talipes.

Our son was diagnosed with bilateral talipes at the 20 week scan. We were told that this made us approximately 10 times more likely to have a child with chromosomal abnormalities. For example, my stats for having a child with Downs Syndrome at the time were 1 in 66,000 so because he had both feet affected (it does not stand the same with a child that has only one foot affected) this now made my chances 1 in 6,600. Still very low in my opinion.

On the 28th of December 2012, we had a perfectly healthy, beautiful baby boy. He has so far had 5 castings, a tenotomy, and is now in boots and bar for 23 hours a day for 12 weeks. We are on our 7th week. He had a check on Tuesday and all is going really well. I can say, hand on heart that he has taken everything in his stride. Even after the tenotomy he was just grumpy for a couple of days then back to his usual self. His usual self by the way is a very smiley little boy. I have 5 children and he chuckles more than any of them ever did!

I have met so many other talipes mum’s and dad’d sat in the hospital waiting room and, I am yet to meet anyone who’s child was born with anything else along with their funny little feet. Perfectly ‘normal’ healthy little babies.

User52929’s views are extraordinarily extreme and the result I expect of a little too much net trawling. The only thing our son has ‘put our family through’ is sheer joy! Myself, his Daddy and bother and sisters would not change him for the world.

Must go, I have a little man banging his bar on his bouncer. It means Mummy assistance is required!

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ClareC33 said on 14 March 2013

i was born in the early 80’s with club foot on both feet, had several surgeries to try and correct issues, didnt walk properly till i was approx 7 years old. spent several years going to physio (had to wear those special shoes/boots etc), had casts etc. i am now in my early 30’s and have spent the last 4 years or so in pain in my left foot and lower back. have received acupuncture and physio to no avail. doctor has me on strong pain meds and anti-inflamatories (offer little relief). in pain on a regular basis. my back seizes up for no reason and i can be stuck in that position between 5 minutes and 5 hours. reeceived several xrays and they told me what i already knew, my back is out of sync due to being born with club foot, was given special shoes and insoles (still dont work). have been backwards and forwards to the doctor to no avail. the only other thing i was told that i have to either deal with the pain for the rest of my life or have another operation to try and *correct* this issues. i cant walk for long periods of time, cant sit for long periods,my balance is completely out and i fall alot. cant stand people who have no idea what its like to suffer in silence. im really at the end of my tether. can anyone offer any help/resolution? thankyou

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amber_is_awesome said on 12 March 2013

I was born with clubbed feet and I didn’t have the Ponseti method I instead had 6 surgeries, plaster casts, splints, physiotherapy and these little boots with bars when I was little why didn’t I have the Ponseti method and don’t worry about your daughter Jonathan I didn’t start walking until 18 months

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Vanessa1 said on 06 February 2013

Hi, Vanessa here, the mother of Lexi in the video. I just wanted to give you an update. Lexi had a foot check today and everything is absolutely fine – this is now annual. She has great movement in her feet. She finished wearing the bar and boots at night-time 16 months ago, just before she turned 5. I wrote a letter to her teacher requesting time off from school for her appointment, and her teacher had no idea she was born with clubfeet – speaks volumes. Especially as she was a 6 out of a 6 for severity on both feet. The only limitation I have found was the other week in her swimming class, Lexi was struggling with butterfly kicking her feet as she didn’t have the strength in her ankles. If that’s the only limitation she has, we are doing more than OK, and far exceeded our expectations for our darling daughter when she was first diagnosed. I cannot recommend the Ponseti method highly enough.

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sianybaby82 said on 02 February 2013

I recommend looking at the Steps Charity website as they provide lots of information and support.

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sianybaby82 said on 02 February 2013

I found out my son had talipes at my 20 week scan. He was born with bilateral talipes which were scored at 5.5 in one foot and 3.5 in the other. He went through 5 weeks of casting then straight into boots and bars. He is currently wearing them 23 hours a day. The treatment isn’t as bad as initially I thought it would be.

