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Club feet – thanks to medical science clubfeet is not a curse!

Wikipedia: Congenital talipes equinovarus - Clubfeet (bilateral = both feet)

Wikipedia: Congenital talipes equinovarus - Clubfeet (bilateral = both feet)

 poplarchick.com

poplarchick.com

The fact that I was born with clubfeet never affected me in any way. Thanks to medical science my feet were straightened while I was a baby. I grew up with only the knowledge that crawling on my knees or walking on my ankles would have been my lot in life if I was born in a previous century.

But let me be honest – to say it never affected me in any way is a lie. Of course it did. It kept me humble and grateful and able to appreciate many things I would have taken for granted if I was born with normal feet.

I undertook to write about my own case after Judicastro mentioned that a friend of her is expecting a baby and the doctor suspects he will be born with clubfeet. One of my fears was that my children will be born with it, and my first question after they were born was in fact: "Are the feet normal?" God knows why I was so worried about this, because it is one of many deformities that can be expeditiously corrected.

Before I tell my story, just a brief summery of the congenital deformity called clubfeet, clubfoot, club feet, club foot.

The medical term for clubfeet is ‘Congenital talipes equinovarus (CTEV). ‘Talipes equinovarus’ is a Latin word. Talus = ankle, pes = foot, equino = of/like a horse, varus – turned inward. A baby could be born with unilateral (one) clubbed foot, or bilateral (both feet). Two groups of CTEV has been identified - Postural TEV or Structural TEV, which compels persons to walk on their ankles or on the sides of their feet.

In Western countries one in every one-thousand babies is born with one or two clubbed feet. In South African blacks it occurs three times as frequently and six times as frequently in Polynesians. In all cases approximately fifty percent are males.

Clubfeet is not an embryonic malformation, but a developmental deformation. The foot, or both feet, turns into clubfeet during the second trimester of pregnancy.

 

Dr Ponseti (left), Dr Wang (right)

Dr Ponseti (left), Dr Wang (right)

 poplarchick.com

poplarchick.com

dr-deded.blogspot.com

dr-deded.blogspot.com

Treatment of clubfeet

Manipulation will be the first attempt to correct the deformity. It means gradually stretching tendons, then casting and bracing the feet until it is in the correct position. Treatment starts immediately after birth. The doctor changes the cast approximately every third week to do the next stage of stretching, casting and/or bracing. This treatment is known as the Ponseti Method, introduced by Dr. Ignacio Ponseti in the 1950’s. (Some sources allege 1940’s). In the meanwhile this method was improved and applied today with a success rate of 95%.

23 videos demonstrating the Ponseti Method is obtainable at http://talipestogether.com/video?sort=highestRated or Watch a Video on the Ponseti Method

There are also other treatments supporting the Ponsetti Method, like Botox (Botulinum Toxin type A), which is a chemical that acts on the nerves that control the muscle. It weakens the Achilles tendon which allows the foot to be turned into a normal position.

Surgical treatment

In some cases, such as mine, tendons, ligaments and joints in the foot/ankle have to be adjusted with surgery. After surgery, casts have to hold the feet still while it heals over a period of approximately six weeks. Thereafter special shoes, or braces or any of many external fixtures have to be used for up to a year or more. 

Causes

are divided in categories: positional, congenital, teratologic, neurogenic or syndromic.

Some syndromes are: 

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  • Edwards syndrome, also called Trisomy 18 – meaning a person has three copies, or two plus a part of a third, of chromosome 18 instead of only two. After Down syndrome this defect is the second most common autosomal trisomy.
  • Compartment syndrome – the compression of nerves, blood vessels and muscles inside a specific closed space.
  • Some say Breech presentation could also be a cause, but my logic mind refuse to agree with them.
  • Ehlers–Danlos syndrome may be the cause – which is a group of inherited connective tissue disorders caused by a defect in the synthesis of collagen. Collagen is the protein that helps tissues to resist deformation.
  • Spina bifida cystica could be a cause, which is a defect caused by the incomplete closing of the embryonic neural tube. This is a cause easy to diagnosed, because the spina bifida has to be surgically closed after birth.

