Soooo... On 14th March, I met Alex Green at Bolton Osteopathic Clinic. Jonas had first met him when he was about 3 months old and in full-time boots and bar. At the time, I was worried about his hips and knees and wanted to make sure everything was in order. This time, I wanted a new full check-up for Jonas and to discuss a post-bracing treatment plan.
Clubfoot doesn't stop at 5 years old. Clubfoot doesn't really care what age you are. And Clubfoot cannot be cured. Yes, some people are born with it and are lucky enough to simply forget about it as they grow up, because casting and bracing have been enough for them. However, it is thought that 30 to 50% children will end up needing a tendon transfer after 2 years of age (https://www.orthobullets.com/pediatrics/4062/clubfoot-congenital-talipes-equinovarus) and relapses after 5 years old do happen but don't seem to be typically recorded.
Dr. Ponseti agreed that clubfoot was probably genetic, but had this thought that maybe the gene causing it would "switch off" around the age of 4-5, once his treatment plan stops. After 2 years of reading other children's stories and talking to other parents, I simply cannot believe it. I absolutely wish with all my heart that Jonas's foot remains as perfect as it is now for the whole duration of his life. But since the resurgence of the deformity is thought to be linked with growth spurts and the boy grows like a weed, I intend on being proactive and on teaching him how to take care of his foot.
From the research shared on the Clubfoot Resource Facebook group, it seems that holistic treatments might be the way to go. We're talking of osteopathy, chiropractic, physiotherapy and taping, as well as e-stimulation. Because they look at the body as a whole, osteopathy and chiropractic understand the need for the full lower limb, from hip to toe, to be in perfect alignment with each other in order to maintain a clubfoot's correction.
I'm pleased to report that besides a slight tightness in Jonas's left hip, Alex found him in perfect shape, from top to toe! He was really amazed by the perfect shape and mobility of Jonas's left foot and asked to have a look at our brace. He looked properly mind-blown by it:
"It just all makes sense!
You'd only need to sit and think about it long enough to come up with it!
It's genius!"
I told him about our dilemma, I was still very undecided, one of my fears was that we would continue to brace and cause Jonas damage in the process. I've read so many stories of children bracing till 4-5 with the boots and bar and relapsing within 6 to 12 months, that I came up with a little theory. A pretty unpopular one I expect, but here it is: what if bracing for longer was NOT the solution? What if it was, on the contrary, part of the PROBLEM? 60-70 years ago, when the Ponseti method was invented, it was thought that if you had a sore back (or ankle, or wrist, etc.), your best bet was to immobilise it, until it wasn't sore anymore. Nowadays, it is common knowledge that you should, instead, mobilise it as much as possible in order to strengthen it and prevent any further pain. In that regard, how does it make sense to immobilise children's feet for a full 2.5 years out of 5 years of life?
What if the brace acted like a back support? You're doing great so long as you wear it, but the one day you take it off and go lift up a couch you break your back? I just can't shake off the idea and it scares me.
That being said, our brace is totally different, being dynamic and with the way it attaches to the thigh, the spiral being shorter than the tibia, it offers a resistance to the child, engages the calf and ankle and, as it stretches the foot into the corrected position, it strengthens the calf and teaches the child how to best position their foot when active. I know all that. I do. I just needed a professional opinion on it and until now, nobody I'd spoken to had actually looked at the brace and the way it's made and given me an answer.
Well, Alex did. After studying the brace and looking at it on Jonas, he concluded that the way Jonas's foot is today and the way he can move it practically like his right foot stems from our brace, and that its dynamic design, he can't see it being detrimental to Jonas, if we brace for longer. According to him, since there's no way to predict the future nor whether Jonas is likely to relapse or not, be it in 1 year or 10, using the DTKAFO an extra year won't do him any harm. And he's happy to see us regularly to check up on his mobility and prevent him from tightening up.
What a relief!! At last, someone took the time to listen to me and answer my questions in all honesty!
Next step was our appointment with Jerald on 17th March. Just a few more days and we'd finally have a plan.
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