In fact, I consider myself very lucky. He is a content and happy baby generally. Things could have been so much worse.

User52959’s attitude is very extreme. There is always the risk of any baby having a problem and many problems are not diagnosed prior to birth – what would be the solution then?

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specialfeet said on 01 February 2013

I just want to encourage any one who, like us, are pregnant (I am currently 32 weeks pregnanct) and have been told that their unborn child has talipes (bilateral in our case). Forums can contain a lot of unhelpful and negative comments… that lead to confusion and fear. I hope this is encouraging:

We have just returned from meeting the Physio who will lead the treatment of our babies feet and we have been massively reassured. As we waited for our appointment, a beautiful little 2 and a half year old was running around the waiting room. I thought she was a sister of another child waiting to be treated, but in fact, she had been born with very severe bilateral talipes, had undergone the ‘ponseti’ treatment, and honestly, you would never have known… she was a joy to watch, and so inspired and encouraged us!

Our Physio gave us really clear and honest information, and we left with real hope that it really is a very treatable condition and that we are so fortunate to live in 2013, in the UK, where amazing treatment options (for free!) exist!

Please dont spend hours reading forums and googling this condition – seek professional help and find a good treatment clinic that will opt for minimally invasive treatment for your baby… we’ll let you know how we get on.

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kimmij said on 31 January 2013

My son is now 2 years old, he was born with congenital talipies in hes right foot, which we didn’t know he would have till he was born. Hes been through 8 casts, 1 operation to release he’s tendon, wearing boots and bars 23 hours a day for 12 weeks and is currently wearing them just at bedtime untill he will be 4 and a half.Hes right foot is 2 shoes sizes smaller than his left foot, none of this has slowed down his development he crawled at 7months and walked at 14 months and is now a very active 2 year old but just lately he has been complaining of hes feet hurting and screaming out in pain at night while wearing hes boots and bars, as hes young and cannot yet explain to me where about it hurts i believe its hes "bad" foot that is aching. His consultant always said it wont cause him any pain in future, but i was confused on how she would actually know this unless she had been through the same? I just hope as he grows hes pain free.

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Whitehead84 said on 29 January 2013

Hi, I thought I would comment, I was born with Club feet in both feet back in 1984, and thanks to the Dr’s I lead a very normal life, I had corrective surgery for a number of years.

I am training to race an Ironman Triathlon and partake in a number of other endurance events. Nothing stops me.

Yes I would agree that I do get pain in my feet more than others. However I live for the moment.

The comments by User52959 are a little extreme. Why would 100% confirmation of talipse been a problem, its there feet for crying out loud plus we live in 2013 not the dark ages.

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User52959 said on 24 December 2012

I am currently 24 weeks pregnant and found out that my fetus has bilateral clubfeet at 23 weeks and 6 days. The reason for this is that the sonographer, who saw something being wrong, referred us to a consultant in fetal medicine, who said he could not see the feet. At the time I was 21 weeks. The consultant advised I saw him again 2 weeks and 6 days later – the day before the 24 week deadline for termination. He gave me no warning that talipes, which he said there was a ‘very small chance I had’ could be very serious, with between 5 and 25% of bilateral talipes being associated with serious abnormalities at birth and beyond, such as neurodegenerative problems and musculosceletal problems of very high seveity. This is just the severe cases, and who knows just how high the risk is of lifelong problems as no studies of long term follow up for associated conditions actually exist. I found out about the diagnosis the day before the 24 week limit and immediately said I wanted a termination, but they told me it was too late. Now, after 24 weeks there is no chance I can save myself my family and this poor fetus from a lifelong pain at best and a high risk of very serious associated conditions. The consultants who say it is a low risk – woudl they get on a plane what has say 10% risk of crashing? Even if it is just 5% which seems to be the minimum official figure of serious abnormalities associated with bilateral talipes, is this acceptable? And then talipes does not seem to be a picnic for the poor child or the family, either, with risk of chronic pain and years of misery with casts and boots, developmental delay due to not being able to use their little legs and feet… I have been tricked into bearing a child I wish I would not bear, for their sake and mine , all because of the wait to get the diagnosis and no information about that it would be impossible to get a termination if they did find talipes. The arrogance!

