Equine foot

The equinus , also known by other names such as clubfoot, clubfoot, can be defined as one foot that is located in a plantarflexion permanent, ie the foot is extended downward along the axis of the leg.

Generally, while there is equine position (foot “dropped” down) there is deformity in other planes and axes of the foot. For example, the clubfoot is one that is in the equine position and has a varus component, which means that the foot is turned outwards, showing the sole of the foot towards the center of the body and with a convex deformity on the external face. of the foot.

Causes of clubfoot

The causes that can produce clubfoot are very diverse, the most important of which are the following:

• Causes related to neurological disorders.
• Congenital causes, that is, the individual suffers from these diseases from birth.
• Traumatic causes.
• Causes related to rheumatic processes.

There are equine feet of less gravity than the previous ones that are produced by the constant maintenance of the foot in a bad position. For example, long-term continuous use of high-heeled shoes causes the posterior leg and foot muscles to be shortened and the foot to be equine.

Production mechanisms

Among the congenital causes, the clubfoot is considered one of the most important deformities of the foot at birth. It is because it is one of the most common foot malformations. In addition, it is easy for it to occur on both feet at the same time. To explain why this deformation occurs at birth there are several theories:

• Genetic theory: it is related to heredity. It is thought that there is a gene that is responsible for the appearance of clubfoot and that therefore passes from parents to children, but there is no experiment that proves it with certainty.
• Mechanical theory: it is a very old theory that explains that clubfoot deformity is caused by a poor position of the fetus within the mother’s uterus, and this poor position is caused by the existence of possible tumors, the lack of amniotic fluid, multiple pregnancies, etc. In this case, it is not proven that these alterations produce clubfoot.
• Neuromuscular theory: which explains this deformity by saying that there is an alteration in the muscles of the foot and leg in which some work a lot and others little so that an imbalance of forces is produced that results in the clubfoot. Depending on whether the muscles are more or less affected, the deformity will be more or less important.
• Theory of development arrest: in this case it is thought that during pregnancy there is something (exposure to radiation, infectious disease, reaction to some medication …) that interrupts the normal development of the fetus just in the position of the clubfoot. At birth, therefore, this deformity appears.

Regardless of the theory that explains the method of production of the congenital clubfoot deformity, it is certain that abnormalities arise in the development of the bones in the foot, especially the talus bone, the scaphoid bone and the calcaneus bone; The muscles and ligaments of the back of the foot contract, pulling the heel upwards, the muscles of the back are stretched, losing strength, and a muscle imbalance is created that maintains the equine position of the foot. In the end, bony stops appear that fix and structure the deformity.

There are several neurological disorders that can cause clubfoot. For example, a paralysis of some muscles such as the sural triceps (located in the calf) that becomes excessively tense and deforms the foot. Polio sequelae and other neurological syndromes also paralyze the muscles.

Rheumatic and arthritic processes that affect the body as a whole, sometimes cause equine deformities of the feet during their evolution.

Symptoms of clubfoot

Among the symptoms that appear, it is worth highlighting the appearance of the deformity that generally forces the person suffering from it to walk on tiptoe without supporting the heel. In the most severe cases, the deformity is so great that the foot is completely overturned on its lateral edge. Other symptoms that appear are:

• Dificulty to walk.
• Difficulty putting on a conventional shoe.
• Muscular fatigue.
• Repetition sprains.
• Appearance of calluses in the forefoot area.
• Sometimes alterations in the spine due to the existence of dismetria.

How is it diagnosed?

Generally, the severe clubfoot and congenital origin is detected right after birth due to the great deformity in the foot and leg.

To diagnose clubfoot, a very rigorous clinical examination is necessary to evaluate the possible cause of the alteration. Within the examination, a photopodogram is made to see the appearance of the footprint.

In addition, a radiological study is needed to analyze the bone status.

The gait analysis shows us the position of the foot, leg and the rest of the body when walking.

Clubfoot treatment

The treatment of clubfoot will depend on the age of the person, the severity of the deformity and the cause that originates the problem.

When it occurs at birth, an attempt is made to correct it through movements, stretching and the placement of splints or devices that maintain an adequate position of the feet. If the malformation is very severe, surgery is usually performed to try to correct the foot.

In adults, treatment consists of orthopedic insoles that compensate for the deformity of the foot and help us to walk in a better position. These insoles must be accompanied by suitable orthopedic footwear that will be modified to allow greater safety and comfort for the person.

If the orthopedic insoles are accompanied by a much better muscular rehabilitation.

How can I avoid it?

The prevention of congenital clubfoot or caused by neurological causes is very difficult. You have to follow a healthy life, follow the advice of medical professionals at all times (during pregnancy, at the beginning of an illness).

In the case of a clubfoot maintained by an abnormal position, the most important thing is to choose the correct footwear and of course visit the podiatrist regularly to prevent any alteration.

In the event that you suffer from the symptoms and deformity described above, you should go to the health professional who takes care of the health of the feet: the podiatrist. They will examine you, diagnose you, and treat you if appropriate.