 

club-feet-thanks-to-medical-science-clubbed-feet-are-not-a-curse

Some cases in my family –

We have three cases of Oral-facial-digital syndrome, which affect the development of the oral cavity (the mouth and teeth), facial features, and digits (fingers and toes). The OFD1 gene is to blame for this defect - a gene providing instructions for making a protein whose function is not fully understood, but it appears to play an essential role in the development of many parts of the body, including the brain, face, limbs, and kidneys.

Members of my family born with a defect OFD1. (I include myself because it seems so obvious that this gene may also be the baddy in my case).

  1. My mother’s paternal grandfather was born with a cleft palate.
  2. My mother’s brother was born with his middle finger attached to his ring finger (of both hands.)
  3. I was born with clubfeet.
  4. My brother’s daughter was born with extra tissue like warts to her gums.

My uncle was, and still is, an accomplished musician on many music instruments. Although his fingers were separated when he was about six years old, those fingers always stay together while he plays the piano, as if the brain recognize them as one and not two separate fingers.

My brother’s daughter is a beautiful and highly intelligent young lady with only pictures proving that she was born with warts on her gums.

Alarming is the fact that genetic influences increase dramatically with family history!

club-feet-thanks-to-medical-science-clubbed-feet-are-not-a-curse
club-feet-thanks-to-medical-science-clubbed-feet-are-not-a-curse

My personal story –

Five days before my father turned twenty-two, and four weeks before my mother turned nineteen, I was born. Their first child. With clubfeet.

I can clearly visualize the horrible shock they had to deal with. “Why us? What did we do wrong? What sins we or our fathers or our grandfathers or great-grandfathers committed that justify this kind of punishment?” They were dedicated Christians and their minds were set in the common believes of their time. My mother blamed herself, because she was often a passenger on my father’s Harley Davidson motorbike.

They were reluctant to allow doctors to correct ‘the work of God’. I don’t know who enlightened their thoughts. Perhaps my grandmother. She and my grandfather also refused to give permission for the separation of their son’s fingers, but when he went to school at the age of five and proved that he was unable to write because he could not hold a pen, they conceded that deformities could be the direct interference of Satan in God’s perfect work and that was exactly the reason why God allows medical science to develop. (Is it not interesting, the ability of Christians to justify all their decisions by merely applying the most relevant scriptures?)

It could have been their son’s teacher who enlightened their thoughts, or perhaps it was my grandfather’s father who was born with a cleft palate. I have no idea how he managed to eat, speak normally – as he did, according to my mother - and even distinguishes himself as an accomplished vocalist with a cleft in his palate. Although the history of surgery of cleft lip and palates reaches as far back as 390 B.C., when a cleft lip was closed successfully in China, a successful operation in the Western world did not, according to Wikipedia, occur until 1816 when chloroform was introduced. However, as far as I know cleft palates were not rectified via surgery in South-Africa in the time of my great-grandfather. He must have kept the cleft closed with some kind of a gadget.

Anyway, my parents finally made a decision that drastically changed my destiny and so I was delivered to specialists in the terra firma of medical science. I will forever be grateful to them, because without any treatment, a child's clubfeet result in severe functional disability.

The Ponseti Method, introduced by Dr. Ignacio Ponseti in the same decade I was born, was exercised on me. The treatment lasted for ten months before they finally realized the tendons, ligaments and joints in my ankles and feet have to be adjusted with surgery. The operation was a success. I was, however, almost two years old before I was able to walk. I still have, somewhere in my house, my first pair of special boots that supported my feet and ankles, and I also have one of the larger pairs I had to wear during my growing-up years - ordinary shoes built up at the sides which forced me to walk on the entire foot and not only on the outer halve.

At the age of thirteen final adjustments had to be done to the tendons and ligaments in my ankles and toes, and the bridges of my feet had to be lowered. This was also successfully done.

No calves - but so what? I can walk!

No calves - but so what? I can walk!

Flat, weird-looking feet, but so what, thank God I can walk and run...

Flat, weird-looking feet, but so what, thank God I can walk and run...

In pretty, well-fitting shoes my feet look normal.

In pretty, well-fitting shoes my feet look normal.

How did this affect my personality?

Naturally I cannot remember the pain and discomfort I must have suffered when I was a baby. I only know what my parents told me.

