Positional calcaneovalgus is a condition that can affect one or both of a baby's feet. Find out more about this condition and learn some gentle stretches and exercises that can help to resolve it.
Key points
Positional calcaneovalgus is a flexible foot shape when one or both feet are in an up-and-out position.
It is present at birth and usually resolves on its own by three to six months of age.
Treatment is typically observation with passive stretches and home exercises that can be done to help move the foot into a normal position. Formal physical therapy is not needed.
If it does not resolve on its own, conditions such as congenital vertical/oblique talus, posterior-medial bowing or paralytic foot deformity may be considered.
Introduction
What is positional calcaneovalgus?
Bilateral 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 fetus’s position during development before birth. Positional calcaneovalgus can affect one or both feet.
Differentiating positional calcaneovalgus from other foot conditions is very important.
In most cases, positional calcaneovalgus resolves by itself within a few weeks to six months without treatment or with gentle stretching. Formal physical therapy is not needed. An evaluation with an orthopaedic surgeon is only recommended if the foot does not respond to persistent stretching after six months of age and does not point down. 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.
Treatment
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 to 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 to 30 seconds, or longer if tolerated.