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What is clubfoot?

A condition a baby is born with, where one or both feet turn inward and downward and stay stiff. The bones, joints and tendons formed in a different alignment. So it does not stretch out, and it does need treatment. It is also one of the most treatable conditions in pediatric orthopedics.

1 to 2in every 1,000 births
~50%affect both feet
Weeksfrom birth to first cast
Ponsetifirst-line treatment worldwide
Written by Heath, who has lived it: casts from birth, a fusion at sixteen, the US Army, and distance running.

Who’s asking

Eight things people want to know. Open whichever matter to you, in any order.

What the name actually means CTEV, talipes, equinovarus (the words on your paperwork, unpacked). For you1 min

Clubfoot is the common name for congenital talipes equinovarus, usually shortened to CTEV. The words are doing real work.

CongenitalPresent at birth. It forms during pregnancy, not afterward.
TalipesFrom talus (ankle bone) and pes (foot), it involves both.
EquinusThe ankle points down, like a horse’s hoof.
VarusThe heel turns inward, toward the other leg.

You may also see plain talipes, or club foot written as two words. Same thing.

The four parts of a clubfoot Why the foot changes shape in stages instead of all at once. For you2 min

Clubfoot is not one deformity but four, happening together. Clinicians use the acronym CAVE, and treatment releases them roughly in this order, which is why the foot passes through positions that look worse before they look better.

C

Cavus, a high arch

The midfoot pitches up into an exaggerated arch. Usually corrected first, because releasing it lets everything else move.

A

Adductus (forefoot turns in)

The front half curves inward, giving the sole its bean shape from below.

V

Varus, heel turns in

The whole hindfoot rotates so the sole faces the midline. Bone, not skin.

E

Equinus, ankle points down

A tight Achilles fixes the ankle toes-down. The most stubborn part, and the last to go.

What you can actually see The physical signs, beyond the position itself. For you1 min
The foot turns inward, toward the other leg
The ankle points downward
The sole faces sideways or inward
A deep crease along the inner arch
A crease across the back of the heel
The heel feels small or empty to the touch
The calf is thinner on the affected side
The foot resists being moved into position

The creases and the “empty heel” matter more than they look. Both are scored formally when severity is assessed.

Is it definitely clubfoot? Three things an inward-turned newborn foot might be. For you2 min
TypeWhat it isFlexibility
IdiopathicClubfoot on its own, no associated condition. Most common.Stiff
SyndromicClubfoot alongside a neuromuscular or genetic syndrome.Often stiffer
PositionalNot clubfoot. A normal foot held oddly by crowding in the womb.Moves freely

The distinction is made by hand, not by photograph. See how to tell if it is positional.

How severity is scored Pirani and Dimeglio, the numbers on your paperwork. For you2 min

Clubfoot is not all-or-nothing. Clinicians grade it at diagnosis and again through treatment, which is how progress gets tracked objectively and not by impression.

ScoreRangeWhat it assesses
Pirani0 to 6Six features scored 0, ½ or 1, three hindfoot, three midfoot.
Dimeglio0 to 20How far the foot moves toward corrected, across four parameters.

Higher means more severe, and a falling score across casts means it is working. A high score at diagnosis describes the starting point, not the destination.

One foot or both Why the affected side stays smaller, and what that means later. For you2 min

One foot is unilateral; both is bilateral. Roughly half of cases involve both feet.

In unilateral clubfoot the affected foot is often shorter and the calf noticeably thinner. That difference is a feature of the condition, not a treatment failure, and it commonly persists into adulthood even after excellent correction. Full detail in why one foot is smaller.

How common is it? You are not as alone in this as it currently feels. For you1 min

Clubfoot occurs in roughly 1 to 2 of every 1,000 births, making it one of the most common congenital orthopedic conditions. It appears more often in boys, though girls absolutely have it.

Families often feel singled out by a diagnosis they had never heard of a week earlier. In practice thousands of children are treated for this every year, along a path with decades of evidence behind it.

What clubfoot is not Six assumptions that cause real distress in the first week. For you1 min
Not an injury. Nothing happened to it. It formed this way.
Not painful for a baby. Newborns are not in pain from the position.
Not cosmetic. It is structural, in bone and soft tissue.
Not something that stretches out. It needs treatment, not time.
Not caused by anything you did. Not position, activity, or diet.
Not a limit on an active life. Treated clubfoot runs, works and serves.

