Foot and ankle: Positional calcaneovalgus

What is positional calcaneovalgus?

Positional calcaneovalgus is a foot that, at birth, is in an excessive "up and out" position through the ankle and the top of the foot approaches or touches the shin. It may occur in up to 30% to 50% of newborns and is likely caused by the baby’s position while they are in the mother’s uterus. Positional calcaneovalgus can affect one or both feet.

Differentiating positional calcaneovalgus from other conditions is very important so an evaluation with an orthopaedic surgeon is recommended.

In almost all cases, positional calcaneovalgus resolves by itself within a few weeks to months without treatment or with gentle stretching. Positional calcaneovalgus does not cause future disability or flatfoot.

Rare cases may need more treatment such as a specific shoe or a stretching cast if the gentle stretching and exercises do not resolve the deformity.

This foot shape must be differentiated from other conditions that need surgery so an evaluation with an orthopaedic surgeon is recommended.

Stretches and exercises

• Ankle down-flexion stretch

  

  To stretch the muscles on the front of the ankle, gently point your baby’s toes down as far as possible and hold for 20-30 seconds, or longer if tolerated.

• Down and in exercise

  

  To stretch the muscles on the outside of the ankle, gently stretch your baby’s foot downwards and inwards. Hold for 20-30 seconds, or longer if tolerated.