Calf tightness is a condition whereby the patient is unable to easily bring the foot up fully which leads to various problems in the foot including excessive pressure on the front of the foot. This is termed forefoot overload.
What are the symptoms of Calf Tightness and Forefoot overload?
Achilles tendinopathies, plantar fasciitis, diabetic ulcers, Morton’s neuromas, pes planus, pes cavus, hallux rigidus, hallux valgus and Freiberg’s infraction can all be exacerbated by tightness in the calf muscle. These conditions are discussed separately in this section.
How is Calf Tightness and Forefoot overload diagnosed?
Expert clinical examination is the key to diagnosis. A tight calf-tendon complex can be demonstrated through the Silfverskiold test. This test compares the ability to dorsiflex the ankle with the knee extended or when the knee is flexed. In inflexion, the calf is relaxed and in extension, it is stretched. Any difference between the amounts of dorsiflexion attained is due to the calf muscle.
How is Calf Tightness and Forefoot overload treated?
A dedicated calf stretching course of physiotherapy along with general strength and conditioning has an excellent outcome and no further treatment may be required. If the patient fails to improve the tightness in the calf then a Proximal Medial Gastrocnemius Release can be performed to allow further improvement with calf stretching. This is a local anaesthetic procedure that requires only a small incision just behind the knee. Risks are low and outcomes have been shown to be excellent in over 80% of patients.