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What is Ankle Equinus? | Find Your Stride | Edinburgh Podiatrist

Introduction

Ankle equinus, a condition characterised by limited ankle joint dorsiflexion, can significantly impact foot function and lead to a myriad of related issues. In this blog post, we will delve into the potential consequences of ankle equinus on foot function, highlighting the importance of detection and intervention. Ankle dorsiflexion is the movement that allows the foot to move upward toward the shin. It plays a crucial role in walking, running, and pretty much every weight-bearing activity. Ankle equinus restricts this movement, causing the foot to assume a more plantarflexed position (pointing down, the opposite of dorsiflexion). Ankle equinus can happen for a number of reasons, the most common (in my clinics) are:

  1. Tightness in the triceps surae (calf muscles)

  2. Osteoarthritis or a bony block at the ankle joint


Runner stops with injured ankle
Runner with ankle pain, could it be ankle equinus?

Why is this important?

When ankle dorsiflexion is restricted the mechanics (movements) of the foot are disrupted, leading to a cascade of compensatory changes throughout the and lower limb. Let's start at the ankle joint itself, with limited dorsiflexion the ankle is unable to absorb shock efficiently, which can be painful at the ankle and elsewhere particularly when running (think of stiff suspension on your car). The result of this is increased stress beneath the foot and other supporting structures. These altered ankle mechanics can therefore disrupt the normal gait pattern, potentially causing a chain reaction of compensatory movements at other joints as as they work to move you forward.


The foot is a highly intricate structure with multiple joints, tendons, and ligaments working in harmony. However, ankle equinus disrupts this harmony, often leading to a variety of foot-related issues. As compensatory mechanisms come into play, the foot attempts to flatten and excessively pronate to facilitate forward propulsion. This additional pronation can contribute towards problems such as plantar fasciitis, or posterior tibial tendon dysfunction. Moreover, the lack of dorsiflexion can also lead to toe walking, where individuals cope with the restricted range of motion by walking on the balls of their feet.


The impact of ankle equinus extends beyond the foot and ankle, affecting the entire lower limb. The kinetic chain concept links each joint and muscle, meaning any dysfunction at one point can have consequences further up the chain. Ankle equinus can cause compensatory moments at the knee, hip, and even the lower back.


What can be done?

To mitigate the negative consequences of ankle equinus, early identification and intervention are crucial. Calf stretching exercises, ankle mobilisation, and orthotic devices are common interventions to address limited dorsiflexion. Timely intervention not only alleviates foot pain and possible compensatory movements it also helps prevent related secondary issues further along the kinetic chain. In conclusion, ankle equinus is not a negligible condition, its impact on foot function can be significant, leading to a range of issues that extend beyond the foot itself. Understanding the biomechanical consequences while recognising the importance of early detection and intervention is vital in maintaining optimal foot function.


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