Clinically reviewed by What is clubfoot
Clubfoot means a baby is born with one or both feet turned inwards and downwards, with the sole facing in. The bones, joints and tendons of the foot formed in that position. Parents call it paidaishi tedha pair.
It is not caused by anything you did or did not do in pregnancy, and it is not painful for a newborn. It affects boys about twice as often as girls.
This page starts by sending you somewhere else. Clubfoot is corrected by an orthopaedic specialist using the Ponseti method. Physiotherapy supports that treatment. It does not replace it.
Symptoms you might have
- The foot turns inwards and the sole faces towards the other leg
- The heel points downwards and sits high, so the foot looks like a club
- A deep crease across the sole and at the back of the heel
- The foot cannot be brought to a normal position by hand
- The calf on that side is thinner and the foot slightly smaller
- One or both feet, and often both
- Visible at birth, and treatable from the first week of life
Why it happens
- In most babies no cause is found. It happens as the foot forms in early pregnancy
- A family history of clubfoot, which clearly raises the chance
- More common in boys than in girls
- Sometimes part of a wider condition, such as spina bifida, which is why a full newborn check matters
- A tight fit in the womb, or very low fluid around the baby
- It is not caused by the mother's diet, her work, how she slept or anything she took
When you should see a physiotherapist
Your first call is to an orthopaedic surgeon or a hospital running a Ponseti clinic, in the first days or weeks of life. Casting works best early, while the tissues are most stretchable, though it works later too with more casts.
Physiotherapy fits in once casting is finished, for bracing support, stretching, strength and walking. It also helps parents struggling with the brace, which is where treatment most often fails.
Go back to the orthopaedic team urgently if the cast slips, if the toes look dark or swollen, if there is a smell or a fever, or if the brace causes sores. Go back promptly if a corrected foot starts turning in again. Relapse caught early is simple to fix. A child who loses a skill he already had, such as walking, or whose muscles suddenly turn stiff or floppy, needs a doctor urgently.
Al-Shama Physiotherapy Clinic
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اپائنٹمنٹ کے بارے میں پوچھیںAppointment ke liye poochein
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یہ فارم پُر کریں؛ واٹس ایپ پر آپ کی تفصیلات کے ساتھ پیغام تیار ہو جائے گا۔Yeh form bharein, WhatsApp aap ki tafseel ke saath khul jaye ga.
How it is treated
The Ponseti method is the treatment. The foot is gently stretched and held in a plaster cast, changed weekly, usually five to seven times. Most babies also need a small cut to the Achilles tendon, done by the surgeon.
- Brace support, where physiotherapy adds most. The boots and bar are worn almost around the clock for about three months, then at night and nap times for years
- Stretching of the foot and calf after casting finishes, as directed by the orthopaedic team
- Strengthening of the foot, ankle and leg, especially the muscles that lift the outer border
- Gait training once your child is walking, with advice on footwear
- Relapse watching, checking foot position and range at reviews so a relapse is caught while it is easy to treat
Physiotherapy alone does not correct clubfoot, and neither does massage by an untrained person. Casting by a trained Ponseti practitioner is what moves the bones. What decides the result is whether the brace is worn as prescribed.
Exercises, and what to avoid
What helps
- Doing the brace hours in full, every night, for as many years as the surgeon asks
- Daily gentle calf and foot stretches once casting is over, exactly as you were shown
- Barefoot play, climbing and squatting, which build the foot and ankle naturally
- Checking the skin at every brace change, and reporting any sore before it breaks down
What to avoid
- Skipping brace nights. Missed nights are the single commonest reason a corrected foot relapses
- Boots that are the wrong size or loose. The heel must be right down in the boot
- Manipulation or hard massage of the foot by anyone not trained in the Ponseti method
- Assuming that once your child walks the treatment is over. Reviews continue for years
What you can do at home
Make the brace part of the bedtime routine from the very first night. Children accept it far better when it is simply what happens at bedtime.
Expect two or three unsettled nights at the start, and at each change of routine. It passes.
Put thin cotton socks under the boots with no seams or folds, and check for redness over the heel and the outer foot each morning.
Keep the cast dry during the casting weeks, and never try to remove or adjust a cast yourself.
Keep every review appointment, even when the foot looks perfect. Looking perfect is what the reviews are protecting.
Do not worry if your child walks a little later than his cousins. Delayed walking after months in casts is common and it catches up.
How long it takes
Casting usually takes five to seven weeks, one cast a week, so the correcting part is done within about two months.
The brace follows: close to full time for about three months, then nights and naps until around four or five years. That long tail is not optional, and it is the part families most often shorten.
With casting done properly and the brace worn as prescribed, most children walk, run and play normally. The affected calf stays a little thinner and the foot a little smaller, and neither limits a child.
Relapse is the main risk, mostly in the first few years. It is treated with more casting, sometimes a small operation, and it is far easier early.
Urdu / Roman Urdu
Choose your reading script / اپنی پسند کا رسم الخط منتخب کریں
اردوUrdu script
پیدائشی ٹیڑھا پیر کا اصل علاج پونسیٹی طریقہ ہے، جو آرتھوپیڈک سرجن کرتا ہے۔ پیر کو آرام سے کھینچ کر ہر ہفتے نیا پلاسٹر لگایا جاتا ہے، پانچ سے سات بار۔ علاج پہلے ہفتوں میں شروع ہو تو نتیجہ بہترین ہے۔
پلاسٹر کے بعد بریس پہنانا سب سے اہم حصہ ہے۔ شروع میں پورا وقت، پھر رات اور دن کی نیند میں چار پانچ سال تک۔ بریس چھوڑنے سے پیر دوبارہ مڑ جاتا ہے۔
فزیوتھراپی اس علاج کو سہارا دیتی ہے: اسٹریچنگ، پٹھوں کی طاقت اور چلنے کی تربیت۔ صرف مالش سے پیر ٹھیک نہیں ہوتا۔
اگر پلاسٹر میں انگلیاں کالی یا نیلی لگیں، بخار ہو، یا پیر دوبارہ اندر مڑنے لگے، تو فوراً سرجن سے رابطہ کریں۔
Roman Urdu
Paidaishi tedha pair ka asal ilaj Ponseti tareeqa hai, jo orthopaedic surgeon karta hai. Pair ko aram se kheench kar har hafte naya plaster lagaya jata hai, paanch se saat baar. Ilaj pehle hafton mein shuru ho to natija behtareen hai.
Plaster ke baad brace pehnana sab se ahem hissa hai. Shuru mein poora waqt, phir raat aur din ki neend mein char paanch saal tak. Brace chhornay se pair dobara mur jata hai.
Physiotherapy is ilaj ko sahara deti hai: stretching, pathon ki taqat aur chalne ki tarbiyat. Sirf malish se pair theek nahi hota.
Agar plaster mein ungliyan kaali ya nili lagein, bukhar ho, ya pair dobara andar murne lage, to foran surgeon se rabta karen.
Treatment at the clinic, and online
INFORMATION → INDIVIDUAL CARE
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Talk with Dr. Zahra Fatima, DPT. Understand your next steps, with guidance for your own symptoms and daily routine.
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Use the consultation to discuss which care and exercises fit your situation.
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Questions people ask
Can physiotherapy alone fix clubfoot?
Will my child walk and run normally?
Why does the brace have to be worn for years?
Is it too late if my child is already a year old?
Did I cause this during pregnancy?
Related conditions
- Cerebral palsy treatment and physiotherapy
- Torticollis in babies
- Child not walking
- Delayed developmental milestones
- Low muscle tone in babies