Suggested ORF Modifications
ICD 10 - M21.6x9
Equinus is a condition in which dorsiflexion or bending up of the ankle joint is restricted. People with equinus often develop secondary disorders in the lower extremities which are often treated as the primary cause of the pathology and misdiagnose equinus. The actual amount of limited dorsiflexion required to be diagnosed with equinus is still in debate. Usually, equinus is the result of tightness in gastrocnemius-soleus complex. Other times, equinus can be the result of a congenital disorder or physical trauma.
- Plantar fasciitis
- Tight calves
- Pressure sores
- Back pain
- Irregular gait or walking patterns
Most patients with equinus will come in with expectations of treating or diagnosing a different ankle and foot pathology. A clinician diagnosing a patient with equinus will test the degree of dorsiflexion available in a patient with both the same limb extended and bent at the knee; this is known as the silfverskiold test. This allows the doctor to isolate the gastrocnemius from the soleus to determine which of the muscles are tight. X-rays and other imaging studies may be ordered to check for other possible complications.
In the majority of cases, conservative treatment is a viable option. A night splint, orthotics and physical therapy will be able to correct the gait, release the proper muscles and retrain the muscles needed to build the proper strength. If the cause of equinus is directly tied to the Achilles tendon or an accessory bone, surgery may be required.