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mama_kas said on 28 October 2012

Haya all just an update, I wrote on here beginning of oct, little man is now out of boots and bar and only uses it during the night now as he is far too active for them. He has started trying to stand and walk but his lil feet cant take the weight and i have been asked to stop him standing till his walking boots arrive. Although the physio is having a lil difficulty with him as his Achilles tendon (which he has already had cut to release his ankle) has decided to become stiff again leaving diminished movement which is typical of A-typical talipies apparently. So lots more stretches to do. His foot is turning in the walking boots (which look like smart lil black shoes) so am really not holding out hope that these ones will work. There’s been talk of recasting and/or another tenotomy. They don’t like rushing which i can understand as he said its a life long thing anyway and he will always need intervention to some degree so its just a case of natural ways to help keep his feet straighter for longer, he is a little trooper and gets on through it with much cuddles as we can give.

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mama_kas said on 01 October 2012

My youngest is a 10 month old boy born with severe A-typical bilateral club foot. He had the Ponseti method, the Tenotomy to cut the Achilles Tendons and now he is in boots and bar. It is extremely important that you keep to the boots and bar rule wearing 23 hours per day 7 days per week. You can mix the hour up into slots like I did 15 mins for play once in morning and afternoon & 30mins in evening for bath time. When they are young babies it is easier to do this but as they get older they do resist. Since the Ponseti Method my boys feet have started to relapse again. It’s very noticeable when he is trying his hardest to pull himself up to reach items on my sofa but his tiny feet are not able to take his weight and he really does stand on both ankles which cause him great pain; I don’t want him to be put off from trying so we give lots of encouragement. He also has extremely poor circulation in his feet and we are forever watching the perfusion in his toes. I am blessed that his consultant is very honest about the condition and he has much great advice. The bar can be a general nuisance where prams, shopping trolleys, changing nappies, highchairs, car seats, clothing, and sleeping arrangements are concerned. The boots and bar can also delay development (sitting, rolling, crawling) if they do not get adequate time to play without the bar on which is why I broke up the 1 hour bar free allowance into slots leaving enough time for him to learn these things. We used an aerobics gym ball to teach him balance we found it helped pace his development as wearing the bar altered his sense of balance so without it he was all over the place. I am not ashamed of having a son with bilateral club foot and the truth is there will always be difficulties to some degree but having a good sense of humour will allow our son to look at the funny side of his condition. I hope this helps and sheds a little more reality on living with the condition. Best wishes to all 🙂

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kelz32 said on 26 September 2012

I wrote on here not to long back about my 5 yr old having club foot and i said that we was lucky with dla has we got high mobility and middle care for him i had to renew in june only to get a decision back that he was no longer entitled to it i am appealing at the moment but i don,t get how things are different now than 2 years ago they say hes like any 5 yr old and they also said that they realise he falls alot but he could use a walking frame or walking stick HE,S 5 i really don,t no were theses peoples heads are sometimes

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Jenny Hopalong said on 22 August 2012

Yes, clubfoot is a never ending pain. I am now 64, was operated on as a child, and the final operation at 18 involved creating an artificial calcaneal bone from a graft taken from my hip. I have never been without pain, and no one has ever believed me. Back in the bad old days the prevailing ‘wisdom’ was that children did not feel pain as adults did. Post operatively I never had so much as an aspirin for pain relief. As I have got older, much as I have tried to live an active life doing lots of exercise and teaching yoga, my right foot has now seized up with no range of motion whatsoever, repeated ankle sprains and every step is agony. When my GP finally agreed to refer me for an xray, the report was lost for a month, and when it finally arrived, my ankle (twisted and deformed) was described as ‘normal’! I can’t get anyone to take it seriously, let alone get to a specialist foot and ankle clinic with experience of adults living with the consequences of club foot. The hip displasia, shorter leg, spinal scoliosis, shoe problems, balance and walking difficulties are all there, and I have been told that arthritis is perfectly normal for someone with my condition!
Yes your article leaves much to be desired. It is full of inaccuracies. You should not be giving parents of clubfoot children false hopes. The Ponsetti method only works for the mildest of cases.
Please get you facts straight.