0 of 8 opened

Once this makes sense

Where people go next

Why it happened →Causes, genetics and family risk. How it is treated →Casting, tenotomy and bracing, in order. Life long-term →What this looks like decades on.

People also ask

Questions about the condition itself

Is clubfoot considered a birth defect?
In the registry sense, yes: it is present at birth, it is counted by birth defect surveillance programs, and that is where prevalence figures come from. In the room, most clinicians and most families use different words, because defect suggests something broken and what this is is a foot that formed in a different position and is highly treatable. Both are describing the same thing. The paperwork uses one and the people usually use the other.
What is clubfoot called now?
The clinical name has not changed: congenital talipes equinovarus, usually shortened to CTEV, which is what appears on paperwork in the United Kingdom, Australia and much of the world. Clubfoot is the common name in the United States, club foot is the same word spaced, and talipes on its own is how many families hear it. Nothing has been renamed. These are different registers for one condition.
What are the four types of clubfoot?
This question is usually reaching for the four components rather than four types, and the components are the more useful answer: cavus, a high arch through the midfoot; adductus, the forefoot turning inward; varus, the heel turning inward; and equinus, the ankle pointing downward. Clinicians use the acronym CAVE and correct them roughly in that order. Types are a separate question, and there are three worth knowing: idiopathic, syndromic, and positional, which is not clubfoot at all.
What is clubfoot?
A congenital condition where one or both feet turn inward and downward. Not just a flexible foot position. The bones, joints, tendons, muscles and ligaments develop in a different alignment, which makes the foot stiff and in need of structured treatment.
What does congenital talipes equinovarus mean?
The medical name for clubfoot, often shortened to CTEV. Congenital means present at birth, talipes refers to the ankle and foot, equinus means the ankle points downward like a horse’s hoof, and varus means the heel turns inward.
What are the four components of clubfoot?
Clinicians use the acronym CAVE: cavus, a high arch through the midfoot; adductus, the forefoot turning inward; varus, the heel turning inward; and equinus, the ankle pointing downward. Treatment corrects them roughly in that order.
What is a Pirani score?
A severity scale from 0 to 6. A clinician scores six features (three hindfoot, three midfoot) as 0, ½ or 1. Higher means more severe, and the score is used to track progress across casts.
Can clubfoot affect only one foot?
Yes. One foot is unilateral; both is bilateral. In unilateral cases the affected foot and calf are often slightly smaller, and that difference commonly persists even after excellent correction.
Is clubfoot painful for a newborn?
Clubfoot itself is not generally painful for a baby. Newborns are not in pain from the foot position, and casting is uncomfortable and not painful. Pain becomes a consideration much later for some adults.
Is clubfoot the same as a positional foot?
No. A positional foot looks turned but moves freely into a normal position on examination, because the structure is normal. True clubfoot is stiff and structurally different.
How common is clubfoot?
Roughly 1 to 2 of every 1,000 births, making it one of the most common congenital orthopedic conditions. More common in boys than girls, though girls can absolutely have it.
What does clubfoot look like?
The foot looks turned inward and pointed downward, often rotated so the sole faces sideways or inward instead of flat toward the ground. There are usually deep creases on the inner arch and behind the heel, and the calf is often smaller on the affected side.
What is a Dimeglio score?
The Dimeglio score rates clubfoot severity from 0 to 20, assessing how far the foot can be moved toward a corrected position across four main parameters plus additional features. Like the Pirani score, higher numbers indicate greater severity.

Sources

Where this comes from

1 Clubfoot overview and Ponseti treatment contextAAOS OrthoInfo 2 Diagnosis and treatment of idiopathic congenital clubfootAmerican Academy of Pediatrics 3 Clubfoot symptoms and causesMayo Clinic 4 Clubfoot diagnosis and treatmentMayo Clinic 5 Club foot overview and Ponseti treatment stagesNHS 6 Relapse of clubfoot after Ponseti treatmentPubMed Central

Written by Heath, founder of Clubfoot Forward, an adult with bilateral clubfoot history. Education and lived experience, not medical advice. Reviewed September 2026. See the editorial policy.

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