International Cunningham Brace patient, Rayah, in her club foot brace
03 June 2023
To celebrate World Club Foot Day, we have gathered stories from parents around the world with help from Jerald Cunningham at Cunningham Prosthetic Care, creator of the revolutionary Cunningham Brace for Club Foot treatment.
Many of these stories reflect the journeys many parents go through when it comes to treating club foot. Including the problems that many parents have with the Boots and Bar following the Ponseti procedure but also highlight the tangible benefits of a dynamic brace that allows babies to move around normally, crawling, rolling, standing and then walking. Plus, of course, if your infant has a unilateral club foot its unaffected foot is not forced to be encased as well.
Baby Ottilie with her club foot before starting bracing treatment
“For us, treating our son’s unilateral talipes with a dynamic type of bracing equipment was a no brainer. Choice in the different types of bracing equipment should be based on the needs and outcomes for the child. We are thrilled with the outcomes Josh has experienced with the DTKAFO, and hope that with more longitudinal research and development others that need this brace will be able to access it easily.”
Logan wearing the Cunningham brace
“After delivery, he had 6 weeks of casting, his first tenotomy surgery, and then was placed in the traditional Ponseti boots for treatment. The Ponseti boots were not tolerable for him. He developed pressure ulcers on both heels and ingrown toenails. He was granted a break from the Ponseti boots so that his feet could heal but the break resulted in a relapse, and he had to go through the tenotomy surgery a second time. I was told Ponseti boots were the only way to fix his feet, but I thought to myself there must be a better way. I couldn’t bear to see him suffer through this treatment, so I did some research and came across Jerald Cunningham’s practice in Maine. The Cunningham brace is life-changing!
We made our first trip to Jerald’s practice in Dec of 2021 and had Logan fitted for his first pair of Cunningham braces. Logan took to them right away and everything has been amazing since then. His skin issues resolved quickly, and he loves his braces. He even tries to put them on himself. Logan started pulling himself up and walking very soon after he got his braces. Now he is running everywhere, and we can barely keep up. I’m so grateful for everyone involved in his treatment and the support our family receives is incredible. I hope that other families hear Logan’s story so that if they are struggling with treatment options, they know there are alternatives and that everything will be okay. The Club foot community is amazing and we are so proud to be part of it!!” Elizabeth
You can also read Néis's story, the first baby in France to be treated with the Cunningham brace, who was treated for club foot at the London Orthotic Consultancy.
“AJ got his first cast when he was only 7 days old following the traditional Ponsetti method. His club foot case was described by his doctor as moderate with fair flexibility, a typical case and treatment. The original planned treatment of 3 casts plus a post-tenotomy surgery cast, quickly and without much explanation turned into 6 + 1 post-op cast. His foot did not look “corrected” to us, however, were told this looked normal and to simply start with boots and bar bracing.
A week later, after many hours of research, we found a highly rated club foot specialist doctor and flew to see him. He evaluated AJ and diagnosed him rocker bottom/complex foot. He performed an “accelerated” additional 3-cast treatment, and another tenotomy surgery and post-op (4th) cast. In out opinion, AJ’s foot did not look better after each cast, and were told this was, again, normal and due to the previous treatment. My heart broke when I finally realized the doctors have simply failed to correct our son’s “moderate” and “easily fixable” club foot. I had lost all trust in doctors at this point.
Further research and feedback from the online club foot community, led us to learn about Jerald Cunningham and his approach to club foot treatment, which includes his specialized brace. We took a leap of faith, packed everyone up and flew to visit a little prosthetics and orthotics practice in Maine. Little did we know then, this would be the best decision we could have ever made for AJ’s foot.
Jerald met with us and evaluated AJ’s case in detail. He gave AJ’s foot a Pirani score of 2.5 (first rating we ever received from anyone), meaning that the foot is essentially, not corrected. Jerald was very informative and took his time to answer all of our questions; more than any other physician or provider had ever remotely done. He was brutally honest and did not paint a pretty picture of where we were in AJ’s treatment journey. We realized we had a long road ahead of us to correct AJ’s foot.
Remaining optimistic and approaching AJ’s case with care, he felt confident that he could work with us to help AJ. Jerald carefully measured AJ’s leg and within a couple of days he produced a custom-fit brace for AJ. It is hard to describe in words, but after a few days in the Cunningham brace we were already seeing AJ’s foot respond to the treatment unlike nothing we had seen so far. It was amazing to see the immediate change in AJ’s foot and his demeanor.
Almost 5 years later, a couple of trips to Jerald’s practice in Maine, several custom-made braces to match AJ’s growth and evolving progress, numerous video-call follow up sessions, plus abundant thought and care from Jerald and his team, AJ is thriving! He does all the things rising kindergarteners do and then some! We are so incredibly grateful for Jerald! He is a true blessing to us, AJ, and his “super foot”.
Jerald is not only a brilliant provider, a very knowledgeable but humble professional, he also treats you like family… the best family. No one had taken any time with us and the amount of time and care Jerald has given us is truly amazing.”
Angie and Alejandro
Jonas wearing the Cunningham brace during club foot treatment
“My son Jonas who is now 7 was born with a left club foot. At the time, he was referred to the Ponseti clinic in Manchester, UK, under Miss Naomi Davis (to whom we’re ever so grateful!). After a round of casting and a tenotomy, we were given his first boots and bar. It broke my heart and he stopped sleeping. I spent nights holding him and crying with him. I felt that there MUST be a better less disruptive way to maintain a straight and flexible foot. On one of the FB group I was part of, a man posted a video of the DTKAFO-Cunningham brace, asking if anyone knew anything about it. I didn’t, but it was clear to me that I HAD TO KNOW!