During the day or three when they allowed my feet to rest before the next treatment, I yelled hysterically when I saw my feet moving in front of me. The muscles in my legs were undeveloped because my legs were most of the time in heavy plaster casts, I could not control my feet, they were unknown, weightless objects flying in front of my eyes. I could not grap them with my hands, due to undeveloped coordination between brain, hands and feet. My mother had to calm me down with pillows on my legs. Until today, particularly during times of distress, I need weight on my legs to fall asleep.

It took three nurses to hold me down every time the doctor had to remove a set of casts. The sound of the cast saw frightened me out of my baby mind. Because of my resistance I was on numerous occasions injured by the saw. I never outgrew the fear of noises representing cast saws. When they removed the plasters after follow-up surgery when I was thirteen, I shocked the doctor, two nurses and my mother with an anxiety attack they confused promptly with an epileptic seizure. Until today anxiety overpower me when I hear a sawing noise.

While I was a baby pain made me cry a lot. My mother was afraid I might get addicted to the medicine, therefore she withheld pain killers and encouraged me to bear pain as long as I could. My father made me lie on his chess while he read a book or newspaper aloud. He encouraged me to 'talk to him', and so I moaned and muttered myself often to sleep. That my own voice comforts me, was something I must have learned during that time and that is probably why I've grown into a chatterbox, talking the hind leg off a donkey whenever the opportunity presents itself. “Martie talks too much, therefore she forfeits her chances to be the best achiever in her class,” was a teacher’s comment in one of my school reports.

Until about ten years ago I was not at all able to handle silences. If nobody talked, I woud kill the silence with my own voice, talking-talking-talking. My friends did not mind – they hung on my lips and assured me that they enjoy listening to me. I was regarded as clever, witty and interesting. The fact that my parents often begged me to stop bombarding them with questions and my interpretations of whatever I see and to give their poor ears some rest, did not bother me. I was happy until I was yanked out of my childhood. But in spite of the secrets I only shared with my diary - something I all of a sudden needed - I kept on talking to my friends about everything under the son. I was the leader of all conversations.

My ‘talking disorder’ was identified by my husband (to be), the day he shouted at me: “Can’t you be quite for a minute? I can’t hear my own thoughts because you are thinking aloud all the time, irritating me with every damn thought that pops up in your mind.”

"Okay, now how do I change myself in order to keep him happy?" I asked my diary. And the answer I got was: "Don't share your thoughts with him."

Until today I take my mind off physical and emotional pain with humming. Oh, and singing to my children, and now also to my grandchildren, had the same positive effect on them. (Next time you are in pain, try singing/humming/moaning yourself to sleep.)

I became for the first time aware of the appearance of my legs after the last operation I had at the age of fourteen. I noticed that all the girls, except me, had beautiful calves. My legs above my knees were beautiful, but below the knees I had only straight poles and ugly feet while they had awesome calves and slender feet. Naturally this awareness instigated an inferior complex I still have today, which I inhibit by wearing slacks or dresses long enough to hide my missing calves. Mini's were the fashion when I was a teenager, so I worn the shortest skirts with boots or sandles with bootlaces. Nobody ever noticed there was something wrong with my legs and feet until I told them and showed them my scars.

Although I walk normal, I am not able to walk as far as normal people. I am able to walk one mile, while they can walk five. In shoes with too high heels I am not able to walk at all – two inches is my limit. Comfortable shoes in which my feet look normal and even pretty is hard to find. My feet are not too small – I wear number four shoes – but it is broader than normal feet and the bone structure appear to be bunions on the first joints of the little toes.

Recently artritis in my ankles bothers me sometimes, but after treating the pain and inflammation with some brufin I am up and about again.

I am aware of the fact that there are many people born with clubfeet or a clubfoot who are not so fortunate as I. In many Africa countries no treatment is available for children born with deformities, in some countries they are summarily killed immediately after birth. There are also those who have to cope with pain and discomfort daily because their treatment and surgery were not as successful as mine. My heart goes out to all of them, and they will always keep me humble and grateful and even sad because I was more fortunate than they.

At the same time I am extremely thankful and filled with joy because I am able to walk and run like a normal woman while I could/should have been a deformed victim of some faulty chromosome, gene or syndrome if it was not for medical science and my open-minded parents who were able to realize that the will of God is beyond human comprehension... and therefor not to be underestimated and misjudged by humans.

