Equinus Contracture - Right & Left Ankle, Problems in Adults, ICD-10

Equinus Contracture:

• What is Equinus Contracture?
• Right & Left Ankle Equinus
• Problems in Adults
• ICD-10

What is Equinus Contracture?

Equinus contracture refers to a limitation in the upward movement (dorsiflexion) of the ankle joint. This condition is caused by tightness in the calf muscles—primarily the gastrocnemius and sometimes the soleus—or tightness in the Achilles tendon. When the ankle cannot bend properly, the foot remains in a downward-pointing position, similar to walking on toes. This imbalance affects gait, posture, and overall lower limb mechanics.

Equinus contracture may occur in children or adults and can be associated with various conditions such as diabetes, cerebral palsy, prolonged immobilization, or simply tight calf muscles due to poor stretching habits. Early recognition is important to prevent long-term complications, including altered walking mechanics, foot pain, and tendon overuse injuries. Treatment may include stretching, physical therapy, orthotics, casting, or in severe cases, surgical lengthening of the Achilles tendon or calf muscles.

Right & Left Ankle Equinus

Equinus contracture can affect either the right ankle, left ankle, or both. When unilateral, patients may experience asymmetry in gait, leading to limping, foot rolling, or compensatory overuse of the opposite leg. This can eventually cause knee, hip, or lower back pain. Right-sided equinus may lead to more pressure on the lateral foot, while left-sided equinus can similarly alter gait mechanics depending on dominant foot usage.

Bilateral equinus contracture often results in toe-walking, shortened stride length, and difficulty walking uphill or climbing stairs. Patients frequently report tightness in the calves, early fatigue, or chronic heel pain. Evaluating both ankles is essential because even mild differences in dorsiflexion can significantly affect biomechanics. Proper diagnosis typically involves a physical exam, gait observation, and measurement of ankle range of motion with the knee bent and straight to identify whether the gastrocnemius or soleus is tight.

Problems in Adults

Adults with equinus contracture may experience a wide range of problems due to altered biomechanics. Common issues include plantar fasciitis, Achilles tendinopathy, metatarsalgia, and recurrent ankle sprains. The lack of dorsiflexion forces the foot to compensate in ways that stress other structures of the foot and leg. Over time, adults may also develop knee pain from hyperextension or increased pressure in the forefoot, particularly when wearing shoes with minimal heel elevation.

Walking difficulties are also common. Adults often describe a feeling of stiffness, difficulty squatting, or trouble walking barefoot. In longstanding cases, equinus can contribute to forefoot deformities, including bunions and hammertoes. Left untreated, the condition can significantly limit mobility and increase the risk of falls, especially in older adults. Intervention through stretching programs, night splints, heel lifts, or physical therapy can help slow progression and relieve symptoms, while severe cases may require surgical correction.

ICD-10

The ICD-10 code used for equinus contracture is M24.571–M24.579, depending on the affected limb:

• M24.571 – Contracture of right ankle
• M24.572 – Contracture of left ankle
• M24.579 – Contracture of unspecified ankle

These codes are used for documentation, billing, and insurance purposes when diagnosing or treating ankle equinus contracture. Additional ICD-10 codes may be added if the condition is related to another underlying disease, such as cerebral palsy (G80) or diabetes-related neuropathy (E11.40). Proper coding ensures appropriate clinical tracking and reimbursement for therapy, casting, or surgical procedures when required.