Club Foot

Foot turned inward and downward at birth
Stiffness of the foot
Smaller calf on the affected side
Usually painless in infancy

Quick answer

Club foot is a congenital condition where a baby’s foot is turned inward and downward. It is treated primarily with the Ponseti method — serial casting from the first weeks of life followed by bracing. Physiotherapy supports the programme and maintains movement and strength as the child develops.

Typical recovery

Casting from birth; bracing until age 4–5

Club foot, or talipes equinovarus, is present at birth: the foot is turned inward and pointed downward, and the tissues on the inner side are tight. It affects roughly one in a thousand babies and is more common in boys. Both feet are involved about half the time.

The treatment that works

The Ponseti method is the established approach worldwide: gentle weekly manipulation and serial casting starting in the first weeks of life, usually a small procedure to release the Achilles tendon, and then a foot abduction brace worn full-time for around three months and at night until roughly age four or five.

Starting early matters — the tissues are most responsive in the first weeks.

Where physiotherapy fits

The casting programme is led by the orthopaedic team. Physiotherapy contributes alongside and afterwards:

Maintaining foot and ankle movement between and after casting
Strengthening the calf and foot muscles, which are typically smaller on the affected side
Supporting normal motor development — rolling, crawling, standing, walking
Gait retraining once the child is walking
Helping families manage the brace, which is where the whole outcome usually hinges

The single biggest factor in the result

Brace compliance. Relapse is common when the brace is not worn as prescribed, and uncommon when it is. Families find the brace difficult, and practical support with it is genuinely part of the treatment.

What to expect long-term

Most children treated with the Ponseti method walk normally and take part in sport. The affected calf usually stays slightly smaller and the foot slightly shorter, neither of which limits function.

Medically reviewed by Nasir Mughees, BPT, MPT, Orthopaedic Physiotherapy · Last reviewed September 2026

Frequently asked questions

When should treatment start?

Within the first few weeks of life. The tissues are most responsive then, and early treatment gives the best results.

Will my child walk normally?

Most children treated with the Ponseti method walk normally and participate in sport. A slightly smaller calf and shorter foot on the affected side are common and do not limit function.

How important is the brace?

It is the single biggest factor in whether the correction holds. Relapse is common when the brace is not worn as prescribed and uncommon when it is.

Others in ankle & foot

Flat Feet Ankle Sprain Achilles Tendinopathy Stress Fracture High Arch Foot (Pes Cavus) Ankle Pain