Equinus is a foot condition wherein the ankle joint has limited upward bending motion. It can occur in one or both feet, and can lead to other foot, leg, or back problems. People with equinus often develop negative habits like toe walking, hip or knee bending when taking steps, or flattening the arch or picking up the heel early when walking.
Possible Causes of Equinus
One of the most common causes of equinus is tightness in the Achilles tendon or calf muscles like the soleus muscle or gastrocnemius muscle. This tightness can be congenital or inherited, acquired through being in a cast or frequently wearing high-heeled shoes, or be caused by diabetes. Equinus can also develop due to a bone blocking the ankle motion, like a bone fragment caused by broken bones, or because one leg is shorter than the other. In some patients, equinus is caused by calf spasms, which may be related to underlying neurologic disorders.
Foot Problems Related to Equinus
People with equinus often develop other foot problems due to their compensatory mechanisms. These can include plantar fasciitis or arch and heel pain, calf cramping, tendonitis or inflammation in the Achilles tendon, metatarsalgia or pain and callusing on the ball of the foot, flatfoot, arthritis of the midfoot, pressure sores on the ball of the foot, bunions and hammertoes, ankle pain, and shin splints.
Diagnosis and Treatment
Most patients are unaware of having equinus until they seek medical help due to foot problems. The foot and ankle surgeon will evaluate the ankle’s range of motion when flexed and extended, and may order X-rays. They can then identify if there is tendon or muscle tightness, or if bone is interfering with ankle motion. In some cases, the surgeon may refer the patient for neurologic evaluation.
Non-surgical treatments are aimed at relieving symptoms and conditions related to equinus, and include the following:
1. Night Splint: The foot is placed in a splint at night which reduces tightness of the calf muscles.
2. Heel Lifts: Placing heel lifts in shoes or wearing moderate-heeled shoes can take the stress off the Achilles tendon when walking and can reduce symptoms.
3. Arch Supports or Orthotic Devices: Custom orthotic devices that fit into shoes can properly distribute weight and help control muscle/tendon imbalance.
4. Physical Therapy: to help stretch the calf muscles to remedy muscle tightness.
Surgery may be recommended for patients whose equinus is related to a tight tendon or a bone blocking ankle motion. The foot and ankle surgeon will determine what type of procedure is the best for the individual patient.
Equinus can occur in one or both feet and can result in other foot problems due to compensatory mechanisms. It is important to seek medical attention if experiencing any of the symptoms associated with equinus. Dr Gilbert Huang, DPM, is an expert in diagnosing and treating this condition, and he can help guide patients toward the best treatment options for their individual needs.