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Musto said on 08 June 2012

Since this page was last reviewed it has subsequently been updated on 8th June 2012 to reflect that club foot can be a very painful condition to live with (particulalry for those born with club foot before the late 1990s when the Ponseti method was introduced in the UK).

In response to feedback, the word ‘corrected’ has also been changed to ‘altered’ to more accurately reflect the fact that treatment can often improve the position and function of the foot but cannot always fully correct it.

Editorial team, NHS Choices

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Willy Kiyotte said on 22 May 2012

Please stop using the term, “corrected.” They are not “corrected,” they are merely altered. TEV is not merely a positional deformity, there are significant, and seriously under-researched neuro-muscular aspects that lead to further problems as one ages. And contrary to the NHS’ position, TEV, or more correctly, post club-foot syndrome, cause on-going and increasing disability for a high percentage of those with this disorder. That your “experts” haven’t admitted this is merely a sign of their failure to do the necessary research. Isn’t it time you were more honest about this? Stop misleading parents and their children, and admit there is still a lot you do not know.

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shiney9 said on 12 May 2012

Just to add insult to injury, I discover that this very page is used by the Department for Work and Pensions to decide whether people with CTEV should work or not. I’m speaking for 100’s of people when I say that "NHS Choices, you have wrecked our lives." I can’t physically work yet here I am having to put my house on the market, because my benefits have been stopped. Thanks!! Come here and spend a day in my shoes and tell me after that what "corrected" actually means. I’ve forgotten!!!!!

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midlander said on 16 March 2012

Club foot is indeed painful – not all the time, in my case, but like most people with a club foot I learned to be very careful with it at an early age.

I was born in 1961, and my left foot was corrected surgically. As a child, if I put my foot down to hard it hurt – the pain is similar to a fracture – I broke my right foot as a child and that hurt less than jumping in the air and landing on my left foot.

Kicking a football? Agony. Jump off a wall and land on my left foot? Agony. Run fast? No chance. Slip off a kerb – agony. I can not balance on my left foot for more than a few seconds, or hop on it at all. Drop more than a few inches and land on my left foot? Agony. Plus my balance is poor due to shorter foot and weak muscles in left calf. Sport at school was a non-starter – couldn’t jump properly, or kick with my left foot or even with my right as my left foot and ankle aren’t strong enough to take the strain involved if my weight is on them.

It still hurts now at age 51 if I forget to take care how I put my foot down or slip off a clump of grass or kerb. Somedays it just aches for no reason.

My right calf/hip is overdeveloped as it does all the work or walking. My left leg is shorter than the right as well as foot, so my pelvis is permanently tilted which started causing painful hip/right thigh muscle problems in my 30s and now causes lower back pain as well.

Maybe babies don’t feel any pain because their uncorrected foot isn’t under stress, but believe me a corrected club foot can really hurt unless you are careful and cautious in what you do with it.

