Equinus contracture is a condition in which the upward bending motion of the ankle joint is limited, lacking the flexibility to lift the top of the foot. This happens due to either tightness of the muscles and/or tendons in the calf. This condition can occur in one or both feet. When it involves both feet, the limitation of motion is sometimes worse in one foot than in the other. If you develop ways to compensate for your limited ankle motion, it can often lead to other foot, leg or back problems. It is named after horses (equine) who essentially walk “on their toes”.
There are several possible causes for the limited range of ankle motion. Often, it is due to tightness in the Achilles tendon or calf muscles. In some cases, this tightness is present at birth, and sometimes it is an inherited trait. You can also acquire the tightness from being in a cast, being on crutches or frequently wearing high-heeled shoes. Medical conditions such as diabetes may cause muscles to stiffen.
Sometimes equinus is related to a bone blocking the ankle motion. For example, following an ankle injury, a fragment of a broken bone can get in the way and restrict motion. Equinus may also result from one leg being shorter than the other.
Injuries to the Achilles Tendon
An overly stressed Achilles tendon can be subject to mild or serious injuries. If the injury is mild or moderate, it may be limited to burning or stiffness.
A strain is a stretch or tear in the tissues making up a tendon or muscle. These injuries commonly occur while participating in sports.
Most patients with equinus are unaware they have this condition when they first visit a doctor. Instead, seek relief for other foot problems associated with equinus.
Contact your doctor if you notice:
Arthritis is a challenging problem impeding daily activities. It is characterized by chronic pain and swelling, further aggravated by standing and walking.
Bunions are visible bumps at the side of the big toe or at the base of the little toe. This reflects changes in the bony framework of the foot.
Calluses are areas of thickened skin that form as a response to repeated friction, pressure, or other sources of irritation.
Cramps, or muscle spasms, are involuntary contractions causing the muscles in the calf or foot to suddenly become hard, tight, and painful.
A foot ulcer is an open sore on the foot. It can be a shallow red crater that involves only the surface skin but can also be very deep.
A hammertoe is a toe that is bent all the time because of a weakened muscle. They can be hereditary, but can also be caused by shoes that are too short.
Inflammation is a process by which the white blood cells, and substances they produce, protect us from an infection of foreign organisms, such as bacteria.
Heel pain is pain localized in the back of the foot. Heel pain may be due to numerous conditions, including a stress fracture, tendonitis, arthritis, nerve irritation or, rarely, a cyst.
Metatarsalgia (Pain in the Ball of the Foot)
Metatarsalgia is a condition of inflammaion and pain in the ball of the foot. It is usually from excessive pressure under the foot.
To diagnose equinus, your doctor will evaluate the ankle’s range of motion when the knee is flexed, as well as extended. This helps identify whether the tendon or muscle is tight, or if a bone is interfering with the ankle’s range of motion. X-rays may also be performed. In some cases, your doctor may refer you for a neurologic evaluation.
In some cases, surgery may be needed to correct the cause of equinus if it is due to a tight tendon or a bone blocking your ankle motion. Your doctor will determine the type of procedure that is best suited for you.
Ankle Arthroplasty (Total Ankle Replacement)
Ankle Arthroplasty, also called Total Ankle Replacement, is a replacement surgery of a damaged ankle joint using an artificial implant.
A gastrocnemius release lengthens the gastrocnemius tendon. This is done to increase the flexibility of the calf muscle, which can decrease pressure at the front of the foot, improve function, and decrease deformity.
Tendon Repair Surgery
The tendon repair surgery is a surgery used to fix a damaged tendon. This surgery is often used to repair the Achilles tendon.