© Martie Coetser

Famous people born with unilateral or bilateral clubfoot -

The Roman emperor Claudius, Egyptian pharaoh Tutankhamun (who also had a cleft palate), Prince Charles de Talleyrand-Périgord, 1st Prince de Bénévente, Civil War politician Thaddeus Stevens, American comedian Damon Wayans, sledge hockey player Matt Lloyd, mathematician Ben Greenberg and filmmaker Jennifer Lynch, the British poet George Gordon Brown (Lord Byron), novelist/poet Sir Walter Scott, the famous figure skater Kristi Yamaguchi, soccer star Mia Hamm, baseball pitchers Larry Sherry and Jim Mecir, Freddy Sanchez, football players Steven Gerrard, Miguel Riffo, Charles Woodson, Tom Dempsey (born with a right club foot and no toes, which was his kicking foot responsible for the longest NFL field goal in history) and quarterback Troy Aikman. The Nazi Propaganda Minister Joseph Goebels, Captain De Witt Clinton Fort, actors Damon Wayans, Eric Richard, Gary Burhoff, Eric the Midget, Dudley Moore and, of course, many others we don’t know yet.

More information about clubfeet -

club-feet-thanks-to-medical-science-clubbed-feet-are-not-a-curse

Comments

Nell Rose from England on January 07, 2018:

How amazing Martie! I didn't realise that. I am so glad that you can walk and run normally. Like you I was born with internal mess ups! lol! a hole in my gullet now with a huge scar round my chest because of it, an upside down kidney, which I got sorted when I was 33! took me long enough to notice it! caused lots of water etc. and a crooked spine, low down. all sorted now.

Martie Coetser (author) from South Africa on June 12, 2015:

Hi, Tinyiko, I am always very happy to meet someone who was/is facing the same challenges as I. Wonderful to know your operation was successful and that you see your clubfoot as a blessing. Take care!

Martie Coetser (author) from South Africa on June 12, 2015:

Hi Nadine, the things I learn while researching a specific topic always amaze me, and also confirm that I will never be able to know all there is to know. Thanks for the vote!

Nadine May from Cape Town, Western Cape, South Africa on June 08, 2015:

Wow Martie what a great post. Thank you so much for sharing your story. Amazing how people can overcome just about anything even a figure skater like Kristi Yamaguchi. I never knew that about Tutankhamun. What a wonderful post. Voted up!

Martie Coetser (author) from South Africa on January 31, 2013:

Eliza, thank you so much for your beautiful comments. You have pulled my tears. Only 16 and your are so wise, and what a go-getter you are. I am so proud to have you in my corner. Please keep in touch and share your victories. I wish you only the best of the best and lots of exiting adventures :)

Eliza on January 30, 2013:

chiara romano- don't feel inferior! I'm 16 I get it and you know what? I flaunt it because even though it's not "that serious" we are survivors. If people tease you you tell them to shut the hell up and grow screw themselves because they obviously don't know anything. I used to be terrified to take off my shoes and socks until one day I just did it. I was sick of hiding. And guess what! That was the best thing I've ever done because most people are just curious, as normal humans are curious by nature, and just ask questions. You can choose to answer like I do or you can tell them to mind their own. People don't mean to be rude they just are and that's okay because the only opinion that matters is your own and you know you're beautiful

Eliza priest on January 30, 2013:

You're very lucky! I was born with a clubbed foot in 1996. I have had 7 surgeries for my foot and have a scar that wraps around my whole foot with part of my ankle bone missing. I wear one 9 and one 71/2 shoe size so shopping sucks! But you're very right, it's humbling. My friends can't grasp why I am so open and eager to run. They don't understand it's because I can when for so long I couldn't. In the eyes of most doctors still today I'm a medical miracle. I used to play 3 sports and now I've just dropped down to one but in a game we run 5 to 6 miles alone when in the past people with this disorder could hardly crawl. It's amazing and eye opening

Martie Coetser (author) from South Africa on March 24, 2012:

zann17 - I believe if only one foot is clubbed, it cannot be corrected to be exactly as normal as the normal foot. Oh, and we are not our limbs or organs. Our spirits have no choice but to accept their host... the body, and the sooner the better. I am glad your husband is happy. Thank you so much for your comment.

zann17 from Bristol, England on March 24, 2012:

Great Hub. My husband was born with a clubfoot, had surgery and now walks with a limp and a walking stick. But he is happy!

