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Footnotes / Blog

What is Equinus?

Tuesday, December 5th, 2017 Elizabeth Anthony

Ankle 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.

Why is this an issue? 

Patients 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.

Common Foot problems associated with Equinus:

Plantar fasciitis: Equinus causes the heel to lift too soon while walking this creates a sudden tug or pull on the plantar fascia causes inflammation and pain where it attaches to the bottom of the heel.

Ankle sprains: Having equinus means you have limited ankle motion, a sudden shift in body weight or unevenness in the walking surface can result in an ankle sprain. These patients are also more likely to have repeated ankle sprains during recovery of their original sprain if the equinus is not treated.

Flat Feet: A common way the body compensates for equinus is for the arch to lower in height.  This results in a lowering of the arch and an internal twisting of the leg with every step.

Tarsal Tunnel Syndrome: In some cases, the flat feet caused by equinus results in a pinched nerve just below the ankle. Treating the equinus helps remove the pinching forces.

Bunions/Hammertoes: Equinus causes the tendons which move and stabilize the toes to pull abnormally and the toes begin to drift out of their normal alignment. Over time the misalignment becomes stiff, painful and permanent.

Hallux Rigidus: This condition is a painful degeneration of the big toe joint. Equinus can shift the body weight forward toward the toes while walking and standing, which increases the pain and stiffness felt by these patients.

  • Treatment Options:
    • Stretching Regimen: The main treatment for equinus involves a dedicated Achilles and calf stretching program. The good news is that stretching is free, involves no drug interactions or allergic reactions and is the main cure for equinus. The bad news is that the patient must take responsibility for performing the stretching program. The program takes three months to complete and must be performed five times per day to be most effective. Once the stretching program is completed, the patient will need to perform maintenance stretching throughout life before and after exercising in order to prevent recurrence of the equinus and recurrence of the symptoms
    • Night splint: Night splints have been proven in double-blind randomized clinical trials to treat plantar fasciitis. The splints are worn for 30-60 minutes daily at the end of the day when the activities of the day are over. Usually worn when watching TV, reading or check emails, the devices keep the Achilles tendon at a constant, gentle stretch. This method sends a message to the brain to reset the muscle memory of the calf muscle to a more loose position. Night splints work best when used together with a dedicated Achilles stretching program.
    • Surgery: Surgical Achilles or calf lengthening is usually reserved for severe cases, cases where the patient fails to stretch as recommended, or may be combined with other surgical techniques during reconstructive surgery.

The podiatrists at Innovative Foot and Ankle are all well educated in Equinus and how to treat this issue. We have offices located throughout the northern New Jersey area in Little Ferry, Bayonne, Montclair and Kenilworth.