Specialista in Ortopedia Pediatrica
Flexible metatarsus varus
Home Exercise Program
Not every exercise listed here is suitable for every child: the selection is individual and is defined during the consultation.
1.Abduction stretch with hindfoot blocked
Corrects inward forefoot deviation without forcing the hindfoot into valgus
Baby supine and relaxed. One hand firmly stabilises the heel and midfoot in a neutral position. The other hand grasps the forefoot at the metatarsal heads and slowly moves it OUTWARD. The pivot is the midfoot: the ankle stays still. Caution: the push must never bend the heel outward (risk of hindfoot valgus) — if the heel moves, the grip is too low.
Hold 20-30 seconds, 5 reps per foot, at every diaper change
2.Forefoot pronation (supination correction)
Brings the first ray, elevated in metatarsus varus, back down
Difference from metatarsus adductus: here the forefoot is also rotated into supination (inner border lifted). Holding the hindfoot still, place the thumb under the head of the first metatarsal and push it downward while the other fingers guide the outer border upward. The gesture "unrolls" the forefoot. Combine it in a single fluid motion with the abduction above.
10 reps with 10-second holds, combined with abduction
3.Medial border stretch and massage
Stretches the tight medial tissues that maintain the bean-shaped curve
Massage the MEDIAL border of the foot for 1-2 minutes, from heel to big toe, with cream or oil: this is where tissues are shortest. Then, with the heel held still, place the thumb at the apex of the medial curve and keep gentle, constant pressure while the forefoot is taken into abduction. Do not pinch and do not press painfully on the navicular.
10 reps with 10-second holds, 3-4 times daily
4.Active outer border stimulation and positioning
The baby's own active correction plus 24-hour positioning management
With the baby awake, stroke the OUTER border of the foot from heel to fifth toe: peroneal contraction opens the foot outward and lifts it. For the rest of the day: plenty of barefoot time, no tight socks or narrow-toed rompers, supine sleep (never prone with feet tucked under). Once walking, straight-last shoes without an inward curve of the sole.
10-15 strokes per foot several times a day; positioning all day long
RED FLAGS - When to stop and contact the doctor immediately
Stop the exercises immediately and contact the specialist (or go to the emergency department if severe) if any of the following occur:
- Acute or sudden pain during exercise
- Significant swelling after exercises
- Pain that progressively worsens over days
- Fever or general malaise
- Difficulty walking or using the limb after exercises
- Any neurological symptoms (tingling, numbness, sudden weakness)
- Fever, redness or warmth of the joint, or inability to bear weight
In case of doubt, always prefer a check-up over continuing the exercises.
Dott. Daniele Priano
Ortopedia Pediatrica - ASST Gaetano Pini-CTO
ortopediaevolutiva.com • 26/08/2026
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MioDottoreBefore You Start
Who is this guide for?
Newborns with metatarsus varus. Gentle mobilizations and stretching by parents.
What you need
Clear floor space, mat or soft surface, comfortable clothing. Some exercises may require resistance bands or supports.
Suggested frequency
Usually 1-2 times daily, as directed during the visit. Consistency is more important than intensity.
Common mistakes to avoid
- •Performing exercises too quickly without control
- •Pushing beyond the pain threshold
- •Skipping days or doing occasional very long sessions
- •Not warming up before strengthening exercises
⚠️ Red flags — when to stop and contact the doctor immediately
Stop exercises immediately and contact the specialist if any of the following occur:
- Acute or sudden pain during exercise
- Significant swelling after exercises
- Pain that progressively worsens over days
- Fever or general malaise
- Difficulty walking or using the limb after exercises
- Any neurological symptoms (tingling, numbness, sudden weakness)
Detailed Exercises
- 1
Abduction stretch with hindfoot blocked
Corrects inward forefoot deviation without forcing the hindfoot into valgus
Baby supine and relaxed. One hand firmly stabilises the heel and midfoot in a neutral position. The other hand grasps the forefoot at the metatarsal heads and slowly moves it OUTWARD. The pivot is the midfoot: the ankle stays still. Caution: the push must never bend the heel outward (risk of hindfoot valgus) — if the heel moves, the grip is too low.
Hold 20-30 seconds, 5 reps per foot, at every diaper change - 2
Forefoot pronation (supination correction)
Brings the first ray, elevated in metatarsus varus, back down
Difference from metatarsus adductus: here the forefoot is also rotated into supination (inner border lifted). Holding the hindfoot still, place the thumb under the head of the first metatarsal and push it downward while the other fingers guide the outer border upward. The gesture "unrolls" the forefoot. Combine it in a single fluid motion with the abduction above.
10 reps with 10-second holds, combined with abduction - 3
Medial border stretch and massage
Stretches the tight medial tissues that maintain the bean-shaped curve
Massage the MEDIAL border of the foot for 1-2 minutes, from heel to big toe, with cream or oil: this is where tissues are shortest. Then, with the heel held still, place the thumb at the apex of the medial curve and keep gentle, constant pressure while the forefoot is taken into abduction. Do not pinch and do not press painfully on the navicular.
10 reps with 10-second holds, 3-4 times daily - 4
Active outer border stimulation and positioning
The baby's own active correction plus 24-hour positioning management
With the baby awake, stroke the OUTER border of the foot from heel to fifth toe: peroneal contraction opens the foot outward and lifts it. For the rest of the day: plenty of barefoot time, no tight socks or narrow-toed rompers, supine sleep (never prone with feet tucked under). Once walking, straight-last shoes without an inward curve of the sole.
10-15 strokes per foot several times a day; positioning all day long
Frequently Asked Questions
What is the difference between metatarsus adductus and metatarsus varus?
Metatarsus adductus is forefoot deviation inward on horizontal plane (top view). Metatarsus varus also includes a supination component (rotation). Mobilizations are similar but metatarsus varus adds a pronation component.
Does metatarsus varus correct on its own?
Most flexible cases correct spontaneously within first 1-2 years of life. Mobilizations accelerate correction and are particularly useful in less flexible cases. If not improving by 6-8 months, additional treatment may be needed.