AO Newsletter Archive
The Weakest Link: Part One
June 15, 2026
It’s time to talk a bit about plantar fasciitis, the most common foot and ankle badness. Chances are that over 50% of you reading this currently have or have suffered from plantar fasciitis in the past. I will focus mostly on
Three feet north
June 11, 2026
I would categorize this newsletter as more of a PSA, since a few of you may need to know about it.
About 40 years ago, I was a “runner”, sort of. At one point, I started having pain in my left buttocks radiating down into my lateral (outside of) lower leg. Being a hot off the press orthopaedic surgeon...
Complexity bias and fat plantar fascia
May 26, 2026
First, let’s get one important order of “business” out of the way. It has come to my attention that a picture of me is floating around out there. Sadly, that is me, yikes. While this security leak is a potential problem, all I can say is, “What, me worry”?
Sister-in-law visits a surgeon
May 19, 2026
A few years ago, my RN sister-in-law, let’s call her Sue, called me after seeing one of my orthopaedic colleagues, who recommended surgery for her acquired flatfoot deformity. At the time, he was the president of our foot and ankle society, the AOFAS, which means he was the leader of the foot and ankle herd of sheep. Much angriness.
What are your expectations?
May 12, 2026
Why do elective surgeries “fail” when seemingly they should almost always be successful, right?
Well, surgeries can go bad and fail, duh. Head scratching, bad luck, or bad karma.
Your surgeon does not do a stellar job. It happens.
You don’t do your job, which is called noncompliance. It happens, A LOT.
Expectations are not met. How about we talk about this one?
The Perfect Foot
May 5, 2026
This newsletter is basically reverse psychology, so to speak, sort of. Stick with me here.
Last week, we covered the predilection phenomenon and why the poor gastrocnemius is picked on like a little brother. Actually, it is the foot and ankle that is bullied downstream from the gastrocnemius. As a simplified preamble, the incremental damage to the foot and ankle produced by a tight gastrocnemius (equinus) produces unacceptable tension and bending forces on the foot and ankle. You have to trust me on this one...
Predilection, “You keep using that word.”
April 28, 2026
Now for my favorite and final building block regarding the origins of equinus, and it is a two-parter, yahoo. I’m afraid you will have to put on your thinking and engineering caps and be open-minded to this voodoo, but essential voodoo.
Evolution suggests...
FaceBook mumbo jumbo
April 20, 2026
Oopsies, I missed last week. Apologies all around because I know you stare at your device waiting for my terse enlightenment.
This week, I am going to take a break from our muscle tightness journey to address some nonsense I found and continue to find on Facebook. Unfortunately, this FB blather is not restricted to this particular FB group; it appears to be systemic.
Awkward adolescents and Sasquatch
April 6, 2026
I’ve labeled this equinus category “bone/muscle growth mismatch.” It is definitely pretty much unknown.
In this category, the gastrocnemius is “normal” length, genetically speaking, but the tibia has grown too long, creating a situational isolated gastrocnemius contracture or equinus.
It’s just destiny
March 30, 2026
There is no doubt that genetics plays, if nothing else, a subtle role in the progressive contracture of connective tissue. This would account for a possible familial proclivity to calf tightness or tightness of other muscle groups.
Genetics might also account for why an individual is more prone to muscle contractures that lead to tendon and joint problems in multiple areas of the body, or to recurrent issues in one location.
The big picture detour
March 16, 2026
The disconnect between the foot or ankle problem you may be experiencing and why it arrived when it did could not be wider. These things don’t just happen without a reason. Yet, the singular reason the majority of non-traumatic acquired foot and ankle issues exist, equinus, is silent. You are totally unaware that you have equinus. To you, it does not exist, so it can’t possibly be a problem...
Overuse; not really. Equinus reason 1c
March 9, 2026
Highly active athletes also develop equinus, even though they're active and would seem less likely to. Their athleticism does not protect them from the same equinus-related foot and ankle problems that can affect less active people.
My esteemed colleagues, Runner’s World, and whoever else wants to have an opinion, would consider these running-related misfortunes to result from training errors; doing too much too fast, too hard, etc. Equinus is not even on the table, period.
The Tortoise and the Hare
March 2, 2026
In the last round, we looked at slow-developing, decreased activity-related changes that can shorten all muscles and tendons to varying degrees, but this is particularly seen in the calf. This is an intermittent process that ratchets the muscle-tendon unit (MTU) shorter, bit by bit. 3 steps forward, two steps back! Think of reduced activity-related changes as the tortoise.
Just sitting around waiting for it to happen
February 23, 2026
Apologies for the delay. I am on the other side of the world, if you are in the US, that is.
So, why in the HE-double-hockey-sticks would we develop acquired equinus (hereby will be just equinus to save my typing digits)? Equinus does not happen by magic, voodoo, or bad luck; i.e., it is not a mystery, even though most of us do not have a clue as to its presence, let alone why it exists in the first place. Talkin’ bout making me angry. OK, maybe bad karma could be in play, but rarely-that’s your call.
Basic Anatomy and Causes of Equinus
February 16, 2026
Mrs. Angry, my bride, told me that my newsletters are too sciencey, her words, not mine. As a result, we are already off to an annoying start. To be honest, which I am ALWAYS, this stuff requires some science.
So, relax, I’m not about to drag you through a med school boot camp. Fortunately, this stuff is way easier than the white coats want you to believe, but there are a few critical takeaways.
Why am I angry, and what is equinus?
February 2, 2026
Welcome to your weekly AngryOrthopod foot and ankle orthopaedic newsletter. Thanks so much for joining me.
My goal here is to have fun, cut through the BS, and help you guys understand the human foot and ankle in a different way, the right way. In turn, I want you to be equipped to solve many of your own foot and ankle issues, thus stopping the waste of time and money. It is all about getting your quality of life back.