Martie Coetser (author) from South Africa on November 09, 2011:

Becky - That is exactly the way the cookie crumbles.

Becky Katz from Hereford, AZ on November 08, 2011:

The old country Dr. didn't have time to write it up and publish it. They were too busy trying to help people. It took specialists to start publishing, They had time because that was all they did.

Martie Coetser (author) from South Africa on November 08, 2011:

Becky Katz - How interesting. This is now another proof of the fact that something, anything, has been done by many long before somebody step forward to introduce it as his personal invention. We find this occurrence in all sectors of life. Thank you so much for your informative comment.

Becky Katz from Hereford, AZ on November 08, 2011:

Martie, my mom was born in 1936 with a club foot. The Dr. who delivered her at home was extremely forward thinking for his time and slapped a cast on it immediately. Changing it every couple of weeks with 2 days in between casts so that the muscles could develop, he fixed her foot without surgery. She never had another problem. She wore the same size shoes and her feet looked just like mine. Sometimes, miracles work through old country Dr.

This was a very good article. I am going to have to read more.

Martie Coetser (author) from South Africa on October 10, 2011:

Nongma – I wish I can speak to you over a cup of coffee. Your foot and its complications currently obviously demand all your attention and strength, just like a baby with many needs. Why not just treat it like a baby? Meaning, you, Nongma, merely take care of it without allowing it to keep you from being you. If I may, I would like to encourage you to focus, while you are taking care of the ‘baby’, on something extremely interesting. A new hobby, perhaps, a challenge, or a community project, like charity work. Go for it; give it your all... just to prevent your foot to steal your joy and opportunities to live a meaningful life. The right man and the opportunity to travel the world will come to you at exactly the right time in your life.

Your plastic surgeon obviously knows what he is doing. So trust him and co-operate. You are welcome to send me emails – If you click on my name you will end up on my profile page. There is a link named ‘contact MartieCoetser’ – Only one message via this link will bring you to my email, and then we can communicate via email.

In the meanwhile, take care. I’ll keep you in my prayers.

Nongma on October 10, 2011:

Martie,

Just got back from seeing the plastic surgeon. He said two of the vessels on my foot ended just a little below my knee.They were never fully developed to my foot. Therefore he is afraid to do the micro vascular free flap because failure for flap to take might result in me loosing my foot. Right! half a loaf is better than none! He is deciding to debread the wound and then try skin grafting. What a long and rough road to travel! I am hoping for the best. I am about to turn forty and not married. was married one time, had two boys but my husband treated me like nothing because of my leg. I Will like to get well and get married again to someone who will love me for me and travel the world! I sure need my feet.Before my wound I met this guy who really liked me and wanted to date me. He asked if I could wear heels and I said yes I could only wear heels 2.5inc tall. He said to move on!I haven't lost hope. Keep me in your prayers.

Martie Coetser (author) from South Africa on October 10, 2011:

NONGMA – My heart goes out to you and I will keep you in my prayers. I hope with all my heart that your treatment will be successful. One can never predict the many complications of surgery. It is really heartbreaking for me to know that someone out there – you - have to deal with unforeseen additional problems on top of a club foot. Please let me know the outcomes of your appointment with the doctor.

NONGMA on October 09, 2011:

I WAS BORN IN aFRICA WITH A CLUB FOOT ON MY RIGHT LEG. aFTER SURGERY TO GET MY FOOT CORRECTED, I WAS LEFT WITH A HUGE SCAR ON MY ACHILLIS TENDON. NOW I HAVE A WOUND THERE THAT WILL NOT HEAL. hAVE BEEN DEALING WITH THIS FOR TWO MONTHS NOW. NOW HAVE TO HAVE A MICRO VASCULAR FREE FLAP TO COVER THE WOUND. HOWEVER, AS YOU MAY KNOW THE DEFORMITY DESTROYS SOME BLOOD VESSELS OF THE LOWER LEG. I THEREFORE HAVE ONLY ONE VESSEL WORKING EFFECTIVELY. i AM NOT SURE IF FREE FLAP CAN BE DONE ON MY LEG. SEEING THE DOCTOR TOMORROW. I NEED EVERYBODY'S PRAYERS AND MORAL SUPPORT TO SEE ME THROUGH THIS TOUGH TIME.

