Noelle and Blaire McDaniel receive medical care at UI Health Care, Photography by Justin Torner

As the music starts, Noelle McDaniel stops, rises to her knees, and starts swinging her arms and bopping up and down. Her twin, Blaire, soon joins in on the dancing, their “Free the piggies” onesies in honor of World Clubfoot Day on full display.

The music stops and the girls drop to all fours and continue scooting across the room—unhindered by the open-toed boots connected by a bar on their feet.

“They don’t get in their way one bit,” says Jill McDaniel, mother to the 1-year-olds who both were born with clubfoot in both feet (known as bilateral clubfoot). “They bulldoze through everywhere.”

Despite a few bumps along the way, the McDaniel twins soon will be racing through the house and yard and everywhere else on their feet. This is in large part thanks to University of Iowa Hospitals & Clinics pediatric orthopedic surgeon Jose Morcuende, the world’s leading practitioner and teacher of the Ponseti Method. The revolutionary clubfoot treatment was developed at the University of Iowa Hospitals & Clinics by Morcuende’s mentor, celebrated orthopedic physician Ignacio Ponseti.

About one in 1,000 babies is born with clubfoot in the United States each year. Morcuende treated about 525 patients with clubfoot from 2021-22, but the McDaniel girls were unusual.

“Clubfoot tends to run in families, but we don’t see a lot of twins who both have it,” Morcuende says.

While clubfoot sometimes is diagnosed during pregnancy, Jill and Brandan McDaniel, who live in Colona, Illinois, were surprised to learn the girls had the condition shortly after they were born in June 2021.

“The girls went in the NICU after delivery and Brandan was sending me photos. I asked what was wrong with their feet,” says Jill McDaniel, who is an OB nurse in Moline, Illinois. “The doctor came in and said they both had bilateral clubfoot. We had no idea. It was very shocking.”

A physical therapist recommended they contact either the University of Iowa Stead Family Children’s Hospital or another facility a similar distance away.

“I had heard good things about Iowa City and Dr. Morcuende,” Jill McDaniel says. “We didn’t want to trust just anyone with our girls’ feet. We wanted the best, and we were truly given the best.”

While most babies begin clubfoot treatment a few weeks after birth, Morcuende wanted the McDaniel twins, who each weighed just over 5 pounds at birth, to reach about 8 pounds before they started casting.

Casting, which moves the feet incrementally outward toward normal alignment, generally takes six to eight weeks. Noelle’s and Blaire’s feet, however, proved to be a little trickier, slipping and wriggling loose from the casts.

“I told them that it was going to be OK. Every foot is different, and some are more challenging and require a little more work,” Morcuende says. “But we have a 100% correction rate. I assured them we would get there and it would be just fine.”

He recommended that they take a break from casting for a couple of months to allow the girls’ feet to get a little bigger before continuing.

“There were a lot of tears from everyone,” Jill McDaniel says. “They knew we were frustrated, but Dr. Morcuende and his team reassured us and encouraged us to trust the process and not give up. So that’s what we did.”

Casting resumed in January 2022 and went exactly as it was supposed to, with the girls graduating to their boots and bars in April. After wearing the boots and bars for all but a few hours each day, they were given the go-ahead in early July to wear them only while sleeping, which they’ll do until they are 4 or 5 years old.

 

I had heard good things about Iowa City and Dr. Morcuende. We didn’t want to trust just anyone with our girls’ feet. We wanted the best, and we were truly given the best.

Jill McDaniel, whose twins were treated at the University of Iowa Stead Family Children’s Hospital for clubfoot

“Now they’re off to the races,” Morcuende says. “They have all been such troopers throughout everything.”

The McDaniels are looking forward to the twins learning to walk and being able to better keep up with their older sister, Iris, who is 2. They also are grateful that they trusted their daughters’ care to Morcuende and the Stead Family Children’s Hospital team.

“It’s been crazy, but I’m so thankful we went to Iowa City,” Jill McDaniel says. “We would drive there once or twice a week and everyone was so welcoming and kind—they became like family. You can tell they all love what they do.”

McDaniel also has used her experience with her daughters to help her own patients.

“It’s not common, but if there is a clubfoot diagnosis, I’m a good reference to use for parents,” McDaniel says. “It’s nice to be able to be that little bit of comfort for them.”

She urges other parents who find themselves in a similar situation to take one day at a time.

“Just be patient and stay positive. There is a light at the end of the tunnel,” McDaniel says. “We would always say, ‘Where is the light?’ And then we finally saw it. Just trust the process.

“We are so thankful for what Dr. Morcuende and his team did for our girls. They will always hold a special place in our hearts.”

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