Lecture 3 - Equinus and Flatfoot Clinical Correlation Flashcards
Consensus among the majority of experts is that at least _____ degrees of ankle dorsiflexion with knee extended is needed for normal gait with limited foot compensation
+10
Congenital Etiologies
-Perhaps the most common???
A tight Achilles Tendon is the primary pathology
Seen in children
Causes excessive pronation
Developmental Etiologies
Achilles tendon shortens as a result of another pathology
Causes: Excessive STJ pronation FF Varus > 4 degrees- Is the varus aquired? Tarsal coalition Internal malleolar position Tight hamstrings Limb length discrepancy
Tonic spasm of triceps surae STJ or Ankle joint DJD Clonic spasm of triceps surae Upper motor neuron lesion Acquired Trauma Casting
Caused by a tight Gastrocnemius muscle
GASTROCNEMIUS EQUINUS
Type of Equinus **
Less than 10º of dorsiflexion with knee extended
Greater than 10º of dorsiflexion with knee flexed
GASTROCNEMIUS EQUINUS
Caused by a tight Triceps Surae
GASTROSOLEAL EQUINUS
Will have less than 10º of dorsiflexion with knee extended and flexed***
GASTROSOLEAL EQUINUS
Abrupt end to dorsal ROM
Charger radiographic view
impingement of the tibiotalar articulation
Osseous Equinus
Actually have 10º of dorsiflexion at ankle, but functionally need more because of a plantarflexed forefoot
PSEUDO EQUINUS
- In a high arch foot appears that they do not have it but they do
Less 10 knee exteneded and knee flexed and end range of motion is spongy ?
GASTROSOLEAL EQUINUS
- IF osseous it would be an ABRUPT stop
What phase of stance phase is shorted with equinus
More rapid entrance and exit into and out of mid-stance
Most common limiting factor is what for equinus?
tight Gastroc or Gastroc-Soleus Complex
When there is a pronated foot the mobility of the MPJ……. (Increase or Decrease)
Increase
Compensatory Mechanisms for equinus
STJ & MTJ (oblique axis) Pronation
- Dorsiflexion of forefoot on rear foot compensates for the lack of ankle joint dorsiflexion
ADF with knee extended is 5 degrees
ADF with knee flexed is 5 degrees
motion ends abruptly
Osseous Equinus
