Ankle Equinus

Ankle Equinus



Gastrocnemius muscle originates on the femur and crosses three joints (knee, ankle, STJ).

Soleus muscle originates on the tibia/fibula and crosses two joints (ankle, STJ).

Plantaris muscle originates on the femur and crosses three joints (knee, ankle, STJ). Plantaris runs between the gastrocnemius and soleus muscle and inserts on the medial aspect of the posterior calcaneus. This muscle is absent 7% of time.

The triceps surae muscle is referred to the two heads of the gastrocnemius muscle and the soleus muscle.

Silfverskiold Test

▪ Tests for gastrocnemius equinus

Passive dorsiflexion is measured with the knee extended and again with the knee flexed. If the amount of dorsiflexion increases with knee flexion, there is an equinus due to a tight gastrocnemius, because the gastrocnemius crosses the knee joint and the soleus does not.



Spastic equinus

CP (hyperreflexia, +babinski, +clonus)

Duchenne’s (post muscle contractions, weak/atrophic muscles, absent reflexes)

Congenital equinus

Birth history, childhood diseases

Note: Toe walking for the first 3 to 6 months of ambulation is a normal variant.


Improper casting with the foot plantarflexed

Repetitive use of high-heel shoes



Talotibial exostosis

Clinically there is a hard and abrupt end ROM upon dorsiflexion.

Stress lateral x-ray may aid diagnosis.


Apparent equinus due to cavus foot type


Biomechanics: Look for STJ ROM, ankle joint ROM, rigid vs flexible deformity.



Partially Compensated

Fully Compensated

Hypertrophic calves

Early heel off

Forefoot supinatus

STJ supinated

STJ pronation

STJ pronation

Walking plantarflexed

Mild HAV

Heel valgus, HAV deformity

Smaller steppage gait

+ + + most pathological

RF inverted

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Nov 20, 2018 | Posted by in ORTHOPEDIC | Comments Off on Ankle Equinus
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