Clubfoot Orthotic

Clubfoot used to be treated with surgery, but now doctors use a series of casts to realign the bones of the affected foot.  After this initial stage, the child is fit with a custom orthotic, or brace, commonly known as Boots and Bar.  We provide a number of different styles to accommodate your specialist's request.  This treatment is called the  Ponsetti Method, and all our orthotics conform to this therapy.

The Brace/Boots and Bar maintain optimal alignment of the soft tissues with regular stretching, 6 to 8 times daily, which is performed by the parents following the instructions of the healthcare professionals involved the child's care.

What is clubfoot?

Clubfoot is a common type of birth defect that affects the muscles and bones in one or both feet.   The affected foot looks rotated, inverted, and pointing upwards. The arch is accentuated and the heel turns inwards;  in severe cases the foot may look as if it is upside-down.  

What are the treatment goals?

We book an hour for your first appointment at which time Eric Bapty, our Certified Orthotist, will measure and fit the brace/boots according to foot measurements and size the bar to match your child's sholder width. Often the brace/boots will need to be re-ordered and the bar resized, all to accommodate your child's growth, as the Ponsetti method is usually recommended until the age of three to four years.

Treatment goals:

• Normalize the alignment of the heel (calcareous) and forefoot (metatarsals)
• Stretch the shortened Achilles tendon

How to use the boots and bar

Our Certified Orthotist will show you the correct method of putting on the boots and then attaching them to the bar.  It is important to ensure that the child's feet are positioned correctly in the boots:

• ​Put on soft, thin cotton socks making sure they fit snugly and go above the top of the boot.
• Open all the flaps of the shoe and move them and the straps out of the way.
• Slide the child's foot into the boot, making sure the heel in all the way down and at the back of the boot.  Press down with your thumb to keep the foot in place.
• Holding the foot securely in the boot, put the shoe's tongue over the middle of the foot.
• Always tighten the middle strap first - it snug enough that you are unable to wiggle the foot.
• Tighten the top strap over the ankle, followed by the third strap near the toes.  
• Look through the hole in the back of the boot to ensure the heel is all the way down and back.
• Repeat with the second foot.
• To attach the bar, look for the R (right) and L (left).  Slide the bar into the groove in the bottom of the boot with the R at the right foot - it will click into place.
• To take the bar off the boots, press on the "Push" tab while gently pulling the bar out.

What funding is there?

The Ontario Assistive Devices Program (ADP) will fund up to 75% of the cost of the AFO provided that:

• the child an Ontario resident with an OHIP card
• the child requires the device for longer than six months
• you have a prescription from a physician

ADP will cover 100% of the cost provided you meet the above criteria and you are receiving social service benefits from Ontario Works, ACSD or ODSP.

Private Insurance may pay for all or a portion of the cost not covered by ADP.  It is important to consult your insurance company to determine what coverage you may have.  Most companies require a physician's prescription in order to access funding.  

There may also be coverage by:

• NHIB
• Charitable Organizations

For more information, visit our Funding Page.