Orthopedic and corrective insoles at the Paley European Institute
At the Paley European Institute, we help you choose solutions that can support the biomechanics of walking, reduce strain, and improve comfort while moving.
Orthotic insoles are customized based on age, foot structure, medical conditions, and the goal of treatment.
Orthotic insoles—what are they and how do they work?
Orthotic insoles are medical or semi-medical devices placed inside footwear to redistribute pressure on the foot, support the longitudinal or transverse arch, and improve the foot’s biomechanics while standing and walking. In practice, they can be used by both children and adults, but their effectiveness depends on the type of problem, the quality of the fit, and accompanying exercises.
Why should you consider orthotic insoles?
They can help reduce foot pain caused by overuse or improper weight distribution.
They support the arch of the foot and stabilize its position inside the shoe, which can improve comfort while walking and standing.
In certain patients, they may improve functional parameters such as balance and postural control, especially when combined with appropriate exercises.
They allow you to customize foot support based on age, body type, activity level, and any underlying medical conditions.
As part of a comprehensive treatment plan, they help protect the foot from further strain and make it easier to follow the physical therapist’s recommendations.
When should you consider insoles?
Insoles may be considered for patients with foot pain caused by overuse, flexible flat feet, uneven weight distribution on the limbs, rapid fatigue while walking, and discomfort resulting from improper foot function within footwear.
For children, the goal of therapy is usually to improve function, comfort, and gait mechanics, rather than to immediately “correct” the foot. It is important to remember that not every flat foot requires treatment with orthotics—the decision to use them should be based on a specialist evaluation.
Who can really benefit from insoles?
Orthotic insoles are not intended for every foot “just in case.” We most often consider prescribing them for patients who experience symptoms—such as pain, fatigue, overuse, or foot dysfunction—and when a specialist examination confirms that such support can genuinely improve comfort and mobility.
For whom?
For children with symptomatic flexible flat feet, when the condition is associated with pain, rapid fatigue, or a reluctance to walk or engage in physical activity.
For children and adults with overuse pain in the feet, heels, or forefoot caused by prolonged standing, walking, or intense physical activity.
For people with uneven weight distribution on their limbs, limb length discrepancies, or foot deformities that require pressure relief in specific areas.
For athletes and highly active individuals, for whom properly fitted insoles help distribute pressure more evenly and reduce the risk of certain overuse injuries.
Who is treatment for clubfoot intended for?
When time is of the essence…
The Ponseti method is intended for all newborns and infants with clubfoot—whether the condition occurs on its own or in conjunction with other medical conditions. The earlier treatment begins, the better and more lasting the results. Treatment can begin within a few days or weeks after birth.
Safety Guarantee: Comprehensive Qualification
The path to a healthy foot at the Paley European Institute begins with a thorough assessment of the child's condition.
Clinical indications
Congenital clubfoot (unilateral or bilateral)
Prenatally diagnosed clubfoot (ultrasound)
Recurrence of the deformity following prior treatment
Clubfoot as part of a genetic or neurological condition
The need for Achilles tendon tenotomy
A child who has undergone major surgery and requires further rehabilitation
The Ponseti Method vs. Surgical Treatment—Which Should You Choose?
Discover the differences in approach, comfort, and long-term outcomes that will shape your child’s future.
The Ponseti Method
Gold Standard
A safe, non-invasive method recognized by global orthopedic societies as the first-line treatment.
Minimally invasive surgery
The only procedure required is a minimally invasive Achilles tendon tenotomy—performed in the doctor’s office and taking just a few minutes.
Excellent long-term results
Children treated with the Ponseti method can participate in any sport and lead fully active lives without restrictions.
Short active treatment period
4–8 weeks of active casting + orthotic treatment—no long-term postoperative rehabilitation.
No scars or extensive incisions
The method leaves no visible scars and does not interfere with the normal development of bones and joints.
: Acceptable Comfort for Children
Infants quickly adapt to casts and braces—the method is painless.
