Talipes Equinovarus

I was born with a condition called Talipes Equinovarus and Clubbed foot. As a result, I have a fused ankle and therefore restricted movement of my left foot. There is also muscular dystrophy (wastage) of my Soleus muscle and a true shortening ( Leg Length Discrepancy (LLD)) of my left Tibia and Fibular.

My right foot is generally OK, but does have a Metatarsal Adduction Deformity which means it is severely collapsed and fairly unstable. My left foot however is so flat, that my right looks like it has an arch!

This means I struggle to tip toe or propel off through my toes during movement on the left side. My left foot is a size and a half smaller than my right which makes finding footwear more demanding. More event specifically, this means that running the high jump curve and my penultimate step just before take off is greatly affected. Also due to years of overcompensation, my legs and upper back have a muscular imbalance; however, I work hard to ensure this doesn’t cause me too much of a problem.

 

Talipes Equinovarus

WHAT IS TALIPES EQUINOVARUS?

Congenital Talipes Equinovarus (CTEV) (also known as clubbed foot) is a condition present at birth that affects the lower leg and foot. There are many discussions as to the cause of Talipes in general, and many are referred to as idiopathic (without a known cause), but there are two main distinctions; positional and hereditary .

what is Talipes

I was unfortunate enough to have a combination of both! My biological father had minor Talipes and therefore the hereditary element was present, but in addition my left foot was made worse by the position I was within my mum’s womb.

The clubbed foot part can actually be represented as a separate diagnosis, although the two come hand in hand in most cases (or foot in foot!!!). As can be seen in the above photo, my foot was shaped almost like a golf club (hence the distinction). But through surgical intervention, the foot is brought back to a better shape.

The  Talipes word refers to the foot and ankle, and the  Equinovarus is to do with the foot position. Equino indicates that the heel is elevated (like a horse) which means the foot is pointed down (plantarflexed), whereas Varus indicates that the heel is turned inwards and therefore the foot is twisted (inverted).

TALIPES EQUINOVARUS GROWING UP

It has been quite a journey for me growing up. I learnt to walk much later than most kids in addition to all the procedures and pain undergone throughout my life.

When I was born, I had 2 weeks of my feet being strapped. This started the process of reshaping my feet. Following this, metallic bars were added to the strapping process, which required regular alterations over a number of months.

I then went through a year with a  Solid Bar Brace  (shown in the picture) to keep my feet at the proper angles and ensuring the deformity couldn’t reoccur. This meant playtime with grandad often resulted in grandad getting a bruised chest! After the year of bone hardening, I was then able to have the brace removed for 6 months. During this time, I learnt how to walk, but with my left foot still fairly deformed.

Talipes in children

The first procedure I underwent was a Posterior Tibial Tendon Transfer to my foot. This is a surgical procedure which is intended to correct deformity of the hind foot releasing the tendon. I have a very big scar to prove it! With Talipes however, it is also essential to combine the tendon release during the surgery with soft tissue release after; to help the foot and give it better movement. In layman terms, my mum had to stretch and massage my foot and ankle regularly to get it functioning.

Following the surgery, I then had plaster cast up to my knee but went back to crawling for a few months. This then changed to a night brace and after finally learning to walk, I spent my childhood accommodating my condition with orthotics, as well as orthopaedic and Start Right shoes. When primary school began, I was able to manage the condition with normal school shoes, however there were still many postural issues I had to deal with, and I have spent my life learning ways to further improve my lifestyle.

POSTURAL REALIGNMENT

Since becoming a clinician in 2010, I have spent my time learning about the body and more about my condition. It was always known there was a slight difference in the lengths of my legs, with the left leg being shorter, but the true value was never known. Experimenting with differing levels of orthotic control over the years, I have been able to compete in sport, but have still suffered a bit of reoccurring postural pain. Up until 2015, the build up which I had within my left shoes was insufficient, and meant my foot had a tendency to slip out of my shoes. There was not enough support around my ankle and it also meant my shoes would wear down significantly on my left side (This meant new shoes frequently!).

In 2015, I got a CT scan of my skeleton. This showed my left leg to be 1.4cm shorter than the right, whereas the right femur was found to be 0.3cm shorter than the left (Shown below). This means that the left side has a true shortening of 1.1cm.

Leg Length Discrepancy

Disability Spikes

Therefore, I started building up my trainers and spikes on the outside of the shoe, which made a significant improvement with my back and right knee. It also meant I could have less build up within the shoe, and subsequently have more stability around my heel and ankle. I was able to source an orthotic manufacturer, Footlabs Sport who were able to do this extremely well, and now sponsor me!!! What I found though was that the 11mm was too high and has since come down to a 6mm build up on the outside of my left shoe. I am now able to manage my condition so much better!

DISABILITY / DISABLED?

Talipes DisabilityA question I often get asked is ‘whats wrong with you?’ and ‘do I class myself as disabled?’. This is always a tough question, as up until 2012 I considered myself as normal with ‘my gammy foot’. I was actually unaware that I would be able to compete in the Paralympics, and continued to enjoy the sport of basketball, pushing through the pain and need for regular treatment, which I considered as normal and essential.

The nature of my disability is such that I don’t ‘look disabled’, and actually I pride myself in being able to say I have conditioned and managed myself in such a way that someone looking in wouldn’t know I had an impairment. I don’t need sympathy for my foot and never have done. It serves a powerful message to raise the awareness of disability, because as the image here depicts beautifully, its not always that simple to distinguish a disability. To the outside world, I just have a skinny ankle. That’s OK! But being aware that just because a disabled athlete or disabled person avoid complaining about their condition, it doesn’t mean it isn’t there. The ability to push beyond that which is slowing you down is a feat in itself.

I have never thought of myself as disabled. I have always known I had an impairment, but I have never let that affect me. One of the things I have learnt is to accept my impairment. I won’t be as able as other international high jumpers and may never get to the same level because I can’t strengthen up my lower left leg, however that won’t stop me pushing myself to the absolute limits to challenge all those I face.