No other condition of the foot is responsible for long lasting acute and chronic pain. Equinus is a condition in which the upward bending motion of the ankle joint is limited. Someone with equinus lacks the flexibility to bring the top of the foot toward the front of the leg. Equinus can occur in one or both feet. When it involves both feet, the limitation of motion is sometimes worse in one foot than in the other. Equinus is often due to tight Achilles tendon or calf muscles. People with equinus develop ways to compensate for their limited ankle motion, and this often leads to other foot, leg or back problems. The most common methods of compensation are flattening of the arch or picking up the heel early when walking, placing increased pressure on the ball of the foot. Other patients compensate by toe walking, while a smaller number take steps by bending abnormally at the hip or knee.
There are several possible causes for the limited range of ankle motion. Often, it is due to tightness in the Achilles tendon or calf muscles (the soleus muscle and/or gastrocnemius muscle). In some patients, this tightness is congenital (present at birth), and sometimes it is an inherited trait. Other patients acquire the tightness from being in a cast, being on crutches or frequently wearing high-heeled shoes. In addition, diabetes can affect the fibers of the Achilles tendon and cause tightness. Sometimes equinus is related to a bone blocking the ankle motion.
Foot Problems Related to Equinus
Depending on how a patient compensates for the inability to bend properly at the ankle, a variety of foot conditions can develop, including:
Plantar fasciitis (arch/heel pain)
Calf cramping
Tendonitis (inflammation in the Achilles tendon)
Metatarsalgia (pain and/or callusing on the ball of the foot)
Flatfoot
Arthritis of the midfoot (middle area of the foot)
Pressure sores on the ball of the foot or the arch
Bunions and hammertoes
Ankle pain
Shin splints
Most patients with equinus are unaware they have this condition until they see a physician and surgeons that understand the biomechanics of the foot and ankle. Diagnosis is determined via a detailed examination. Some cases an x-rays is taken to assess bone impingement
Treatment includes strategies aimed at relieving the symptoms and conditions associated with equinus. Treatment goals are to increase ankle range of motion in several ways.
Surgery is also an option as well as it does not effect the strength, is minimally invasive, and preformed in the OR with a small camera, See video below:
Recovery is minimal as you are allowed to ambulate with no crutches, walker or scooter. If you are suffering from the conditions listed above ankle equines may be the culprit.
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