These aim to stretch the soft tissues of the foot and hold it in as normal a position as possible using methods from the following list: physiotherapy, gentle manipulation, use of plaster casts, splints/strapping and special boots.

Methods included in this category are:

The Ponseti Method - an increasingly popular form of conservative treatment which is becoming more widely practised in the UK now. It was developed in the USA over 40 years ago and "long term follow-up studies show that feet treated by Ponseti management are strong, flexible and pain-free" (Clubfoot: Ponseti Management. Global Help Publications)

The method uses manipulation, gently rotating the bones and stretching the soft tissue, then the application of a plaster cast from the toes to the groin to hold the foot in position.

This takes place every 5 - 7 days and most children need 6 - 10 casts, correcting the position of the foot a little more each time.

After this the surgeon decides whether the tendon at the back of the heel (the Achilles tendon) needs to be lengthened. Many do but this is only a small operation, many surgeons only use a local anaesthetic for it. A small cut is made a little above the back of the heel and the tendon is cut. This is called a tenotomy.

The foot is then put into a final cast for 2 - 3 weeks and when this is removed the child has to wear boots attached to a bar. These are worn 23 hours a day for about 3 months then at night and nap time until the child is about 4 years old. At this stage the feet are already fully corrected. Wearing the boots and bar is essential to prevent a relapse.

steps, Both Feet Forward and C-Pro Direct Ltd have also produced a DVD and steps has a a separate leaflet about the Ponseti Treatment.

Traditional methods - these are also based on manipulation, often by a physiotherapist. Between sessions the foot is held in place by either strapping or a Plaster of Paris cast

written 21/3/06. We gratefully acknowledge the steps medical panel for their assistance in putting this information together