One of the most common presentations that a Podiatrist will encounter is ‘stiff’ ankles, or an ankle equinus. An ankle equinus is a restriction in ankle joint dorsi-flexion, which is the opposite movement to pointing your toes.
A patient may, or more typically, may not be aware of the range of motion (ROM) available at the ankle, however it is very important for efficient movement. Restriction has been linked to several conditions;
- Plantar Fasciitis (heel pain)
- Achilles Tendinopathy
- Flat feet
- Posterior Tibial Tendinopathy
- Metatarsal Stress Fracture
- Bunions
- Ankle instability
- Callus and Ulcer formation
It is generally accepted that when the knee is straight there needs to be 10 degrees of ankle joint dorsiflexion, and 35 degrees when the knee is bent.
An equinus can be due to a restriction of soft tissue, bony block, the nervous system or in combination. Therefore, a thorough examination is required to establish the cause, which will determine the best treatment pathway. As an example, some people that have high arches often have an ankle equinus. These people will not be able to improve the available ankle joint movement with stretching because the restriction is due to a bony block, rather than muscle tightness. Therefore, the clinician will need to recommend an alternate means of increasing the ankle joint dorsiflexion.
Compensation patterns for an equinus will vary between individuals as the body finds a way to walk efficiently. Some people may compensate with an early heel raise, increasing the force on the forefoot and Achilles. Other compensation patterns may come from the midfoot, knee or the hip. Simply stated, if there is a restriction of motion at the ankle joint, then the motion must occur at adjacent joint(s).
If you are struggling with any of the mentioned conditions come and visit your nearest Resonance podiatrist. Resonance Podiatrists are your specialists on biomechanical assessments, we can determine the underlying reason for ankle equinus an and can determine the necessary treatment needed.
Article by Resonance Senior Sports Podiatrist
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