Home The Book Dr Articles Products Message Boards Journal Articles Search Our Surveys Surgery ESWT Dr Messages Find Good Drs video

Ankle Equinus

Posted by jspeckman on 5/08/01 at hrmin (047001)

Diagnosed with bilateral ankle equinus of long standing ( first noticed, but untreated as child) by previous DPM (since moved). He advocated stretching. I've been doing yoga and stretching for years, no real improvement.
Several problems: 1)When attempting stretch, feel tearing/stretching/ drawing sensation in medial and lateral plantar fascia on heel attachments.
2) When this sensation is not present, usually can only achieve stretching sensation when hip is flexed 90 deg. knee extended (and stretch is behind knee almost exlusively). With hip extended usually no stretch possible. Same result if knee is flexed- no stretch, only abrubt stop at about 3-4 def. dorsiflexion.
Stretching positions used: standing wall stretch has no effect, so usually I sit with legs extended trunk erect and grab 4th and 5th metatarsals (or plantar region of cuboid, nav.-this seems to cause least amount of stress to plantar fascia), angle pull so as to get something like slight subtalar supination and pull slowly.
One noteworthy exception: About year ago a 'Rolfer' worked on lower leg muscles and also posterior collateral ankle ligaments and retinacula. Afterwards, was able to get clearer and suprising stretch sensation when atttempted, so much so unfortunatly that I overstretched in zeal. Seemed to get about ten degrees DF and even stretching sensation in achilles ( I know that's bad, but ordinarily impossible) with knees flexed for a while but despite stretching efforts to keep range, soon locked back up.
Have history of severe inversion/plantarflexion sprain to both ankles, could I possibly have scar tissue blockages? If so, how do I cajole my new DPM into doing the tests necessary without ego bruising or alienating with my presumptuous patienthood? Many thanks for any response.
P.S. Have any of you read 'Manipulation Method for the Treatment of Ankle Equinus in JAPMA V 90, #8, Sept.2000? I'm hoping to get someone to perform this technique on my ankles soon, definately worth a try from my ankgle.

Re: Ankle Equinus

Dr. Zuckerman on 5/08/01 at 10:59 (047032)

I have read this article . Know the podiatrist. It works that about all I can say about this. The podiatric examination is very important including gait analysis and complete range of motion of the lower extremity. In addition ask this question again with Richard on the insert and orthosis section. He can give you some insights into biomechanical orthois control for this problem

Re: Ankle Equinus

Dr. Zuckerman on 5/08/01 at 10:59 (047032)

I have read this article . Know the podiatrist. It works that about all I can say about this. The podiatric examination is very important including gait analysis and complete range of motion of the lower extremity. In addition ask this question again with Richard on the insert and orthosis section. He can give you some insights into biomechanical orthois control for this problem