Achilles Lengthening Surgery

What is Achilles lengthening surgery?

Achilles lengthening surgery involves surgically extending the Achilles tendon to relieve tightness or spasticity, often caused by neurological conditions. The Achilles tendon is the primary tendon in the calf responsible for movement and flexibility. This procedure is typically performed as a day surgery, meaning patients are admitted and discharged on the same day. There are four main techniques commonly used to lengthen the Achilles tendon, all carried out under general anaesthetic. After surgery, a cast is worn for approximately 4–6 weeks. Patients are generally able to walk with the cast on, though a protective shoe or boot is recommended to avoid damaging it.

How does Achilles lengthening surgery help?

Achilles lengthening surgery offers several important benefits for patients experiencing tightness or restricted movement in the Achilles tendon. These include:

  • Improved range of motion: Increases flexibility in the ankle and allows for more natural foot movement.
  • Reduced pain and discomfort: Relieves pressure and strain on the tendon and surrounding muscles.
  • Better walking ability: Helps improve gait and balance, making walking more comfortable and stable.
  • Prevention of deformities: Reduces the risk of foot and ankle deformities caused by long-term tendon tightness.
  • Enhanced quality of life: Allows patients to return to daily and physical activities with greater ease and confidence.

Who benefits from Achilles lengthening surgery?

There are several conditions that may benefit from Achilles lengthening surgery. These include:

  • Cerebral palsy: To reduce spasticity and improve walking ability.
  • Muscular dystrophy: To ease tightness and maintain mobility.
  • