Equinus
Equinus is a condition in which the ankle is unable to bend upward sufficiently for normal walking. This can happen to one or both feet. Due to the deformity, patients compensate for this limited ankle range of motion by flattening the arch of the foot, or picking up the heel early when walking. In severe cases, some patient walks on their toes, also known as toe walking. This in turn gives a patient a horse like gait when walking, thus the name equinus (horse like). Ultimately, this deformity leads to increased pressure on the ball of the foot.
It is these compensations that causes issues to develop in the foot and ankle. Below is a list of problems that can develop from these compensations.
The most common cause of equinus is tightness in the Achilles tendon (calf muscle). The tightness can be congenital (present at birth) or acquired. Patients can develop tight Achilles tendons from being in a cast, being on crutches,or frequently wearing high-heeled shoes. Systemic diseases such as diabetes can affect the fibers of the Achilles tendon, and cause tightness.
The lack of motion at the ankle can also be from a piece of bone blocking the motion. A small piece of bone that breaks off at the front of the ankle from prior trauma can restrict the motion. Another cause of equinus is one leg being shorter than the other.
Diagnosis:
Many patients are made aware of their equinus deformity after suffering from other foot problems. To diagnose equinus, the ankle’s ability to move up and down is assessed. A gait assessment is also helpful in identifying the compensatory movements. If required, X-rays may be ordered. If the equinus is neurological in nature, then referral to a neurologist might be required.
Treatment:
Conservative treatment for equinus is often effective and can be performed by a patient at home. The treatment options are listed below.
If the symptoms cannot be resolved, or if the deformity is severe, then surgical treatment may be considered.
Equinus is a condition in which the ankle is unable to bend upward sufficiently for normal walking. This can happen to one or both feet. Due to the deformity, patients compensate for this limited ankle range of motion by flattening the arch of the foot, or picking up the heel early when walking. In severe cases, some patient walks on their toes, also known as toe walking. This in turn gives a patient a horse like gait when walking, thus the name equinus (horse like). Ultimately, this deformity leads to increased pressure on the ball of the foot.
It is these compensations that causes issues to develop in the foot and ankle. Below is a list of problems that can develop from these compensations.
- Plantar fasciitis (heel pain)
- Calf cramping
- Tendonitis (inflammation of the Achilles tendon or other tendons)
- Metatarsalgia (pain at the ball of the foot)
- Flatfoot
- Arthritis of the midfoot
- Pressure sores on the ball of the foot or ach
- Bunions and hammertoes
- Ankle pain
- Shin splints
The most common cause of equinus is tightness in the Achilles tendon (calf muscle). The tightness can be congenital (present at birth) or acquired. Patients can develop tight Achilles tendons from being in a cast, being on crutches,or frequently wearing high-heeled shoes. Systemic diseases such as diabetes can affect the fibers of the Achilles tendon, and cause tightness.
The lack of motion at the ankle can also be from a piece of bone blocking the motion. A small piece of bone that breaks off at the front of the ankle from prior trauma can restrict the motion. Another cause of equinus is one leg being shorter than the other.
Diagnosis:
Many patients are made aware of their equinus deformity after suffering from other foot problems. To diagnose equinus, the ankle’s ability to move up and down is assessed. A gait assessment is also helpful in identifying the compensatory movements. If required, X-rays may be ordered. If the equinus is neurological in nature, then referral to a neurologist might be required.
Treatment:
Conservative treatment for equinus is often effective and can be performed by a patient at home. The treatment options are listed below.
- Night splint. The foot may be placed in a splint at night to keep it in a position that helps reduce tightness of the calf muscle.
- Arch supports or orthotic devices. Custom orthotic devices that fit into the shoe are often prescribed to keep weight distributed properly and to help control muscle/tendon imbalance.
- Physical therapy. To help remedy muscle tightness, exercises that stretch the calf muscle(s) are recommended.
If the symptoms cannot be resolved, or if the deformity is severe, then surgical treatment may be considered.