Equinus

Hello wonderful people,

While generally happy with my progress, I have felt uncomfortable with my affected foot. Recently I’ve done a lot of research on foot problems, and concluded I have a certain amount of equinus bothering me. Hopefully I am not turning into a horse, but Equinus (pointed feet, like a horse) is a condition caused by a shortening of tendons (contracture, though I feel that is too strong a word) the most common being the Achilles tendon (compounded by tight Gastroc and Soleus (calf) muscles). So I have been doing calf stretches, and noticing a certain improvement. With equinus, the forefoot strikes the ground too early, too often. It therefore takes most of my effort to keep my toes up and away from the ground (dorsiflexion).

On my team, opinion is split 50/50 ; my Radiologist and Yoga teacher think it’s certainly an issue (to a degree). My physio and Chinese Dr. are very doubtful it is an issue. Therefore, this week I’m seeing a chiropractor who is going to take a look at my foot, and next week a podiatrist who will finally settle the matter. Either way, I will continue with my stretches (Ronald (my stroke half) is in dire need of stretches from head to toe). I thought I’d post this story now, since a lot of mystery (to me, at least) is about to unfold.

Does anyone here have experience with equinus, or shortening of Achilles tendon? I realize that foot drop causes similar symptoms, and there are several mechanisms which can cause foot drop. My senior physio established that I don’t have foot drop, but noticed my ankle was very stiff, and the reason is now clear to me. If anyone has experience of this problem, and can advise I would be most grateful.

Good luck to all, and hope there is all-round progress in abundance,
ciao, Roland

ps. I am going back to my watercolours by the end of the week
(waiting for a new palette)

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Not myself but within my family.
They had surgery to reduce the pulling. Feet were twisting inwards and they were beginning to stand on the inside of their foot. From what I remember they cut into the tendons, just a bit, put into a cast and they would repair a bit longer.
Hopefully stretching is a much better outcome for you.

What does an AFO do for you ? Does that give you enough support to force the foot straighter ?
The one I had came with velcro straps on the side so it was the right angle. At night time, if lying on my back, the weight of the duvet was enough to pull my toes down and it became quite painful after a while (shows how weak the foot was). The AFO kept the foot straight and as the base was longer than my foot, the duvet didn’t press on it.

Could walk on it but certainly made it a bit awkward.

Has the foot changed over time for you ? I remember you posting you had walked a decent distance.

All the best with it
Cheers
Nige

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Thanks for yr reply, Nige

I don’t have a weakness in my foot in the way you describe… at least, not much during the thick of the day, but towards evening I notice the foot is exhausted from dorsiflexion. That’s because I am ensuring the toes don’t snag a carpet edge or something and trip me over. If I relaxed my foot the toes definitely would scrape the ground.

“Stand on the inside of their foot” so the foot was going into classic inversion? i.e. Calcaneus (heel bone) did not follow on in a straight line from the Achilles tendon? I was wondering about that when I got up this morning!

I’m sure I only have a limited amount of equinus… but best caught early where a bit of stretching can restore full freedom of movement. Of course, I could be barking up the wrong tree, but the pros will let me know if I’m imagining it. I have not tried an AFO ; but I gather strapping one on for an hour each evening could, in time, help. Again, the pros will advise. I know what you mean about the duvet pulling toes down, but I can straighten them so they point to ceiling (unless I’m on my side, and I do sleep on my side).

Yes, my foot has changed over time. Maybe I have more feedback (still lacking overall) from my foot proprioceptors, so that it feels like more problems… or I really have a bit of tendon shortening (2 months in bed in hospital in 2022) or my ankle is stiff, and I have gone cuckoo & am seeing horses (equinus). Like I said, the judges on my team have reached a split verdict. The problem remains, however.

On Saturday I went to Tyntesfield (national trust) and walked 0.7 km (checked it on Google Earth). Was more pleased with walking (thanks to my awareness of my forefoot, and my calf stretches of late. I am aware of the danger of obsessing over equinus, and need to keep the big picture in mind…

Thanks Nigel, your experience runs right across the board,
Ciao, ciao, Roland

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ps. in a scientific paper I read that Equinus foot deformity EFD is the most common deformity following a stroke

Physical therapy interventions for the correction of equinus foot deformity in post-stroke patients with triceps spasticity: A scoping review - PMC.

I guess many stroke survivors do not know they have it to some degree. Whether they then overcome EFD depends on their recovery & level of activity… that’s the most common scenario, probably.

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Another update, since I saw the chiropractor today ; yes, I do have equinus, she says, to a moderate degree. Next Wednesday I will see a podiatrist, and see what she says, which should be the same.

I’m happy to have diagnosed myself, because I have been working on corrective stretches for some time, by now…

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Good to hear you seem to be getting some answers & making some positive progress.

Best wishes

Ann

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