This is why you should pay attention to equinus

A recent AO comment got me thinking, and that is always a dangerous thing. (Found in comments section Calf Stretching: Its the AO Way or the Highway, Kapil, 2022/03/10 at 9:30 pm)

Kapil writes, "Hello AO, I started running/skipping lately and I overdid it which caused plantar fasciitis to both my feet and my feet soles hurt when I stand Or walk…please suggest what should I do? Also can I keep doing my workouts – jogging, skipping, weight training? Thank you. Sorry don’t be angry at me."

The grey text block below is most of my response. In summary, the comment/question was about "overdoing it" as the cause of their recent onset of plantar fasciitis.

I know what you are thinking, "Really? There is no way one thing can cause multiple problems." To make a point, how about tobacco smoking? It causes lung cancer, right? Correct, and that is what most people associate with smoking. However, it also causes emphysema, coronary artery disease that leads to heart attacks, cerebrovascular disease leading to stroke, peripheral vascular disease that can result in leg pain and worse, amputation, esophageal cancer, Burger's disease, and a few more. Oh, and I forgot, bad breath.

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Yo Kapil,

I am all fired up. You are in real trouble now. First, contrary to most of the morons out there recommending rest to basically everyone (this actually does make me mad!), you can continue working out on any level you want. Here are the general rules on that. If continued workouts create an escalation in your pain over time then back off to where the pain is steady. Acceptable is a scenario where your pain is improving (with calf stretching) or a steady daily cycle of get worse with activity and followed by recovery, but not gradually worsening over time. A great reference analogy would be the movie “Groundhog Day”. In other words, it is OK to play with pain that is within reason.

How did you miss calf stretching? This is what you do, period!

OK, I am now calm…..

Stay healthy, my friends,

AO

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Here is the list of the 20 foot and ankle non-traumatic acquired foot and ankle pathologies that equinus causes or contributes to in a major way, but I would say CAUSES:

• General start up pain and stiffness, foot and ankle (this in not old age folks)

• Plantar fasciitis

• Sever's disease

• Shin splints

• Posterior Tibialis Tendon Rupture(PTTR)-Acquired flatfoot deformity

• Second MTP synovitis/plantar plate rupture which leads to hammer toe

• Morton's neuroma

• Insertional Achilles tendinosis/Haglund’s deformity

• Achilles tendinitis/tendinosis

• Recurrent musculotendinous Achilles ruptures, medial head of gastrocnemius

• Calf cramps at night/Charley horse

• Midfoot osteoarthritis/midfoot collapse

• Ankle arthritis/Anterior ankle spurs

• Navicular stress fracture

• Calcaneal stress fracture

• Jones/Fifth MT stress fracture

• Diabetic Charcot arthropathy

• Diabetic malperforans ulcer formation

• Metatarsal stress fractures (stretch for prevention and after healed)

• Achilles tendon ruptures (traumatic, stretch for prevention and after healed)

So, the take away folks is if you have any one of these non-traumatic acquired foot and ankle pathologies you should consider calf stretching and keep stretching. Just sayin'.

Keep moving, my friends,

AO

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