28/01/2026
🧡 Why do the boots alone not work on the foot, while the brace as a whole does?
To understand this, we need to explain HOW the brace (boots connected by a bar) works?
1️⃣
During a series of gentle manipulations and casting, the soft tissues lengthen under constant load — a process known as “creep.” In simple terms, tissue stress is applied and then released once static immobilization (the cast) is applied. Casts are changed weekly, which allows tension to subside and enables further gentle stretching manipulations, gradually changing the position of the foot.
This continues until nearly 70° of abduction is achieved. During this time, the calcaneus is released from beneath the talus, the navicular bone moves onto the head of the talus, and correction occurs. The tenotomy addresses the problem of an excessively shortened Achilles tendon. At this point, full correction of the foot is achieved. That is why the final cast after the procedure is applied in so-called hypercorrection: 60°–70° of abduction combined with 10°–15° of dorsiflexion.
2️⃣
After removal of the final cast, the foot — prepared in this way — is placed in a foot abduction brace, where this “stress relaxation” is no longer as intense. The load is reduced while continuous lengthening is maintained. However, over time, with use of the derotation brace, kicking movements, and the child’s other activities while wearing the device, the condition of the foot improves (increased abduction and dorsiflexion) and is maintained up to a certain point. Thus, the FAB helps continue this process. This is long-duration stretching with low load (low load, long duration) — the only effective method after correction with the Ponseti method.
⛔️⛔️⛔️
Boots alone do NOT effectively “stretch” the Achilles tendon or the calf muscles — that is exactly what the attached bar does!
Boots without the bar:
⛔️ hold the foot in an unstable position
⛔️ do not generate constant tension
⛔️ do not control abduction or external rotation
⛔️ do not enforce dorsiflexion of the foot