After a few weeks, trying to gather information on the brace, I booked a Skype consultation with Jerald Cunningham, in Maine, USA. My gut was already telling me that his brace was the answer to all of my prayers, so I mostly needed him to convince my partner! Less than a week later, I’d crossed an ocean to meet him in person, get rid of the boots and bar forever and pick up a DTKAFO for Jonas. As soon as I experienced Jerald’s care for my son, a heavy weight lifted off my shoulders. Then from night 1, Jonas slept right through! After a few days, his feet were completely healed from the 5 months he’d had to wear boots and bar. I was relieved, confident in my choice and instantly felt the urge to let everyone know about the DTKAFO.
I also wanted to find someone in the UK that would be able to 1. help me out with the brace in case anything went awry, 2. offer the brace to other children in Britain, 3. prove me right. I started sending emails out to random orthotists and orthotics clinics in the UK. In and around Manchester, everyone ignored my emails. So I was incredibly excited when Sam Walmsley offered to meet me and Jonas to inspect the brace! We took a day trip down to Kingston and I felt Sam’s interest was genuine. I was glad to find out, the following year, that he had taken steps to start collaborating with Jerald!!”
Delphine
Jack's parents documented his club foot journey
“January of 2020 is the 1st time my husband and I heard the term club foot. “You know Fred Flinstone’s feet? That’s what a club foot looks like.” That is all the information we started with the day we found out our son Jack would be born with a club foot. Every doctor and ultrasound tech assured us that correcting a club foot was totally possible and not to worry. May 19, 2020, Jack was born with a complex club foot. At 3 months old with 2 months of weekly casting and surgery on his achilles tendon our orthopedic Surgeon tells us of this new bracing option. Unlike the boot and bar method that has been in use for years this new method really allows the tendon, bones, and foot to be manipulated from multiple angles.
The only catch was to get the new brace we would have to travel to Maine. After looking up the Cunningham brace and comparing it to the boots and bar it was a no brainer, we needed to get Jack to Maine. We decided the only way to get Jack to Maine and keep him safe was to buy an RV. We had 72 hours to get from Georgia to Maine with our negative COVID tests with the hopes that we would not have to quarantine. We were all shocked when the cast came off to see that Jack’s club foot was not overly corrected like we were expecting. We found out that because he had a complex club foot the best procedure was to under correct his foot and start using the brace. After getting his brace fitted and we were comfortable we started our journey back home. We originally chose to use the Cunningham brace because we thought it would not prohibit Jack from being able to just be a baby. By 9 months he started crawling . By his 1st birthday you would never have been able to tell he was born with a club foot. By 14 months he was walking all over the place.”
Mariana
If your baby has been diagnosed with Club Foot and you would like to discuss what LOC can do for you please contact us for more information.
AJ's club foot pre-treatment
Ottilie at the end of her club foot treatment journey next to her casts and Cunningham braces
Ottilie's left unilateral club foot was discovered in her anatomy scan and from that moment her mom researched everything she could about club foot and bracing options. After looking at the options it was decided that she was going to go with the Cunningham DTKAFO brace even though it was newer; Ottilie’s doctor agreed to it and off Ottilie was to Maine to be fitted. Ottilie went in to the brace at 5 months old and just finished bracing after her 4th birthday. During this time she had three braces with regular skype appointments and adjustments.
The bracing caused minimal issues for Ottilie and she often wanted to wear her brace, even when not needed, because she became so comfortable with it on. The Cunningham brace allowed for so much freedom with this energetic little girl who was always moving, even through the night; and continued doing its job throughout the entire process.
Now that Ottilie is done with the brace, even people who know that she has a club foot can not tell she has one; and she is just as active as any other 4 year old and is not held back. She can do gymnastics, swim, run, climb and all other very active activities. Ottilie’s mom says that this brace was a lifesaver for Ottilie and she regrets nothing about her decision to go with it.
Club foot, or clubfoot, is the general name given for a medical condition called congenital talipes equinovarus (CTEV). Congenital means that you’re born with the condition, which can occur in one or both feet. It is quite common, occurring in around one in every 1,000 babies born in the UK.
The Ponseti method involves manipulation and repeated weekly casting for about five to eight weeks. After that, a small procedure called a tenotomy is carried out under local anaesthetic to lengthen the tight heel cord – known as the Achilles tendon – in the back of your ankle. The treatment follows very strict, well-understood protocols and is the gold standard in corrective treatment for club foot. Indeed, the procedure is used and endorsed by Great Ormond Street.
The Cunningham Brace was designed by Jerald Cunningham, who runs his own clinic in the US. It works using a firm strap around the thigh and a spring that holds the brace up against the bottom of the foot. This means that the brace is always gently stretching your baby’s foot into the correct position, in a similar way that a therapist applies manipulation.
Jerald developed the brace at the request of an orthopaedic surgeon and colleague who saw how distressing the boots and bar process was for many children and parents. Jerald has worked on the design for more than 10 years, tweaking as he goes, based on x-ray evidence after every patient fitting.
No problem. Often parents come to us after they’ve tried persevering with the boots and bar treatment for a few months. It may change our treatment plan a little and your child might need treatment for a bit longer, but the process will essentially be the same.
At the moment we can fit the brace at our clinics in Kingston-upon-Thames and Bristol; in addition, we can do follow up appointments at our Manchester clinic. There is a certain amount we can do virtually, but your first fitting would need to be done in person.
We have the following facilities and amenities at our Kingston Upon Thames location:
We also have the Gait Laboratory for orthotics patients and Onsite Manufacturing for speedy turnarounds and adjustments whilst you wait.