Extensive surgical treatment
Higher risk of complications
Extensive ligament and tendon surgery is associated with a risk of infection, healing complications, and damage to the developing foot.
A Long Recovery
The child requires immobilization and a long rehabilitation period after surgery, which delays normal motor development.
: Poorer Long-Term Outcomes
Studies show that feet that have undergone surgery tend to become stiff and painful in adulthood—the problem is not always permanently resolved.
Visible Scars and Growth Disorders
Surgery on a growing foot can disrupt its natural development and leave scars.
Used only in exceptional cases
Extensive surgery is reserved for the most severe cases, when the Ponseti method has failed or was not properly applied.
The treatment process for clubfoot includes:
Each case is evaluated individually by a multidisciplinary team. Our care goes beyond simply selecting insoles—it includes examination, diagnosis, rehabilitation, and long-term progress monitoring.
Assessment and Diagnosis
A detailed orthopedic consultation and review of medical history.
Assessment of gait, foot loading, posture, and clinical symptoms. If necessary, the patient also consults with a physical therapist.
Treatment Planning
A strategy for selecting insoles, recommendations for exercises, changes in footwear, and a schedule for monitoring progress are established.
We discuss possible treatment plans and goals with the family.
Selection of insoles
Individual selection of the type of insoles—prefabricated or custom-made—taking into account age, foot structure, type of activity, and clinical indications.
Rehabilitation and exercise
If necessary, the patient follows an exercise program for the feet and lower limbs, which enhances the effectiveness of the insoles and improves the strength of the muscles that stabilize the arch.
Monitoring the results
Regular follow-up visits and functional assessments allow us to monitor progress and adjust the treatment plan as needed.
If there is no improvement, we will consider changing the treatment strategy.
We are part of a European network of pediatric orthopedics
We follow the guidelines of the EPOS (European Paediatric Orthopaedic Society) —the European society for pediatric orthopedics—which has established the standards for the treatment of clubfoot followed by leading centers around the world.
Our approach is based not only on our own clinical experience, but also on many years of research and scientific publications on the Ponseti method.
We collaborate with experts from Europe and around the world, which allows us to keep our treatment protocols up to date.
We use the latest, approved diagnostic and therapeutic methods, ensuring that our patients receive treatment in line with current medical knowledge. Each case is treated individually, with respect for the needs of both the child and their family.
Dr. Jacek Kąpiński – pediatric orthopedist, specialist in clubfoot
Dr. Jacek Kapiński is a physician whose patient population consists of 80% children with clubfoot. He began his journey with the Ponseti method in 2015 at the hospital on Niekłańska Street in Warsaw, learning from Dr. Chomiak—one of the pioneers of this method in Poland.
For years, he has been building relationships with entire families, remembers each patient’s history in detail, and accompanies them throughout the entire long-term treatment process—from the first cast until the child has finished growing.
His office is a place where medicine meets empathy: procedures are kept as short and as stress-free as possible for the baby, mothers can breastfeed while the cast is being applied, and the cast is applied efficiently—in about 10 minutes. “It’s definitely going to be great, it’ll be fine!” he tells parents worried about the diagnosis. And he has every reason to believe so.
Clubfoot by the numbers
Global Scale and Experience
1 in every 1,000 newborns is born with clubfoot (approximately 300 children per year in Poland)
>95% success rate for the Ponseti method when the brace is used correctly
On average, 4 casts are sufficient for full correction
80% of cases require Achilles tendon tenotomy—a minimally invasive procedure performed without general anesthesia
5–10% of the most severe cases may require additional surgery
4–5 years of nighttime orthotic treatment to maintain a lasting correction
80% of treatment success depends on parents' consistency in having their child wear the brace
Our Doctors Meet the Paley European Institute team
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A patient- and family-centered approach
The Family as a Partner in Treatment – Treating clubfoot is a process that spans many months, and as much as 80% of its success depends on the parents’ daily efforts at home. That is why at the Paley European Institute, we treat the family as a full participant in the therapy—not just as recipients of instructions.