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kelz32 said on 11 March 2012

i have a 5yr old son who was born with right footed clubfoot i didnt no as my 6 scans i had did not pick it up he started having weekly casts he should have had around 6 to 8 but after taking him back after the second to tell them his toes had gone grey/purple when the cast was taken off his whole leg under his knee was purple and bruised i was told they would not be doing anymore casts as the cast that had been put on had been put on way to tight im just glad that it was only a weekly cast otherwise i dont like to imagine what could of happened he was given splints and other stuff he now is under no one medical and suffers from pain in his foot on a daily basis he has to go to school in a buggy and home he can walk but not very far and he falls alot his ot did adaptations for us at are home he suffers from pain all the time but the cold is worse for him how anyone can say it is not painful is beyond me but as for dla we was not knocked back and get mobilty and care for my son

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Jacx said on 14 December 2011

Having been born in the sixties with club foot I was horrified to read that you are stating that club foot isn’t painful. I definitely think that the article needs reviewing as it is giving a false impression to new parents with children with clubfoot. After having various surgeries I still have no movement in my club foot it is 2 sizes smaller than my other and leg length difference is substantial causing a knock on affect on the rest of my body. I live with constant pain/ discomfort and I am horrified by the insensitivity of this article. It just goes to prove the struggles that those born with clubfoot continue to fight against in showing the medical world along with benefits agencies and workforce that clubfoot isn’t something that is cured in childhood but has an affect on the person throughout life both through pain, inability to carry out certain daily living tasks and ignorance of general public and professionals in recognizing clubfoot as a disibility that isn’t cured but is managed as best as possible.

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BillyJoel88 said on 06 December 2011

I totally disagree with this saying, talipes is not painful!!! Clearly this was written by someone who doesn’t have this disability. Or it could have been written by a consultant who’s too stubborn to say its painful because they’re in charge of correcting the feet with numerous operations.

I was born with talipes and i have suffered with pain for 23 years. Having op after op.
I have noticed the pain starting to get much worse as i have grown up. Especially in cold weather!
Another thing is, where there’s pain, it stops me from doing things that i would like to do, like play football or exercise. Which, if i’m being totally honest. Gets me down! So really its a mental and physical pain.

Also i hate the fact that talipes is just brushed off by DLA.

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shiney9 said on 29 November 2011

Another thing that disturbs me about this ‘claim’ that clubfeet aren’t painful is that if employers of people with this condition believe this content in preference to what their employees are saying about pain, discomfort, inability to stand too long, walk too far, carry heavy things or negotiate uneven ground. These are things that happen to me every day and I can’t work at present. Please, someone, maybe the author of this page, get your facts right! You are really doing a disservice to thousands of people. Spend a day in my shoes and tell me about painless clubfeet!

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Willy Kiyotte said on 28 November 2011

I see you are deleting a number of comments that do not agree with the statement on this page, that club feet are "not painful." Do you think we are bad for business, or what? Please justify your censorship, as nothing anyone has so far posted constitutes personal info, libel, abuse of privilege, etc. Why are you afraid to tell parents whose child is born with club feet the truth?

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Galatea0426 said on 28 November 2011

I was born in 1964 in New Hartfor, New York in the USA. I have had over 20 operations to “correct” my bilateral club feet. Although I am very grateful to still be walking, to say that club feet is painless is a huge misnomer. My feet cause me chronic pain due to arthritis, scar tissue and a whole host of other things. I remember as a child having surgery every summer until I was in grade 10…and the pain was almost unbearable. Now, as a 47 year old woman, I am dealing with debilitating pain, and huge mobility issues. Please, if you want to know more, please join our group on Facebook called “Adults and Teens with Clubfeet.” We are an articulate bunch, and a huge resource for great information and truth.

Thanks for listening!

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LucyWithClubFoot said on 27 November 2011

“Club foot is not painful and early treatment is usually effective in correcting the abnormal position of the feet. It is important to review the condition regularly as the child may have a relapse and need more treatment.”

Not painful? That made me laugh. As a 21 year old who has Club Foot, it is incredibly painful. You get used to a dull pain and learn to cope, but a lot of the time it hurts a lot. My left foot straightened naturally but has no arch and a couple of fractures that don’t heal, my right is still curved and I’ve had 4 (technically 6 but two surgeries were carried out at the same time, but have 6 scars) operations on my right foot. End product = limited foot and toe movement, chronic pain all over my foot, a flattened ankle joint, cold toes and finally, constant dread of more operations.

