One of the motions that the ankle does is allow you to point your toes and foot downward towards the floor or upward towards the front of the leg. When the ankle won’t perform the upward motion, the condition is called equinus. Since this motion is necessary for proper gait, equinus leads to gait problems such as putting the weight of the body on the ball of the foot, walking on the toes, bending at the knee or hip, or even contracting the muscles of the foot until the arch is lost. Thus, the original calf cramping, pain in the ankle, arch, ball of the foot or heel, and blisters on the ball of the foot or the arch can lead to the development of bunions, hammertoes, flat feet, tendonitis, plantar fascitis, or even shin splints. Cause Tight calf muscles or Achilles tendon is often at the root of this problem. This may occur from wearing high heels, walking on crutches, wearing a cast, diabetes, or other reasons such as a congenital condition or short leg syndrome. If a bone in the ankle has fractured and has been displaced to block the ankle’s range of motion, this may be another cause. Treatment and Prevention A medical evaluation is necessary to determine why the range of motion in the ankle is limited. This will include orthopedic tests and an x-ray. In some cases, surgery may be necessary. In equinus, it’s critical to do the following: • Relieve the muscle tightness with massage therapy and stretching exercises • Wear orthotic arch supports to correct the faulty biomechanics of the foot. This may include arch supports, heel cup for stability and metatarsal pads to cushion the ball of the foot. • Restore the proper gait.