Clubfoot (Talipes Equinovarus)

The correction itself is orthopaedic: weekly casts in the first weeks of life, usually a minor release of the Achilles tendon, then a brace holding the feet apart, worn full-time at first and at night until around the age of four 1. That protocol corrects the great majority of feet, and rehabilitation does not replace any part of it.

What rehabilitation adds is everything around it: keeping the family able to continue the bracing, which is where most relapses come from; treating the calf weakness and ankle stiffness that a corrected foot is left with; and retraining walking once the child is on their feet.

A corrected clubfoot is smaller and stiffer than the other and its calf is thinner; some children walk with the foot turned in or on the outer border, tire quickly, or avoid running. Those are the children who benefit from a programme of ankle range work, strengthening of the muscles that lift and evert the foot, balance training and gait retraining.

Gait analysis shows exactly what the foot does in walking, which decides whether the answer is therapy, an insole, a brace adjustment or a return to the surgeon.

A foot that starts to turn in again after bracing stops is a relapse, and it is treated early — repeat casting and sometimes a tendon transfer — rather than watched. Rehabilitation resumes after that treatment with the same aims.

Older children and adolescents whose feet were treated late or incompletely are assessed individually. Some gain a great deal from strengthening and orthotics; some need surgery first, and the programme is then planned around it.

A written home programme of stretches and play-based exercises, instruction in checking the brace fit and the foot position, and the measurements — range, strength, walking pattern — that show what changed during the block.

Review is planned rather than left to chance, because clubfoot is a childhood-long condition and the foot grows between visits.

Often enough to plan for. A 2026 systematic review of 25 studies and 1,624 children found relapse after Ponseti treatment in about one child in four (26.4%), with wide variation between studies 2. Children whose brace was not worn as prescribed were far more likely to relapse, which makes brace wear the most important factor a family can influence 2.

In one follow-up study, missed brace wear began after the first year of life and rose sharply after the second 1. Practical help with brace fit and bedtime routines matters most in that period, and planned reviews are there to catch early signs of relapse.