According to the CDC, the coronavirus spreads from people who are in close contact with one another, meaning less than 6 feet apart. Launching a new clinic in the midst of a pandemic has had some drawbacks. While I am still available for off-site mounted and unmounted evaluations, the clinic allows me to house all of the tools that I will need in one accessible site. It features a massage table and a wide variety of physical therapy equipment and diagnostic tools, such as exercise balls, scales, exercise bands, and more. The clinic is located at Shields’ Fields Farm in Woodbine, Maryland, just up the driveway from the barn. Now I can support equestrians who don’t have a horse or who would like an unmounted assessment in a traditional physical therapy clinic environment. This involves surgical lengthening of the Achilles tendon.The Physio Equine Solutions’ Clinic opened on August 1st, 2020 and has been a great addition to my practice. In severe cases there is a surgical option for muscular equinus. It is preferable to use these treatments in conjunction with one another as the gastrocnemius-soleus complex becomes more flexible, the heel lift and orthotics can be adjusted. There is also complex orthotic therapy and stretching using a brace or splint, or simple “calf wall stretches.” Muscular equinus can be treated conservatively with a heel lift, which will reduce the strain on the gastrocnemius-soleus. Bony equinus can be treated conservatively by physical therapy, orthotics, anti-inflammatory medication, and cortisone injections, but the only way to increase range of motion is by surgical removal of the bony obstruction(s) (1). Treatment depends on whether the equinus deformity is bony or muscular. What Are the Treatment Options for Equinus Deformity? The lower back can be affected also due to body malalignment, causing lower back pain (lumbar lordosis) (1). For example, the limited range of ankle-joint motion can increase pressure on the knees (knee flexion and genu recurvatum), since most of the body weight is shifted forward (1). What Are the Effects of Equinus Deformity?Įquinus can also have detrimental effects on other areas of the body. As this muscle works hard to lift the ankle joint, the toes also lift up, causing the hammertoe deformities. One of these muscles, located on the top of the foot, is attached to the toes. If a tight ankle joint has difficulty achieving the normal ten degrees of ankle movement, it will recruit all the muscles it can to lift the ankle up (dorsiflex). Hammertoe deformities can also be caused by equinus (1). So when the tight ankle joint tries to walk “normally,” and the gastrocnemius-soleus complex is stretched, the plantar fascia is also stretched, leading to possible tears in the fascia. It is usually not seen as a single deformity.įor example, plantar fasciitis (which is defined as inflammation or damage of the plantar fascia, a band of tissue that runs underneath the foot) has an attachment to the heel bone, much like the Achilles tendon (gastrocnemius-soleus complex)(3).īecause of this common attachment, any stretching of one will cause the other to stretch also. What Causes Equinus Deformity?Įquinus deformity can contribute to certain foot and ankle injuries.
An extreme example of muscular equinus can be seen in individuals with neuromuscular diseases such as cerebral palsy (1). If these muscles are tight, they will want to pull the ankle joint down (plantarflexion), opposing the ankle dorsiflexory motion during walking.
It is located at the back of the leg and ends at the back of the heel bone. The Achilles tendon is the longest tendon in the body.
Muscular equinus is due to tightness of the gastrocnemius and soleus muscles, which make up the Achilles tendon. This equinus allows very little ankle motion, and the motion usually stops abruptly (1). If you have less than ten degrees, then you have either bony or muscular equinus (1).īony equinus is when extra pieces of bone around the ankle (either from the talus or tibia bone) block the normal motion of the joint. Classically, ten degrees of ankle dorsiflexion is required for normal walking (2). What is Equinus Deformity, and How Does It Affect Me?Įquinus is defined as limitation of ankle joint dorsiflexion (upward movement of the ankle) (1).