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 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.

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.