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Equinus: Ankle Joint Restriction Leads to Other Foot Problems

Walking on your toes all the time is not good for your body. It is always interesting to learn how a medical condition gets its name. Just as clubfoot comes from the shape of the leg and foot resembling a golf club, equinus implies its similarity to the structure of a horse’s front leg. A close look will show that a horse seems to be walking on its “toes” while the ankle joint stays straighter and doesn’t touch the ground.

In humans, the term refers to ankle joint restriction with reduced dorsiflexion, which means there is less lift of the front of the foot than with a normal gait.

Why Your Foot Doesn’t Lift

Most podiatrists believe the restricted movement is related to tight Achilles tendons and calf muscles which keep your foot pulled in a downward position during your stride. This can be present from birth, or an inherited trait that shows up a little later.

Sometimes bone injury can result in a fragment that inhibits joint movement, and a disease like diabetes can affect tendon fibers and make them tight.

Tightness can also occur from using crutches or being in a cast, or even because you wear high heels too much and the tendon is always in a shortened position.

The Consequences of Equinus

Because it is harder to lift the front of your foot, you compensate with other movements. Kids may toe walk, and teens and adults may lift the heel during their stride and “bounce” on the ball of the foot. Others may bend the knee or hip abnormally.

Obviously, all these ways of compensation can result in further problems. Common secondary complaints are conditions like plantar fasciitis, metatarsalgia, flat feet, bunions and hammertoes, shin splints, ankle pain, and cramping of the calf muscles. These are the conditions that will likely bring you to our office. It is only on further examination that we discover that the problem beneath them all is tight tendons and muscles.

If The Tendon Is Too Tight, Stretch It Out

Treatment for equinus usually has two components: relief of symptoms, and loosening the tension in the tendon and calf muscles.

Flats can make the problem feel worse, but heel lifts or shoes with slight heels can reduce some of the tension on the tendon and relieve pain. Arch supports designed to correct imbalances in your feet may also benefit you, and we can always prescribe a pain reliever that can help.

The other goal is to gradually stretch out the Achilles tendon and calf muscles. Night splints can help by holding the foot at a right angle to keep the plantar fascia and Achilles slightly stretched. Physical therapy usually involves stretches that loosen tendon and muscle tightness, such as heel drops, calf wall stretches, and others.

When You Need a Foot Surgeon in Austin, TX

If the tightness is severe and foot pain is limiting your activity, you may want to consider a surgical procedure to lengthen the Achilles, or to remove a bone fragment that is causing an issue. That’s when you call Dr. Craig H. Thomajan DPM, FACFAS of Austin Foot and Ankle Specialists at (512) 328-8900 to set up a consultation. He can evaluate your foot and recommend what should be done, and you will have the peace of mind knowing that you are in the hands of a foot expert. Call today, or if you prefer, set up your appointment using our request form online.

Dr. Craig H. Thomajan, DPM, FACFAS, FAENS
Founder and Managing Partner of Austin Foot and Ankle Specialists