Equinus

Equinus

Drop foot is a malposition of the foot, either congenital or acquired over the course of life, in which the heel is raised, which results in problems in the gait pattern and on the skeleton.

What is a pointed foot?

Drop foot is when the heel is high so that only the ball of the foot touches the ground when walking. The equinus is in a permanent flexed position, which cannot be corrected passively either. For definition of throat cancer in English, please visit acronymmonster.com.

The equinus is also referred to as pes equinus (horse’s foot), since almost all quadrupeds appear with the ball or toe area of ​​the foot. In humans, however, the equinus foot is not physiological, since the body weight only rests on the forefoot and a stable stance cannot be guaranteed.

Uncertainties in the aisle are also caused by the non-existent roll-off process.

Causes

The causes of a drop foot can be very different. First of all, a distinction can be made between congenital and acquired drop foot.

In congenital drop foot, for example, there is an underdevelopment of the lower leg or a bad posture in the womb. In this case, the pointed foot is also referred to as a clubfoot. However, equinus usually develops after birth, for example due to polio, a disorder of the nervous system, after an ankle injury (which has led to a shortened Achilles tendon) or due to mechanical causes such as being bedridden for a long time.

In most cases, however, the nerve function is disturbed, so that the calf muscles are shortened or the nerves are paralysed. Habitual drop foot occurs when children walk on their toes too often when they are learning to walk.

Symptoms, Ailments & Signs

In the case of a pointed foot, the raised heel can usually be seen with the naked eye. Affected children walk predominantly or entirely on tiptoe and cannot roll their foot from the heel onwards. The calf muscles can appear significantly shortened and it is not possible to press the heel to the ground while standing.

Drop foot is common in bedridden people. Just the pressure of the duvet on the toes and forefoot causes the foot to bend more and more. After some time, those affected can no longer actively bring their foot into a 90° angle to the lower leg. The calf muscles and the Achilles tendon shorten noticeably.

The symptoms are particularly noticeable when walking and standing. Depending on the severity of the foot drop, those affected only walk in tiptoe walk, or can no longer walk due to the deformity.

Calluses on the ball of the foot are also a clear sign of a drop foot, since the entire body weight rests on this small area. If the footdrop has existed for a long time, the changed gait pattern can also cause a curvature of the spine.

Diagnosis & History

The diagnosis is not very difficult with a drop foot, since the malposition is very noticeable even for a layman. The gait is also examined by the doctor during the examination, as is the passive movement of the foot.

However, diagnostic tools such as x-rays, electromyography or muscle biopsies (removal of tissue) are needed to find the exact cause. Not only the foot, but also the other joints of the lower extremity and the spine are examined to determine the effects of drop foot.

The course of the drop foot depends on the cause, for example, the habitual drop foot still has a good prognosis in childhood, it often recedes as it grows. In other species of pointed foot, however, the course is somewhat more extensive and longer; usually it cannot be completely reversed. The result is problems in the knees, pelvis and spine.

Complications

The altered gait pattern in drop foot can cause further malpositions. In the long term, this can lead to joint wear, arthritic diseases and other complications of the bones and joints. Visible calluses often form on the feet due to the unusual gait. These are usually associated with severe pain and a feeling of pressure and can rarely develop into abscesses or serious inflammation.

In the long term, the high load on the knee joint causes arthritic joint changes. In children, the spine can curve in the lumbar region and the hip can shift. This creates a functional malposition. This is often accompanied by chronic pain. These also put a psychological strain on those affected in the long term and can trigger depression, for example.

Surgery can involve nerve damage, bleeding, and inflammation. Wound healing disorders, postoperative bleeding and excessive scarring can occur after the operation. The use of painkillers can cause side effects and interactions as well as allergic reactions in some sufferers. If used incorrectly, orthopedic aids can also trigger complications that in many cases exacerbate the underlying condition.

When should you go to the doctor?

