Frequently Asked Questions (FAQs)

Treatment usually takes about two years:
• Year one: The brace is worn for 23 hours a day
• Year two: As your child begins standing and walking, it’s worn during sleep

We usually see patients monthly to monitor progress, but this can vary depending on your child’s needs.

Yes, the Cunningham Brace is custom-fitted based on your child’s measurements. We can adapt in-stock braces to your child’s size, ensuring a proper fit.

At your first appointment, we’ll measure your child and fit their Cunningham Brace. We’ll also explain how to use it and arrange regular follow-ups to check progress and make adjustments.

• It’s more comfortable, as it’s worn on one leg and lets your child move freely.
• Reduces the risk of skin irritation compared to the boots and bar.
•  Supports better muscle symmetry and natural development.

The Cunningham Brace, created by Jerald Cunningham, gently corrects the foot using a strap around the thigh and a spring under the foot. It allows your child to move naturally—crawling, standing, and playing—while encouraging muscle growth and symmetry.

After the Ponseti method, children wear special boots connected by a bar to keep the correction in place. This is worn full-time for the first three months, then during sleep until around age four or five. While it’s effective, some families find it challenging, which is why we also offer the Cunningham Brace.

The Ponseti method is the gold standard for treating club foot. It’s a step-by-step process involving gentle manipulation and weekly plaster casts for several weeks. Then, a minor procedure called a tenotomy is performed to lengthen the Achilles tendon. This method is recommended by many leading hospitals, including Great Ormond Street Hospital (GOSH).

Ponseti treatment is provided by your child’s hospital team, not at LOC. Following initial hospital treatment, we offer assessments for our own bracing treatment.

At LOC, we assess and fit the Cunningham Brace for children with club foot. We do not provide Ponseti casting or boots and bar treatment, which are managed by your child’s hospital team. Our orthotist will assess whether the Cunningham Brace is suitable for your child.

Look for a noticeable inward rotation of the foot at the ankle, with the sole facing backwards. If left untreated, individuals with club foot may appear to walk on their ankles or the sides of their feet.

Club foot, also known as congenital talipes equinovarus (CTEV), is a condition present at birth that affects one or both feet. It causes the foot to rotate internally at the ankle, pointing downwards and inwards. It is a relatively common condition, affecting about one in every 1,000 babies born in the UK.

Treatment duration varies depending on factors such as your age, chest wall flexibility and how consistently the programme is followed.

In many cases, treatment may take between six months and two years. We’ll review your progress regularly and adjust your plan as needed.

For some patients, orthotic bracing may provide an alternative to surgery.

Suitability depends on individual factors such as age, chest wall flexibility and presentation, and should be assessed by an orthotist or appropriate medical professional.

Consistency is key for effective treatment and wearing the brace as advised is an important part of treatment.

Reduced wear time may affect how the chest responds to treatment. Your orthotist will provide guidance on a suitable wearing schedule.

The duration of daily wear varies depending on the severity of the condition and the stage of treatment.

Typically, patients are advised to wear the brace for 16 to 23 hours a day in the initial stages. As treatment progresses and improvement is seen, the wearing time may be gradually reduced.

It’s normal to feel a little uncomfortable at first as your body adjusts to the brace. Most people find this goes away after the initial adjustment period. If you’re experiencing ongoing pain or irritation, let us know right away so we can make adjustments.

• Pectus excavatum: The chest wall sinks inwards, creating a “caved-in” look.
• Pectus carinatum: The chest wall sticks outwards, often called “pigeon chest.”

Both are chest wall differences that may be improved with orthotic treatment following assessment.

If you or your child is concerned about chest shape, you can book a consultation with one of our HCPC-registered orthotists to discuss whether orthotic treatment may be appropriate.

We’re also happy to collaborate with local GPs, thoracic surgeons, and consultants for patients considering bracing after exploring other options.

Many patients need only one brace to achieve their desired goals, as each brace is designed to last the entire treatment period and accommodate growth.

However, some may benefit from two braces, one for the main deformity and another for rib flaring. For pectus excavatum patients, applying pressure to the ribs along with vacuum bell therapy can reduce the appearance of a depressed sternum, pushing it outward into a more desirable position.

Your treatment plan will be based on your individual assessment, and we’ll discuss the most appropriate approach with you.

Yes, exercise supports your overall posture, flexibility and muscle strength during treatment. Deep breathing exercises can also encourage your lungs to expand against your chest wall, helping push it outward. Your orthotist may recommend specific exercises to complement bracing.

Swimming is particularly helpful because it mimics exercises that stretch and loosen the chest muscles, though you should take off your brace for swimming or contact sports, and ask your orthotist about the best swimming strokes for your treatment.

This is a common concern for many patients. The Dynamic Chest Compressor brace is designed to be discreet. Most patients find it easy to hide under loose-fitting shirts for school or work.

If you need to wear two braces, one for the main deformity and another for rib flaring, they might be more noticeable under tighter clothing. But loose clothes generally work well to keep the braces out of sight.

During your appointment, an HCPC-registered orthotist will carry out an assessment to understand your chest shape, posture, and individual concerns.

This may include:

• assessing chest wall shape and posture
• observing movement and overall alignment
• considering chest wall flexibility
• discussing your goals and any symptoms or concerns

If you are under 18, a parent or legal guardian must attend the appointment with you.

If appropriate, measurements, photographs, and a 3D scan of your chest may be taken to help us model a brace if you are considering bracing treatment and it is considered suitable. If so, we will arrange a follow-up appointment to fit your brace.

Regular follow-up appointments are an important part of your treatment.

You’ll usually see your orthotist in person, although virtual appointments may also be available where appropriate.

The frequency of your appointments will depend on your individual needs. Younger patients may be seen more often to review fit and make adjustments during periods of growth, while others may have appointments spaced further apart based on their progress.

These reviews allow us to monitor how you’re getting on, adjust your brace if needed, and check for any discomfort. If you experience any issues between appointments, such as irritation or changes in fit, you can contact us and we’ll advise you on next steps.

For international patients, we can offer remote follow-ups via video consultation where appropriate.

Outcomes vary depending on individual factors such as age, chest wall flexibility and brace wear.

Many patients seek treatment to improve the appearance of their chest and confidence. Your orthotist will discuss realistic expectations based on your individual assessment.