Martie Coetser (author) from South Africa on September 03, 2011:

felicity, thanks for reading and commenting. My heart shrinks when I see those bad cases, and I am so grateful for the privileges I had, and still have. I actually see one of those bad cases every day walking down the street - not only his feet, but his legs as well are clubbed. And yet he walks where he wants to be. Extremely crooked, but so courageous and proud. May all disabled people be blessed with courage and the will to make the best of their lives.

felicitylovespari on September 02, 2011:

Thanks to medical technology advancements. Traveling, I have seen some bad cases in underdeveloped countries and I pray those people can get some real treatments.

Martie Coetser (author) from South Africa on August 24, 2011:

chiara romano – I know that feeling of inferiority – knowing you are different – and for all to see – and always fearing the opinions of others and even their sympathy.

But put yourself in the pretty shoes of others. They feel actually worse than you. They have to pretend they don’t see what they are seeing, while they are realizing with a shock how lucky and fortunate they are to be not in your shoes. In your presence they feel guilty because they are normal. They don’t really react - by teasing or ignoring you - on your feet, but on their own uncomfortable feelings. Their manners towards you reveal their characters that might be more deformed than your feet.

The power to change the way others treat you, is in fact in your hands. You are not your feet; you are your character/personality. Make it beautiful. Determine your best qualities and your talents and use all you energy and time to develop it. Dress in such a way that your best qualities overshadow your legs and feet. Let your hair style be striking. Emphasize everything that is not deformed in/on you. Not only for you to feel good and grateful because you are not only two clubfeet, but also arms, head, body, etc., but also to make others feel comfortable when they’re with you. Sadly, we all prefer to see beauty instead of ugliness, but because we cannot chance some ugliness into beauty, we focus on the beauty and try to make it more beautiful.

I know how difficult it is to ‘get over’ something that really bothers us, but actually it is not so difficult. We just need to change our thoughts. Replace every negative thought immediately with two positive thoughts, and one-two-three this becomes a habit you will enjoy practicing for the rest of your life :)))) I just know you will soon be over your feet. Feel free to contact me via e-mail.

chiara romano on August 24, 2011:

i feel the same way you are feeling i was born with clubbed feet. im only 15 years old i cry my self to sleep everyday knowing that i cant go to the pools with all my friends or to the beach without being scared that they will look at me strange or tease me. i hate the fact that im different to others but at the same time im great full that i can walk and run. but after reading what you wrote has changed my mind a little but then again my feet are very different compared to yours but im glad your happy and i cant wait till that happens to me one day when i wont mind anymore.

Martie Coetser (author) from South Africa on February 15, 2011:

tonymac04 – Don’t tell me treatment is not available at our state hospitals? I’m speechless! The mere thought that parents have to beg for money to straighten their baby’s feet saddens me to tears. I wish I was in a position to do something about this. Thanks for coming over. Take care!

Tony McGregor from South Africa on February 15, 2011:

I just had to come and re-read this one after seeing the olittle boy on the news last night who has club feet and the parents can't afford the operation.

Your Hub is very informative and I wonder why more people don't know about this treatment.

Anyway thanks for sharing your experience.

Love and peace

Tony

Martie Coetser (author) from South Africa on February 02, 2011:

saddlerider1 – I can only imagine how unpleasant the treatment was for the baby, but I can clearly remember the two I had when I was 13 and 14. It affected my life negatively in many ways, though I was always grateful.

Two cousins in my family had polio. One suffered only mild complication - one of her legs was affected - but the other one – my age – suffered brain damage and was confined to a sanatorium from the age of five until she died at forty-five. This may give you an idea why I always regarded my own problems as ‘not so bad’.

Thanks for your much appreciated visit, dear saddle. I’m sending you hugs and peace galore :)))

saddlerider1 on February 01, 2011:

What a wonderful write Martie. I learned more about club feet than I recall. One of my female cousins had club feet and I remember when we visited she would often be in braces and once I saw her in casts.

Although as an adult she looks fine now, she had a couple of operations in her younger years, thus the correction in adulthood. Yes your baby picture is so pretty, but I can imagine the trauma you and your parents went through with your feet.

I also remember a lot of kids catching polio and seeing them in braces, I was one o