That’s the medical stuff. As a child with a funny way of walking (until I was 6 I walked on the side of my foot) and up into my adult years, people find it funny to bully me about my foot. Not being able to run very well, jump or climb set me apart from my friends and just increased that bullying.

Please change this page, NHS, it’s very painful and a huge thing. You don’t belittle people with bad kidneys, don’t belittle a severe issue.

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LucyWithClubFoot said on 27 November 2011

“Club foot is not painful and early treatment is usually effective in correcting the abnormal position of the feet. It is important to review the condition regularly as the child may have a relapse and need more treatment.”

Not painful? That made me laugh. As a 21 year old who has Club Foot, it is incredibly painful. You get used to a dull pain and learn to cope, but a lot of the time it hurts a lot. My left foot straightened naturally but has no arch and a couple of fractures that don’t heal, my right is still curved and I’ve had 4 (technically 6 but two surgeries were carried out at the same time, but have 6 scars) operations on my right foot. End product = limited foot and toe movement, chronic pain all over my foot, a flattened ankle joint, cold toes and finally, constant dread of more operations.

That’s the medical stuff. As a child with a funny way of walking (until I was 6 I walked on the side of my foot) and up into my adult years, people find it funny to bully me about my foot. Not being able to run very well, jump or climb set me apart from my friends and just increased that bullying.

Please change this page, NHS, it’s very painful and a huge thing. You don’t belittle people with bad kidneys, don’t belittle a severe issue.

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shiney9 said on 27 November 2011

How can the author of this page state that “Clubfoot is not painful?” I am genuinely agog at this statement! I was born, in 1959 with severe bi-lateral clubfeet. Memories are blurred from my early childhood, because children are so adept at blanking bad memories. I do remember much pain, and also sadness at being ‘different’ from others my age. I remember numerous (6+) long hospital stays for surgery and not being with my family. I never really got to know my younger brother as he was not allowed to visit me! That’s pain too in case you didn’t know and it definitely still pains me now! I am truly offended by the comments on this page. Also I find it unacceptable that so few people in the NHS have any understanding at all of Talipes Equinovarus. I understand that treatments have changed and that prospects are better now. But what about us? We are seemingly forgotten and you may just understand over the next few weeks, how many of us there are in constant daily pain from this severe disability. No wonder the DWP won’t take any notice of us! Even the NHS don’t know what they’re talking about!

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er84 said on 27 November 2011

I was born with a clubfoot 27 years ago and I experience a life of daily pain. I have been refused a Freedom Pass and I have been refused DLA on the grounds I am not disabled.

Please tell me what it takes to be disabled if it means living with scars on your feet, very sore scar tissue, chronic cramping in the arch, an inability to move my toes on my clubfoot from surgery, tripping up stairs because of sudden loss of feeling down the leg, a much thinner leg on the clubfoot leg than on the normal leg, chronic fatugue from standing too much and chronic pain in the hips and lower back from the imbalance.

I have had to pay privately for years for physio and a chiropractor because my GP gave up giving me NHS physio… and still I receive nothing to compensate me for the pain and fatigue I experience on a daily basis.

Growing up apart from the nightmare of buying shoes and sandals… I was able to be active but when becoming an adult, all that changes we are not healed… this is when our problems become worse. My foot swells up after walking so much, my ankle still is red and covered in a rash… the scar tissue is still very sore and when I stand at 5’11 with a clubfoot size 4, it is hard to balance and grip on public transport but I still get refused disability support because I “look” normal.

I am not a scrounger, I work hard and I get up and go to work every day but I would love it if clubfoot was recognised as a disability so that I could get a seat on public transport and support with getting around when I cant manage the stairs or all that walking….

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jonathanhubbard said on 26 April 2011

A good review but very biased towards the best case scenario.

