Equinus | Intelligent Management| No. 2 in a Series

The concerns and issues of Equinus treatment are faced by patients first, then their podiatrists and other professional contacts. I am suggesting some standard definitions for diagnosis and treatment so that we can help patients ‘get back in step’

Informational literature has Equinus definition ranges between -10 and +22 degrees of ankle joint dorsiflexion for normal ambutlation. I found a consensus of 13 different studies for10-degrees. Having a firm definition range should make communication between specialties and among practitioners much easier when discussing equinus.

For example, I am the team podiatrist for both the Indiana Pacers team and the Indiana Fever team. Within my determination of the measurement degrees, I think every player has equinus. The trainers use different measurements which lead them to think none of the players have equinus. It is a matter of definition and evaluation.

An article written by R.S. Hill; “Ankle equinus: prevalence and linkage to common foot pathology.” in JAPMA 85: 295, 1995, discusses the evaluation of 206 new patients from Kaiser Permanente clinics over a six-week period of time. This article helps establish a definition of equinus that we need.

Additionally, the information shows how frequently equinus is associated with the pathologies we see every day in our podiatry practices. Twenty-six patients were excluded because they didn’t meet criteria – ingrown toenails, onychomycosis, verrucae plantaris were involved among other similar conditions. Six patients of the remaining 174 had normal ankle joit dorsiflexion. Of the 168 patients left in the study, three had gastrocnemius equinus and 165 had gastrocsoleus equinus. Hill used a definition of 3-degrees of ankle joint dorsiflexion and normal ankle joint dorsiflexion. In the study, 96.5% of the patients with foot or ankle symptoms had equinus using these definitions. I think Hill’s definition was a little low and will use the remaining two articles to further discuss a definite definition.

Readers who are experienced with foot conditions will be more familiar with some of the terms than patients or people who have foot pain but haven’t found someone who can offer relief. If you have questions about your condition — perhaps your pain is connected to equinus — I recommend that you contact a professional with your questions and seek a professional evaluation.