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Printed at: 11:39:34 / 18-04-2021

Positional Talipes Equinovarus

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General Advice
1. What is positional talipes?
Positional talipes is one of the most common abnormalities of the newborn foot. It occurs in approximately 16 per 1000 of live births. It is a treatable condition in which the bony anatomy of the foot and ankle is normal at birth but the foot is held in either a downwards and inwards position or an upwards and outwards position. It can also be referred to as talipes equinovarus or talipes calcaneovalgus, which simply indicates the direction that the foot is pointing.

2. What are the causes?
The causes remain unknown but it is thought to be due to the baby’s position in the uterus, especially in the later stages of pregnancy when the baby is not always freely able to move.

3. How does it present?
Your child may have some or all of the following features:

– Foot pointing downwards or inwards

Treatment
Positional talipes is highly responsive to a simple exercise programme. It is important that these exercises are performed regularly throughout the day, usually about 5 times a day or at each nappy change.
1. Stretches
a) Heel stretch
– Cup the heel with one hand or between thumb and first finger.

– With the other hand, place your thumb on the ball of the foot and your fingers on the top and bring the foot upwards towards the knee in line with the leg.

– Hold this position for as long as your baby will tolerate, aiming for 20 seconds.
– Release and repeat 5 times.

b) Stretch to inside of foot
– Position hands as in above stretch.
– Holding the front of the foot between thumb and fingers rotate the foot upwards and outwards.
– Hold this position as tolerated for up to 20 seconds.
– Release and repeat 5 times.

2. Stimulation
The muscles that actively pull your foot upwards and outwards are located on the outer side of the leg. To stimulate these muscles you can:
– Brush you finger up along the outside of the foot from the little toe towards the knee. This can also be done in reverse.
– This should encourage your child to move their foot upwards and outwards.

Remember your Health Visitor is always available for help and advice should you have any further concerns about your child.

Your GP will review foot position at your child’s 6-8 week check.