The Ponseti method is fantastic, it’s helped our daughter no end. However in my opinion there are delays in my child’s development – she is 11 months and not started crawling for example. She is still in pain when one stands her on her feet, suggesting another tenotomy will be required.

The casting and boots can be uncomfortable for the child, and can cause other issues such as colic, poor posture etc – my daugher has required approximately 7 chiropractor visits as a result.

Having said the above, if anyone reading this is unsure about using the Ponseti method please don’t be. It is by far the best way to treat this in my opinion, a much better alternative to evasive surgery.

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Leg and foot problems in children

Common problems affecting the legs and feet of children under five

Find and choose services for Club foot











NHS Choices Syndication


Club foot

Diagnosing club foot

Club foot can often be diagnosed before a baby is born. However, sometimes it is discovered at birth during the physical examination of the baby.

Unborn babies

Club foot can be detected in an unborn baby using an ultrasound scan. However, it cannot be treated before birth.

If club foot is detected in the womb, you may have further tests to determine whether your baby has any other problems, such as restricted growth (see below).

An ultrasound scan is a fairly accurate method of diagnosing club foot, but it is not 100% reliable. Therefore, if club foot is suspected, you will be told about the condition and the type of treatment that will be needed. Your child may be referred to a specialist in treating conditions that affect the bones, usually an orthopaedic surgeon.

At birth

Your newborn baby will usually be given a physical examination within 24 hours of being born. This will include examining the baby’s feet and legs. Club foot will usually be immediately visible.

If your baby has club foot they will be referred to an orthopaedic surgeon.

Other conditions

If club foot is diagnosed, your baby may also be checked for other, associated conditions such as:

  • spina bifida – a series of birth defects that affect the development of the spine and the brain 
  • other neurological conditions 
  • conditions that cause short stature, stiff joints and collagen defects – collagen is a protein that supports tissue and gives it strength

Published Date
2014-01-30 14:46:34Z
Last Review Date
2013-02-04 00:00:00Z
Next Review Date
2015-02-04 00:00:00Z
Classification
Club foot






NHS Choices Syndication


Club foot

Introduction

Club foot is a deformity of the foot and ankle that is present at birth (congenital). If it is treated early, the position and function of the foot can be greatly improved.

In a baby born with club foot, the foot points down and inwards with deep inner and heel creases, and the soles of the feet face backwards.

What causes club foot?

In most cases the cause of club foot is unknown. There is evidence of a genetic link, but no other causes have been confirmed.

If you have one child with clubfoot then your risk of having a second child affected is one in 35.

Club foot affects one baby in every 1,000 born in the UK and is one of the most common congenital abnormalities.

Boys are twice as likely to be affected as girls and around half of the children born with club foot will have both feet affected.

Treatment 

Treatment for club foot should ideally start within a week or two of the baby being born, but can still be effective if started much later.

A treatment technique known as the Ponseti method is the main treatment for club foot, which involves your baby’s foot being gently manipulated into position and put in a cast. The gentle manipulation involves gradually stretching out the ligaments and reshaping the bones of the foot, until the foot is in a normal position.

This is repeated weekly for an average of five weeks, but shouldn’t take longer than eight weeks. 

After this series of casts, it is likely your baby will need a small, quick procedure called an Achilles tendon tenotomy, usually performed under local anaesthetic. This allows the foot a more normal range of movement. The tendon takes two to three weeks to heal in a plaster.

After this, your baby will need to wear special boots attached to a bar. These are only worn full time for the first three months, then overnight until your child is at least four years old. During the day, your child can wear normal footwear and should start to walk and run at the same time as any other child.

Although the Ponseti method can be a time-consuming process to go through, it is not painful and in around 95% of cases it is an effective method of treating babies with club foot. It is important to stick to the treatment, particularly the use of the boots and bar, to prevent club foot re-occurring.

Your child’s condition will be regularly reviewed in case they have a relapse and require further treatment.

Evidence shows that effective treatment with the Ponseti method can ensure a child with clubfoot will have pain-free, normal looking feet that function well.

