Massage therapy · Kitchener–WaterlooClub Foot

Club foot can be either mild or severe. In some cases, the bottom of the foot faces sideways or even upward (AAOS, n.d.). It can affect one foot (unilateral) or both feet (bilateral). Even after treatment, the calf muscles on the affected side stay smaller and the foot is usually 1 to 1½ sizes smaller than the other foot. However, with treatment most children can run, play and wear normal shoes (AAOS, n.d.).

Club foot treatment is led by a specialist team, and it is important to follow the treatment plan they discuss with you (NHS, 2025).

Options outside my scope

• Ponseti method: this is the most widely used treatment. The baby's foot is gently stretched into a better position and held there with a plaster cast, which is changed and improved each week over several weeks (AAOS, n.d.; NHS, 2025). About 9 in 10 babies then need a minor procedure to release the tight Achilles tendon (heel cord), followed by another cast while it heals (AAOS, n.d.).
• Boots and bar (brace): after the foot has been corrected, the baby wears soft boots attached to a bar, at first most of the time and later only at night and for naps. This usually continues for several years, and your clubfoot team will tell you for how long (AAOS, n.d.; NHS, 2025). Parents need to put the brace on properly every day. If the brace is not worn as prescribed, the club foot is very likely to come back (AAOS, n.d.).
• Surgery: more extensive surgery to adjust the ligaments, tendons and joints of the foot and ankle is now usually only needed if the foot cannot be fully corrected with stretching and casting, or if the club foot comes back (AAOS, n.d.). Afterwards, the muscles may still try to pull the foot back into its old position, which is why special shoes or braces are often used (AAOS, n.d.).

How I can help (see the My Approach tab)

• Gentle hands-on care for tight or tired muscles and stiffness, within your clubfoot team's plan
• Scar and swelling care after surgery, once the surgeon has cleared it
• Play-based strength and balance work as your child grows

I never work on or under a cast, and care fits around the brace routine rather than replacing it. If your child is too young to agree to treatment, you decide, and parents are welcome to sit in, with their child's agreement. If you're worried the foot is turning in again or the brace isn't fitting well, contact your clubfoot team.