Which shoe modification is most effective for a fixed equinus deformity?

A heel lift is an effective shoe modification for addressing a fixed equinus deformity, which is characterized by significantly limited ankle dorsiflexion resulting in the inability to bring the foot into a neutral position or beyond when the knee is extended. By elevating the heel, a heel lift allows for a more functional range of motion at the ankle, accommodating the lack of dorsiflexion. This modification helps to create a more optimal alignment of the foot and lower leg during walking or standing, thereby reducing potential compensations that can lead to discomfort or further issues.

Additionally, a heel lift can assist in redistributing the weight and pressure throughout the foot, which is particularly beneficial in cases of equinus where there may be increased forefoot pressure. This adaptation can also help improve gait mechanics and reduce the risk of secondary complications associated with the fixed equinus deformity.

While other shoe modifications such as a cushioned heel, Thomas heel, or reverse heel may have specific benefits in certain situations, they generally do not address the core limitation of dorsiflexion in the same effective manner as a heel lift does for someone with fixed equinus. These alternatives may provide comfort or support but do not significantly enhance ankle movement or function, which is crucial in managing