A doctor should be consulted as soon as irregular movements occur. If it can be observed in children or adults that they only walk on tiptoe, it is advisable to clarify the cause. Normally, the foot is put down with the heel when moving and then the foot is rolled over the heel to the toes. This is a natural movement. Any other walking or running sequence should be discussed with a healthcare professional. Permanent impairments of the skeletal system can occur which should be prevented.

If muscle complaints, pain or malpositions occur, an examination and the creation of a treatment plan should be carried out. In the case of a curvature of the spine or an overall changed gait pattern, the affected person needs medical help. If it is difficult to move, if it costs the affected person a lot of strength or if they tire quickly, the observations should be discussed with a doctor.

If sporting activities cannot be carried out as usual due to the symptoms, a doctor’s visit is necessary. A decrease in physical resilience or psychological problems are also reasons for which a cause analysis should be carried out. There is a need for action if you have joint problems, swelling in your feet or an uncomfortable feeling of pressure in your calves.

Treatment & Therapy

The treatment for a drop foot also depends on the cause and, above all, the degree of severity. If there is no shortening of the calf muscles, simple but consistent active movements can reduce the drop foot.

This is done through physical therapy. Patients are often given a lower leg standing cast, which stabilizes the foot and is intended to bring the foot back into its normal position over a period of several weeks. Surgery is rarely performed on a drop foot, only when the Achilles tendon needs to be lengthened due to excessive shortening.

This operation is particularly successful in children; in adults, in the worst case, a joint fusion of the upper ankle is performed when the cartilage is already severely worn. In addition, equinus can be treated with orthopedic shoes.

Prevention

Drop foot can definitely be actively prevented. Even if you are bedridden for a long time, for example, you can fix your foot in the normal position by positioning it sufficiently at the foot end.

Physiotherapy is necessary to stretch the shortened muscles, both actively and passively. Except in the case of a torn Achilles tendon, it is important that if the foot is injured, it is also fixed in the neutral position so that drop foot can be avoided.

After a rupture of the Achilles tendon, the right physical therapy is particularly important in order to bring the foot back into the correct position and not to get permanent drop foot. The stretching of the calf muscles is also the most important component here.

Aftercare

After treatment of a foot drop, comprehensive follow-up care by a specialist is necessary, especially after surgery or lengthy physiotherapy. The follow-up includes a physical examination and an interview with the patient. During the physical examination, the orthopedist checks whether the foot is healing properly.

If necessary, an X-ray or other imaging method will be taken to accurately determine the health of the affected foot. After an operation, it is important to check the surgical wounds. If necessary, the prescribed painkillers and anti-inflammatory drugs must also be adjusted. Various medications must be gradually tapered off.

This should be monitored by the family doctor in order to minimize the side effects as much as possible. The orthopedic surgeon who was already responsible for the treatment of the deformity is usually responsible for the equinus aftercare itself. If complications persist, other doctors may be involved in the treatment.

If no complications or other abnormalities are noticed, the treatment is completed. The patient should consult the orthopedist once every six months to ensure that the equinus foot does not return and there are no other discomforts. In case of pain in the feet and other problems, the responsible doctor should be informed.

You can do that yourself

To avoid accidents or other complications, feet and movements should be exercised daily. It is particularly important to tense your muscles and perform movement sequences when you are bedridden. Anyone can do this independently, you do not need any instructions or specifications. Joint activity should also be used daily so that impairments and disorders can be avoided.

It is particularly important to pay attention to the requirements of the organism when moving. Hectic movements should be avoided. In addition, one should refrain from subjecting the body to severe physical stress. If mobility is impaired after illness, a fall or an accident, particular caution is advised during the healing process. Excessive demands can lead to complications.

If a physiotherapeutic treatment takes place, the techniques and training learned there can also be carried out independently outside of the sessions. Appropriate footwear should also be worn. High heels are not recommended and shoes should fit the size of the foot. Otherwise, the risk of accidents while moving increases. In order not to build up additional stress on the organism, overweight should be avoided. This has a very strong effect on the feet and leads to pain. As soon as the affected person notices disturbances in locomotion, he should take breaks in good time.

Equinus