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Clubfoot: Can Stretching and Casting Really Work?

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Total views: 70 | Word Count: 621 | Date: Tue, 1 Sep 2009 | 0 comments

Clubfoot is a problem that many parents hear about, but few have to deal with.  Babies are born with clubfeet infrequently (about 2.5 clubfoot babies in 1000 births).  For those that do have to experience having a child with clubfeet it’s hard to believe that those contorted feet can be straightened out with simple stretching and casting.  Studies show that 95% of clubfeet improve with casting and a heel cord release or physiotherapy.  As a parent you may be given the choice of stretching and taping or casting. Let’s talk about which one of these treatments really works!

First though, some background.  Clubfoot has been around as long as humans and was originally described by Hippocrates.  He said that casting was the treatment of choice.  Since then books and papers have been written on this subject, and treatments have swung from stretching to casting to surgery and back.

In fact, experts still can’t agree on what causes clubfoot or even the exact positions of the bones of the foot that give the high arch, in-turned ankle and tight heel cord.  What experts are agreeing is that initial treatment should not involve major operations.  These researchers have all come to agree that operations can lead to stiff, weak and painful feet in adult life.

One success story of stretching and casting is Troy Aikmen, the Dallas Cowboys quarterback and football commentator.  His clubfoot was corrected with casting, and look what he went on to do!  Other success stories can be found on Youtube, including a video showing Dr. Ponseti, the creator of the Ponseti Technique, treating Benjamin (http://www.youtube.com/watch?v=Xu-E0R16lzw).  

The Ponseti Method of stretching and casting is well-tested, and has been shown to work to correct the foot’s position in the short term, and into adult life.  A competing treatment is called the French Method, which involves taping and physiotherapy.  Just recently the two methods were directly compared in Texas.

The researchers couldn’t prove that one was better than the other, but they did find an important difference between the treatments: Parents preferred the Ponseti casting method over the French method which requires more frequent visits to a physiotherapist or orthopedic surgeon.  Given the choice, parents picked the Ponseti Method 2.5 times more often than the French Method!

If you have a child with a clubfoot you must be wondering if they will need surgery.  Aside from a minor tendon release (Achilles tendon) and a single tendon transfer (Tibialis Anterior in 30% of Ponseti’s casted patients) the majority of children don’t require surgery.  For the other 5% of children a big surgery may be needed to get the foot flat on the floor.  But, that’s the exception rather than the rule.  The most important part of the treatment of clubfoot is patience.  It takes time to correct clubfoot, but near normal feet in adulthood is worth the wait.

Have you had experience with the Ponseti Method?

Did you choose the French method?

What made you pick one method over the other? 

Do you have any advice for parents on how to survive the anxious period of casting?

Did you have a clubfoot as a child? ...  How are you doing now?

Are you running marathons or having problems?

About the Author

Everyone’s story helps to educate the parents of the Dr.everyone community and ease the worry that clubfoot can cause.

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The author is a co-founder of DrEveryone.com, a user-generated health site that helps everyone find what works or does not work in treating health issues and achieving health goals.

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