Patient Guide: Gastrocnemius Recession or Achilles Tendon Lengthening Surgery

If you’ve been dealing with persistent foot pain or deformities caused by tight calf muscles or an Achilles tendon issue, you may have heard about gastrocnemius recession or Achilles tendon lengthening surgery. This procedure offers a solution for many individuals facing these challenges. Let’s delve into what the surgery entails, why it might be necessary, and what you can expect during recovery.

Understanding the Procedure

Tight calf muscles or Achilles tendons can place excessive tension on the foot, leading to discomfort and long-term issues such as foot deformities. Gastrocnemius recession or Achilles tendon lengthening surgery aims to alleviate this tension by lengthening the calf muscle or tendon. This adjustment helps reduce the destructive effects on the foot, addressing the root cause of the problem.

By opting for this surgery, you can expect benefits such as reduced flattening of the foot and relief from the underlying deformities. However, like any procedure, it does come with specific risks. These include a potential rupture of the lengthened tendon, which would require surgical repair or a recurrence of foot collapse. You might also notice a temporary reduction in strength when raising your toes, though this usually improves with rehabilitation exercises.

What to Expect During Surgery

The procedure itself is relatively quick, typically lasting between 40 to 60 minutes. Small incisions are made around the calf muscle or Achilles tendon to perform the necessary adjustments. A combination of absorbable and non-absorbable stitches is used, and depending on your individual case, internal fixation such as screws or pins may be involved. In some cases, a cast may be necessary post-surgery.

Most patients can expect this to be a day surgery, meaning you’ll go home the same day after a few hours of monitoring. It’s important to arrange for someone to accompany you home and assist you during the initial recovery phase.

For those wondering about time off work, non-manual workers typically need 6 to 8 weeks, while those in manual labour may require 8 to 10 weeks to recover fully before returning to their jobs.

Who Can Benefit from This Surgery?

• This procedure is often recommended for individuals experiencing conditions such as:

• Painful equinus or limited upward motion of the ankle.

• Chronic plantar fasciitis or pain in the ball of the foot (metatarsalgia).

• Diabetic ulcers caused by pressure from tight tendons.

• Painful, unstable arches that affect mobility.

If these conditions sound familiar, your healthcare provider may discuss this surgical option with you. However, alternatives like calf stretching programs, night splints, or special footwear may also be explored first.

Anesthesia Options and Recovery

The procedure can be performed comfortably under local anesthesia, with injections around the ankle or behind the knee. While you’ll remain awake, you won’t feel pain, only touch, pressure, and vibration. For those who prefer not to stay awake or when the surgeon deems it necessary, local anesthesia with sedation or general anesthesia can be used.

Post-surgery, it’s vital to rest and follow all provided instructions. During the first two weeks, you’ll need to minimize mobility and rely on crutches, placing weight only on your non-operated foot. Pain is most prominent during this phase but can be managed effectively with prescribed medications.

Recovery Timeline

Recovery from gastrocnemius recession or Achilles tendon lengthening surgery happens in stages:

Initial Phase (First 2 Weeks):

Rest is crucial during this time. You’ll need to keep your foot elevated and limit movement to essential activities like bathroom trips. Crutches will be your primary support.

At Two Weeks:

You’ll return for a redressing appointment. Stitches may be removed, and if you had a cast, a new one might be applied or replaced with an air cast boot. X-rays may also be taken to monitor healing progress.

Between 2 and 8 Weeks:

Depending on your procedure, your surgeon may allow gradual weight-bearing. Supportive footwear, like lace-up shoes or trainers, will help you ease back into walking. Some swelling and discomfort are normal as activity increases. You may also begin rehabilitation exercises or work with a physiotherapist to regain strength and mobility.

At 8-12 Weeks:

The foot should feel more functional, and swelling will continue to decrease. Sporting activities may be considered around the three-month mark, provided your recovery is progressing well.

Beyond 12 Weeks:

A final review will take place approximately 6 to 8 months after surgery. By this time, most patients notice significant improvements and experience long-term benefits.

Planning for Success

To ensure a smooth recovery, it’s essential to prepare in advance. Arrange for someone to assist you at home, particularly during the initial days when mobility is limited. Make sure you have support for childcare or caregiving responsibilities if needed.

If you have any concerns or questions at any stage, your healthcare team at The Coriel Clinic is there to help. Don’t hesitate to reach out for guidance or clarification.

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Gastrocnemius recession or Achilles tendon lengthening surgery is a valuable option for individuals struggling with tight calf muscles or Achilles tendons. With proper preparation, adherence to recovery protocols, and guidance from your medical team, this procedure can help you regain comfort, mobility, and quality of life. If you’re considering this surgery, consult your healthcare provider to discuss the best plan for your needs.