Hands-on training – We teach parents how to apply a brace, care for a cast, and recognize warning signs. Caregivers are with the child every day, and they are the ones who determine the success of the treatment.
A comprehensive team of specialists —orthopedists, physical therapists, and orthotists—work together to provide seamless care from the moment of diagnosis until the child has finished growing. We’re here every step of the way.
Support and barrier-free communication – Parents can contact the doctor by phone or via WhatsApp – a quick response to any questions about casts or braces is standard for us. We also place great emphasis on psychological support—because we know that a diagnosis can be a deeply emotional experience. We want parents to feel, from the very first visit, that they are in good hands and that—as Dr. Kapiński says— “everything will definitely turn out great.”
Your most frequently asked questions
That is, What you as a parent should know before making a decision.
Clubfoot (talipes equinovarus) is the most common congenital bone and joint deformity in newborns—it affects approximately 1 in 1,000 children (in Poland, about 300 cases per year). It is not a disease of the foot itself, but a disease of the connective tissue: some of the muscles undergo fibrosis, altering the distribution of forces and causing abnormal foot positioning as early as around the 13th week of pregnancy. The deformity resembles a golf club in shape (hence the English name "clubfoot"). It can affect one or both feet. In the vast majority of cases, it is an isolated (idiopathic) defect and—with proper treatment—does not preclude any physical activity.
The cause is multifactorial. If one family member has clubfoot, the risk of it occurring in subsequent children is approximately 14%. There is also documented genetic predisposition, though a large proportion of cases still await full explanation. Importantly, idiopathic clubfoot is a congenital defect that a child is simply born with. It is not the result of parental actions or neglect. There is no reason to feel guilty.
Ideally, this should be done during the baby’s 3rd to 4th week of life, after the mother has bonded with the newborn and the baby has reached a minimum weight of 4 kg. There is no need to begin casting immediately after leaving the delivery room—the mother needs time to get to know her baby. The elasticity of the tissues in a newborn is very high at this stage, which facilitates correction. The Ponseti method also yields good results in older children and in cases of recurrent deformities.
Treatment consists of several stages: (1) Manipulation and casting—gentle manipulation of the foot once a week + a thick, full-length cast extending to the groin (above the knee), changed every 5–7 days. Typically, 4 casts are sufficient. (2) Achilles tendon tenotomy—in approximately 80% of cases; minimally invasive, without anesthesia, performed in the procedure room. (3) Final cast—applied 2–3 weeks after tenotomy. (4) Abduction brace (FAB)—23 hours a day for 3 months, then at night for 4–5 years.
A cast stretches tight tissues, which can cause discomfort—infants often cry, especially in the first few hours. However, older children describe it as a mild, annoying discomfort rather than severe pain. What’s more, many children quickly get used to the cast and react more negatively when it’s removed during bath time! We ensure maximum comfort for the child during the application of the cast: breastfeeding during the procedure, a soothing clinic environment, and quick and precise application of the cast in about 10 minutes.
An abduction brace (FAB) is the only effective method for preventing recurrence after correction. As much as 80% of treatment success depends on the parents’ consistency in using it. Missing even one nap teaches the child that they can “escape” the brace—and gradually undermines the entire discipline of wearing it. That is why it is so important to treat the brace as an inviolable daily routine until the child turns 5 years old. The orthosis does not delay walking, sitting, or crawling—children quickly adapt to the shoes with straps.
With proper treatment, a child can lead a completely normal, active life—playing sports,
including competitive sports. The treated foot may be slightly smaller than the other and have slightly less
calf muscle mass, which most people do not notice or consider insignificant. We know many
outstanding athletes with a treated clubfoot. The goal of treatment is a pain-free foot,
that fits into standard footwear and is ready for any challenge.
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See how we take care of our patients
