What is Clubfoot? – Signs, Exercises and Treatment

What is Clubfoot?

There are a host of congenital defects that can occur in children. Clubfoot is one such abnormality that is present since birth. It can be detected after birth or in the womb using ultrasound.

Clubfoot, also called ‘Talipes Equinovarus’ (TEV), is a rare birth defect that affects the foot of the baby and causes it to twist inwards. It may affect one, or both the legs and can make it difficult for children to walk normally. In clubfoot, tissues connecting muscles to the tendons (bone) are shorter than the usual.

It usually does not cause any discomfort or pain in newborns but can affect the shape and size of the feet.

What are the Signs That Your Baby has Clubfoot?

Few signs that might indicate clubfoot in children are:

1. Twisted Foot: If your child suffers from this condition, his foot might look twisted and turned downwards and inwards, increasing arch and turning the heel inward. The foot may turn so severely that it may actually look as if it is upside down.
2. Underdeveloped Calf Muscles: Children with clubfoot have underdeveloped calf muscles, and hence, they may not be able to stand upright.
3. Shorter Feet: The feet might be shorter in proportion to the body. If only one foot is affected, then that foot will be shorter than the other foot.

Are There Any Exercises to Treat Clubfoot at Home?

Your doctor may advise you on some easy exercises that can be done at home to treat your baby’s clubfoot. They are:

• Metatarsus Adduction (stretching instep out): To do this exercise, place your left hand on the inside of the baby’s foot. Place fingers of your right hand between your toes and gently stretch the front side of the foot (with the toes) downwards, away from the heel. Hold it for 5 to 10 seconds and bring it back to the normal position. 
• Ankle Plantarflexion (foot goes down): To do this exercise, hold your baby’s heel and ankle with your left hand. Place the right hand above the foot. Gently push the midfoot and toes down using the palm of your right hand while the left hand holds the heel in place.
• Ankle Dorsiflexion (foot goes up): To do this exercise, hold your baby’s heel with your right hand. Gently pull the calf muscles down using that hand. Place your left hand in the middle of the back of your baby’s foot and gently push it towards the heel. 
• Toe Stretches: For this exercise, make your baby lie down and gently pull his toe one by one while keeping the ankle and heel at 90 degrees.
• Strengthening Exercises: To strengthen your baby’s muscles, gently tickle the toes, calf, and the backside of the foot of your baby. He will respond to it by lifting his leg and stretching the muscles. Repeat it ten times.

What are the Risk Factors of Clubfoot?

Since it’s a congenital defect, genetics plays a major role in the development of this condition. However, your baby can be at risk of developing club foot due to various other factors like:

1. Gender: Males are more likely to develop clubfoot than females.
2. Age: Pregnant women above the age of 40, may have a higher chance of giving birth to a baby with clubfoot.
3. Congenital conditions: Congenital abnormalities in the skeleton or the spine like spina bifida can also put your baby at the risk of developing this condition.
4. Smoking: Smoking or inhaling smoke during pregnancy can substantially increase your baby’s risk of developing clubfoot.
5. Family history: If one of the parent or their other children have had clubfoot, then the baby is prone to have it as well.
6. Not enough amniotic fluid during the pregnancy: Too little of the fluid which surrounds the baby in a womb may also increase the risk of clubfoot.

How can  Clubfoot be Treated?

The treatment occurs during the initial weeks after birth to restore functionality and reduce pain in the feet. The treatment options available include:

Stretching

For mild cases, stretching might help manipulate and align your child’s feet. The techniques used for stretching your baby’s foot are:

• The Ponseti Method: In this method, the doctor will stretch the baby’s foot using his hands to correct the bend in the foot. After bringing the foot into position, the doctor will wrap the foot with a cast so that it stays in shape. 
• The French Method: The French Method involves the doctor stretching the baby’s foot daily and applying adhesive tape to keep it in position. This doctor will continue using this method to treat your child until he is six months old to correct the  club foot.

Surgery

Surgery might be done if it is a severe case, and the child’s foot cannot be corrected through stretching.

The surgery will help align various parts of the foot like bones, joints, muscles, tendons, and ligaments and correct their position. 

When to See a Doctor?

Your doctor may diagnose the condition based on a visual examination after birth. Post that, he may advise you to seek treatment by consulting a pediatrician and an orthopedic surgeon. 

To know more about this condition and for immediate consultation,

Request an appointment at Apollo Hospitals.

Call 1860-500-1066 to book an appointment

What are its Complications of Clubfoot?

If left untreated, clubfoot may lead to various complications like :

• Arthritis: Your baby may develop arthritis, which is an inflammation of the joints and muscles.
• Low self-esteem: Your child may experience low self-esteem and have a poor self-image due to his foot’s unusual appearance. 
• Movement: The foot that is affected may be slightly less flexible.
• Leg length: The leg that is can slightly be shorter. However, this generally does not cause major issues with mobility.
• Calf size: The calf muscles on the affected side of the leg may always be smaller compared to the other side.
• Shoe size: The affected foot can be up to 1 1/2 shoe sizes smaller compared to the unaffected foot.

However, clubfoot may cause more serious problems if not treated. These problems may include:

• Poor self-image: The unusual and awkward appearance of the foot can make the body image of your child a concern during his/her teen years.
• Arthritis: The child may develop arthritis
• Inability to walk normally: The twist in your child’s ankle may not allow him/her to walk on the sole of the foot. To recompense, the child may walk on the outside of his/her foot, on the ball of foot or even on the top of his/her foot in certain severe cases.
• Problems cropping up from walking adjustments: Walking adjustments due to clubfoot may prevent natural growth of calf muscles, cause calluses or large sores on the foot, and result in an unusual gait.

How can This Condition be Prevented?

There are no preventive measures available to prevent this condition as it is a congenital disability. However, you can avoid this condition by taking certain precautions like:

• Quit smoking and alcohol consumption: It is advised not to smoke or consume alcohol during pregnancy to prevent this condition in your baby.
• Avoid drugs: Do not consume any drugs or medications that your doctor does not approve of as it may lead to complications.

Conclusion

Clubfoot is a rare congenital condition and does not go away on its own. Proper medical treatment is necessary to manage this condition. If appropriate care is taken, your baby will walk and normally run like other children. However, the feet and calf muscles will remain shorter in size.

Frequently Asked Questions (FAQs)

Is clubfoot a fatal condition?

No. Club foot is not a fatal or life-threatening medical condition. However, if left untreated, it can lead to other severe complications.

Can clubfoot come back?

No. In most cases, clubfoot correction is permanent, and relapse does not occur. However, there are chances that specific muscles in the foot might gradually lose their function after treatment and cause difficulty or pain.

When should I start my baby’s clubfoot treatment?

You can start your baby’s treatment  a week or two after his birth. Since the baby’s bones and muscles are soft after birth, it is easier to correct their position and align them with their body.