Performed by Dr. Venkat Ram Thyalapalli at Dr Venkatram Thyalapalli
Equinus deformity or persistent toe-walking occurs when a child cannot bring their foot flat to the ground due to tight calf muscles, a short Achilles tendon, or neurological conditions. Dr Venkatram Thyalapalli evaluates the underlying cause and may recommend stretching, casting, or surgery to lengthen the tendon and improve foot position. Treatment is tailored to each child's needs and developmental stage.
We believe in honest, upfront disclosure so you can make an informed decision.
A step-by-step look at what happens during this procedure.
A small incision is made at the back of the ankle or in the calf to access the Achilles tendon or gastrocnemius muscle.
The surgeon releases or lengthens the tight tendon or muscle fibres to allow the foot to rest flat on the ground.
The foot is gently brought into a neutral or slightly dorsiflexed position to confirm adequate correction.
The incision is closed with sutures, and a sterile dressing is applied.
A below-knee cast or brace is applied to hold the foot in the corrected position during early healing.
A structured, patient-first approach from first consultation to full recovery.
Dr Venkatram Thyalapalli examines the child's gait, ankle range of motion, and any underlying neurological or structural causes to determine the most appropriate approach.
The procedure is tailored to the degree of tightness, the child's age, and whether the problem affects one or both legs.
Where suitable, Dr Thyalapalli uses smaller incisions and precise releases to reduce tissue trauma and scarring.
Regular check-ups monitor healing, cast changes, and the transition to physiotherapy or bracing as needed.
What to expect at each stage of your recovery journey.
The child rests with the leg elevated and remains in a cast or splint. Pain is managed with prescribed medication, and weight-bearing is restricted.
The foot is kept immobilised in a cast for several weeks to allow tendon healing. Cast changes may be needed to adjust position as swelling subsides.
Once the cast is removed, physiotherapy begins to restore strength, flexibility, and gait. Return to full activity is gradual and guided by clinical progress.
Many children achieve a more neutral foot posture and can place the heel on the ground during walking. The degree of improvement depends on the underlying cause and severity.
Correcting the equinus can help improve walking patterns and reduce compensatory movements at the knee or hip. Persistent habits or neurological factors may require ongoing therapy.
Children with neurological conditions such as cerebral palsy may experience recurrence of tightness as they grow, and may need repeat procedures, bracing, or therapy.
If toe-walking is habitual or related to sensory preferences rather than structural tightness, surgery alone may not resolve the pattern.
The right choice depends on your diagnosis, risks and circumstances — discussed with you at your consultation.
Supervised exercises and home stretching programmes can help lengthen tight muscles in mild cases or as a first-line approach before considering surgery.
A series of plaster casts applied over several weeks can gradually stretch the Achilles tendon and improve ankle flexibility without surgery. This is often tried in younger children or less severe cases.
Custom braces worn inside shoes help hold the foot in a neutral position and prevent further tightening. They may be used alone or after surgery to maintain correction.
Let's clear up some of the most common myths about equinus / toe-walking correction.
Get a personalised assessment from an experienced specialist. Understand your options, ask your questions, and decide with confidence.
Consult Venkat Ram Thyalapalli for Equinus / Toe-Walking Correction at any of these 2 centres — pick the one nearest you.
