Talipes, commonly known as ‘Club Foot’ or ‘TEV’, occurs in around 1 in 1000 children born in the U.K. It is a condition where the tendons in one or both feet are too tight, turning the foot inwards. Talipes is a condition that results from complications during prenatal development, and issues could occur later in life if physiotherapy isn’t administered during the ongoing stages of postnatal support. Positional Talipes on the other hand is a condition that occurs much more frequently in newborns and can often be treated with tailored Talipes Physiotherapy and routine follow–ups. In this blog, we outline how you can successfully assess your child’s foot development, administer home physiotherapy and how to speak with us to book further developmental sessions.
So, what is Talipes and how can physiotherapy help? Talipes is a condition affecting the feet in newborn children and is diagnosed as ‘Club Foot’ or or as Positional Talipes which is much more common and less serious. Physiotherapy can be administered in the early stages of development to correct the misalignment of the foot.
How can you tell if your child was born with Talipes? What are the best methods of Talipes Physiotherapy, and how long does Talipes take to correct using these methods? Find some of our recommendations below to help you properly identify and address issues related to Talipes.
What is Talipes?
Talipes, sometimes referred to as ‘Club Foot’, or professionally as ‘Congenital Talipes Equinovarus’ is the misplacement of a child’s foot during prenatal development, which results in the function of the affected foot being impaired. The foot is often positioned to face downwards and inwards towards the baby’s body and can be recognised by examining the feet of the child after birth.
Depending on the mobility of the child’s foot, different diagnoses can be offered by either your midwife or paediatrician. If the affected foot can be moved into a normal position with little resistance from tendons at the rear of the leg, then your practitioner may diagnose the condition as ‘Positional Talipes’. If the foot cannot be straightened under normal movement, then your child may be diagnosed with ‘Club Foot’, which is more serious and would require medical intervention immediately.
What Causes Talipes?
Talipes is caused by a number of factors, many of which are debated or not yet fully understood. In our experience, however, we consider there to be 2 leading contributors towards the development of Talipes that should be considered.
The average rate for Talipes in children born in the U.K. is around 1 in 1000, however, if 1 parent has the condition, this number becomes 1 in 30. If both parents are born with the condition, then this number is brought down to around 1 in 3.
It is worth noting that common TEV is not caused by actions performed by the mother during pregnancy or labour, but is the familial tendency passed through genes that are believed to be the root cause. However, extrinsic factors such as intrauterine compression caused by a large baby or small uterus are considered to be contributing factors also. Other factors have also been noted, such as abnormal intrauterine fluid levels, which should be addressed by your NHS assessor during pregnancy.
Genetics is believed to play a significant role in the development of Talipes in the womb, with both parents contributing equal levels of genetic influence. Conversely, some gene mutations happen at random, where no particular genetic influence plays a part in a baby’s development. Further information on the genetic influence on your baby can be provided by your doctor through family medical records. We recommend consulting your G.P. for further support with genetic influence with regards to the diagnosis of Talipes in your child.
Some external factors have been linked to Talipes in newborns such as drinking and smoking during pregnancy. It is believed that either of these external factors heighten the occurrence of Talipes in children, but greatly heightens the risk when combined with pre-existing genetic risks. For more information on drinking and smoking along with an assessment of the associated risks, please consult your G.P.
Symptoms of Talipes
It should first be noted that it is believed that Talipes does not cause the baby to experience pain until they start to develop the ability to walk. Club foot is often noticed after the baby is born by your midwife or paediatrician, but it also can be seen in your routine ultrasound scan taken between weeks 18 and 21 of pregnancy.
Positional Talipes is often noticed at birth and can be seen in the way a baby holds its foot. However, with Positional Talipes the foot doesn’t appear to be ‘stuck’ in this position, offering a wide range of movement. The affected foot appears squashed and more wrinkled than what would be normally, as it faces inward.
How Can Physiotherapy Help Talipes?
Physiotherapy is key to the development of newborns with Positional Talipes or Positional Club Foot, however, the type of physiotherapy recommended and when it should be administered alter slightly. Below we have outlined the key steps you should take if you are concerned about the development of your child’s feet, and how we can help.
We are going to focus on physiotherapy for Positional Talipes as medical treatment is not usually needed outside of these exercises. These practices should help your baby’s foot return to a ‘normal’ position at a quicker rate and can be performed by you at home between physiotherapy sessions.
Types of Physiotherapy for Positional Talipes
Our helpful guide for you and your baby’s journey through Talipes physiotherapy is easy and you shouldn’t encounter any negative side effects. We recommend carrying out the below stages of therapy during nappy changes, with your newborn on their back in a natural position.
Gently move your child’s foot to a ‘normal’ position and back, lightly stretching the affected area. You should not feel much resistance during this process. Areas to focus on there are the tendons at the back of the ankle. You want to encourage the foot to face up and out, as it is currently facing in and down.
Hold your baby’s knee, then place your thumb on top of the baby’s foot and your fingers at the bottom, clasping lightly. Then, rotate the foot down, around and up in a circular motion. This helps gradual stretching of the tendon as opposed to any quick or jolting actions, which should be avoided.
You can also stabilise your baby’s leg with the palm of your hand resting on their shin. Meanwhile, place your free hand around the middle of their affected foot. Bring their foot back into a middle position so their foot is aligned with their leg, and then gently stretch it out and to the side. The amount your baby’s foot resists this movement is indicative of their progress towards normal mobility.
These actions should take around 2 – 3 minutes each and be performed several times a day.
Tickling and Encouraging General Movement:
Not only can gentle tickling be a fun bonding activity for you and your child, but it is also a great way to help your child flex their muscles and tendons normally.
With something soft, such as the corner of a blanket or cotton wool, tickle the side of your baby’s foot that faces away from the curve. Your baby will naturally flex its lower leg back in this direction. You can also gently massage the foot with baby oil, or olive oil. Any additional movement is important. However, this method should be carried out at your baby’s discretion; some babies aren’t too pleased with being tickled.
Allow Time Outside of Restrictive Baby Grows and Shoes:
Allow time outside of restrictive baby grows and shoes where possible. As it is claimed that cramped conditions in the womb cause Positional Talipes, it is recommended to allow free movement where possible to help your baby move into positions it would have struggled with whilst in the womb. Allow more wriggle room whilst administering the above home remedies and during nappy changes, which the baby will love. This should be for about 15 minutes several times a day.
How Long Does Positional Talipes Take to Correct?
The question of ‘how long does positional Talipes take to correct?’ isn’t straightforward, however, it should be administered until the child gains correct positioning of their foot. It should be considered that, as a baby grows, it will naturally position its feet in ways which correct Positional Talipes under normal movement alone. Any help you can give your child will greatly benefit their recuperation.
Most cases of Positional Talipes will correct itself within 6 months. Some rare instances can result in the need for corrective procedures such as casts or other orthotics. However, with correct Talipes Physiotherapy, your child should not require any special footwear.
Talipes Physiotherapy with Therapy Stars
Here at Therapy Stars, we offer expert services in all areas of Childhood Physiotherapy tailored from birth up to 12 months in rehabilitation with Club Foot or Positional Talipes. We offer key support for many early conditions found with childhood development such as Talipes and take great pride in helping your infant reach their walking milestones.
We are here to give a helping hand with you and your child’s journey with Talipes Physiotherapy, so Get In Touch to book and know more about our Baby Physiotherapy Service or if you have any questions or concerns about your baby. We can then offer personal and long-lasting guidance and care for you and your family, which is the key to thorough and effective physiotherapy.