What is Equinus?
Achilles equinus or “tight Achilles tendon” is a condition in which the upward bending of the ankle joint is limited. Someone with equinus lacks the flexibility and can occur in one or both feet. People with equinus develop ways to “compensate” for their limited ankle motion. Individuals can compensate by picking up the heel early when walking (early heel off) leading to “toe walking”, picking up the heel early when walking, and this often leads to other foot, leg, or back problems.
Causes of Achilles Equinus (Tight Achilles Tendon):
- Tightness of gastrocnemius muscle (calf muscle)
- Tightness of soleus muscle
- Congenital (present at birth)
- Long cast immobilization
- Use of crutches
- Wearing high heel shoes
- Lack of stretching exercises
- Neurological (spastic) disorder
Foot Problems Related to Achilles Equinus:
- Plantar fasciitis (arch/heel pain)
- Calf cramping
- Achilles Tendonitis
- Metatarsalgia (pain on the ball of the foot)
- Callus formation on the ball of the foot
- Flatfoot deformity
- Midfoot arthritis
- Ulcer (pressure sore) to the ball of the foot
- Shin Splints
Diagnosis of Achilles Equinus:
To diagnose equinus, the foot and ankle surgeon will evaluate the ankle’s range of motion when the knee is flexed (bent) as well as extended (straightened). Less than 10 degrees of ankle dorsiflexion is considered tight Achilles tendon (equinus)
Non-Surgical Treatment of Achilles Equinus:
- stretching exercises that lengthen Achilles tendon
- Night Splints
- Physical therapy
- Topical pain relieving gel
When is Surgery Needed for a Symptomatic Tight Achilles Tendon?
In some cases, surgery such as Achilles tendon lengthening or gastrocnemius recession may be needed to correct the cause of equinus.