Foot Deformities in CT: Have Limited Ankle Motion? It Could Be Equinus

Are you finding that when you walk, your ankle doesn't want to move properly, or that you have limited motion?
You may possibly have equinus, a condition in which the upward bending motion of the ankle joint is limited. Someone with equinus does not have the flexibility to bring the top of the foot to the top of the leg. Equinus can happen in both ankles, and when it does, it is typically worse in one foot than the other.
Those with equinus will often develop ways of compensating for their limited ankle motion, and therefore other leg, foot, or back problems will occur. The most common method of compensation is to flatten the arch or pick up the heel early when walking, placing increased pressure on the ball of the foot.Others will do "toe walking", while some will take steps by bending abnormally at the knee or hip.
There are several causes for a limited range of ankle motion. Often it is due to tightness in the Achilles tendon or calf muscles. In some patients the tightness is congenital and can be an inherited trait. Some will develop this condition because they were in a cast, on crutches, or frequently wear high heels. As well, diabetes can affect the fibers of the Achilles tendon and cause tightness.
Sometimes a bone will block the ankle motion. This may happen because of a fragment of a broken bone following an ankle injury, or bone block, can restrict movement. Leg length discrepancies may also be a cause of equinus, and less often, equinus is the result of spasms in the calf muscles, which may be a sign of underlying neurological disorders.
Depending on how the patient compensates for the restricted ankle motion, several foot and ankle conditions can develop. They include: plantar fasciitis/heel pain, calf cramping, tendonitis, metatarsalgia, flatfoot, arthritis of the midfoot, pressure sores on the ball of the foot or the arch, bunions and hammertoes, ankle pain, and shin splints.
When most patients go to the podiatrist they do not know they have equinus. They are seeking treatment for one of the conditions that has occurred because of the compensation. The podiatrist will first test the range of motion of the ankle when the knee is bent and straightened. This will allow the doctor to see if the tendon is tight and see if bone is blocking the movement. X-rays may be ordered and in some cases the podiatrist may refer the patient to a neurologist for further evaluation.
Treatment is aimed at relieving the symptoms and conditions associated with equinus. Non-surgical treatment options include:

Night splint. The foot may be placed in a night splint to keep it in a position that reduces the tightness of the calf muscle.
Heel lifts. Heel lifts placed in the shoes or wearing shoes with a moderate lift takes stress off the Achilles tendon when walking and may reduce symptoms.
Arch supports or orthotic devices. Custom orthotics are often prescribed to evenly distribute weight and control muscle or tendon imbalance.
Physical therapy. To remedy muscle tightness, exercises that stretch the calf muscles are prescribed.

Surgery is required if it is related to a tight tendon or bone blocking the ankle motion. The podiatric surgeon will determine the best surgical option for the individual patient.
If you have a equinus, call our Glastonbury or Middletown office to make an appointment.
Ayman M. Latif, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Glastonbury and Middletown, CT
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