However, there are a small number of children with clubfoot that cannot be fully treated with the Ponseti Method. This can be due to other underlying conditions which make treatment more challenging. Some children will require further surgery which have a less successful outcome.

Read more about treating club foot.

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Published Date
2014-01-30 14:46:10Z
Last Review Date
2013-02-04 00:00:00Z
Next Review Date
2015-02-04 00:00:00Z
Classification
Club foot






NHS Choices Syndication


Club foot

Treating club foot

If your baby has club foot, treatment will usually begin within a week or two of their birth. The aim is to improve the position and function of your baby’s foot and minimise any pain.

The Ponseti method

A technique called the Ponseti method (named after Dr. Ignacio Ponseti who developed it) is the main treatment for club foot. An increasing number of orthopaedic specialists (bone specialists) use the Ponseti method and it is available in many clinics. However, not all hospitals provide the service.

The Ponseti method is successful in treating more than eight out of 10 cases of club foot. Long-term results are also very promising compared to previous surgical treatment methods.

One long-term study followed up people with club foot who had been treated with the Ponseti method 30 years ago. More than three-quarters of the people who were treated either had good or excellent function in their feet. This was only slightly less than a group of people of similar ages who were questioned about pain in their feet and had never had club foot.

How it works

The Ponseti method involves weekly sessions with a specialist, or another trained healthcare professional, who will manipulate your baby’s foot with their hands, gradually altering the bend in their foot. They will then apply a plaster cast from your baby’s toes to their thigh to hold the foot in its new position.

The casts will be changed weekly at each session and your baby’s foot will be altered a little more each time. On average, five or six casts are usually used, but your baby may need to have a few more or a few less, depending on the severity of the condition. 

Your baby’s foot will be manipulated gently, so the procedure should not hurt them. Babies will often cry during manipulation and casting although it is not usually due to pain.

Achilles tendon surgery

Following the Ponseti method, your specialist will decide whether your baby needs to have a small operation to release the tight tendon at the back of their heel (the Achilles tendon). This is a very minor operation that most babies with club foot will need to have.

Achilles tendon surgery is often recommended after the front of the foot has been manipulated (usually after the fourth or fifth cast) but when the ankle cannot be fully altered.

The procedure is usually carried out under a local anaesthetic on an outpatient basis, which means that your baby will not have to stay in hospital over night. In some cases, a general anaesthetic may be used so that your baby will be unconscious during the operation.

During the procedure, the surgeon will make a small cut in your baby’s heelcord to release their foot into a more natural position. Your baby’s foot and leg will be put in a plaster cast for about three weeks.

A small number of children will require further surgery when they are between two and seven years of age. This may involve moving a tendon in front of the ankle to a different position to improve the foot’s function.

Boots and bar

After your baby’s foot has been treated, they will need to wear special boots that are attached to a bar (brace). This will hold their feet in the most effective position. The boots have straps to attach them firmly to your child’s feet and the bar will keep their feet about shoulder distance apart.

The boots will need to be worn 23 hours a day for three months, and then after this time just at night and nap times until your child is about four years old.

It is very important that your child wears the boots for the required amount of time otherwise their foot may return to how it was previously and treatment may have to begin again.

Relapse   

Sometimes, club foot can reoccur. This is known as a relapse and it is estimated to occur in one or two out of every 10 cases. Relapses are more likely if the treatment method described above is not followed exactly.

If club foot reoccurs, it may be necessary for some of the treatment stages to be repeated – for example, your child may need to have their foot manipulated again and put in a cast.

In some cases, ensuring that your child continues to wear the boots and bar may be enough to improve their club foot significantly. However, in other cases where there has been a relapse, surgery may be required. 

Published Date
2014-01-30 14:46:54Z
Last Review Date
2013-02-04 00:00:00Z
Next Review Date
2015-02-04 00:00:00Z
Classification
Club foot,Foot


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