The Ponseti Method

The Ponseti method is a treatment for clubfoot where doctors use casts, braces and stretching to reposition a child’s foot. Our care team sees children with clubfoot every day. We’ll create a custom treatment plan for your child and take extra steps to keep them comfortable during treatment — putting them on track to be happy, healthy and active as they grow up.

What is the Ponseti Method?

The Ponseti method is a non-surgical way to treat clubfoot. Our orthopedic doctors (doctors who treat bones, joints, muscles and ligaments) use casts and braces to gently reposition your child’s foot. Casting usually happens over four to eight weeks. Then children wear braces for between six months and two years after casting.

What are the benefits of the Ponseti Method?

Surgery used to be the typical treatment for clubfoot, but studies now show that the Ponseti method leads to less scar tissue, better mobility and less foot pain later in life. This means kids are more able to run, jump, play sports and lead more active lives.

What are the side effects of the Ponseti Method?

The Ponseti approach has few side effects. Some children may develop blisters while wearing casts or braces. Children who have clubfoot may crawl slightly later than other children, but this does not impact how they develop and grow. Studies show that 5-year-olds who had the Ponseti procedure walk just as well as other kids who never had clubfoot.

What can I expect with the Ponseti Method?

The Ponseti method looks a little different for each child, depending on how severe their clubfoot is. We use a series of casts to reposition each child’s foot, then use braces to help their feet grow in the right direction. Our team of doctors, nurses, physical therapists and others support families through every stage of treatment and for years after.

What can I expect before treatment with the Ponseti Method?

We can often detect clubfoot on an ultrasound before a child is born, and we start working with kids as early as two weeks after birth. We offer patients quick access by getting families into our clinic shortly after they contact us.

Before we start treatment, your child’s orthopedic specialist will closely examine your child’s foot. Then they’ll create a custom treatment plan that maps out when your child will need to come in for casting, bracing, and any other care they may need. We’ll track their progress throughout treatment and make any necessary adjustments to their care plan.

What can I expect during treatment with the Ponseti Method?

During the first stage of treatment children come in every seven to ten days to get a new cast.

We ask parents to bring a bottle and pacifier to each casting appointment, to help make the child as comfortable as possible while we’re applying the cast. We take extra steps to make this easy on kids — such as playing music in the background, offering a sugar-coated pacifier, and applying the cast in five to ten minutes so babies don’t have to be still for too long. For families who travel from far away to see our team, our doctors may be able to adjust your child’s casting timeline to achieve the same results with fewer visits to the clinic.

We’ll also talk to families about whether we’ll use fiberglass or a plaster cast. We use both materials — but with improvements in fiberglass cast technology, we’re often able to achieve the same results with a fiberglass cast that comes off like a wrap, rather than needing a saw to remove a plaster cast.

After the first weeks of casting, most children need a simple surgical procedure to lengthen their Achilles tendon, because their tendon is too short to move their ankle properly. We perform this surgery through a small incision using local anesthesia.

Next, you’ll meet with our brace makers onsite, where they’ll make a custom Ponseti brace for your child. This brace looks like little boots connected by a bar, which helps kids’ feet grow in the right direction. Children typically wear the brace for 23 hours per day during the first months of treatment, then transition to only wearing them at night. Children may be in these braces anywhere from six months to two years, depending on their condition.

What can I expect after treatment with the Ponseti Method?

After casting and bracing, kids come in for follow-ups every six months for the next two to three years, to ensure they’re growing correctly.

Some children with clubfoot may show signs of recurrence (their foot starting to move back into the angled, clubfoot position) a few years after treatment. If this is the case for your child, we’ll pair you with a physical therapist who will help your child stretch their tendons to keep this from happening. If their foot continues to turn inward after physical therapy, some children may need minor surgery to correct their foot position. 

What questions should I ask my provider about the Ponseti Method?

  • How often do you perform this treatment?
  • Will my child need to wear their braces 24/7?
  • Will my child need physical therapy?
  • If we’re traveling from far away, can my child receive follow-up care at our local clinic?

The Ponseti Method Doctors and Providers