Over the past 6 months I have been volunteering at our local Ponsetti club foot clinic. The children seen at the clinic range from newborns with clubfeet  (idiopathic and syndrome related)  who are being treated with manipulation and casting to older infants, toddlers and young children who attend for regular checkups. 

I have become very curious about the role of muscle imbalance in the long term outcomes and relapsed feet. It is well documented that the tibialis anterior and posterior are overactive, with weakness in the evertor muscles. 

Reading the literature on muscle imbalance, I realized that I really did not know very much about the typical development of foot movements in infants, so have been on a mission to rectify this gap in my knowledge. To this end I have created a series of video clips honing in on foot movements of two infants: one full term with typical development, and one infant born 6 weeks preterm. 

Below  you can view a series of clips of lower limb movements at different ages.  What I found fascinating is the tendency of infants aged 9-12 weeks  to invert the forefoot with flexion of the toes. The inversion is associated with varying degrees of  plantar and dorsiflexion with consistent flexion of the toes. At 18 weeks one starts to see independent movement of the toes. 

Birth to 8 weeks 

Both Will and Max (born 6 weeks preterm) show distinct dorsiflexion with eversion and toe extension movements when flexing and extending the LEs.

Will 5 days

Will 5 weeks supine and prone

Max at 3 weeks (CA -3 weeks)

Max at 6 weeks (CA 0 weeks)

9 -12 weeks - foot inversion with toe flexion 

Will at 9 weeks 

Will at 12 weeks 

Will at 18 weeks 

Increasing differentiation of foot movements with exploration of toe movements. 

Will at 23 weeks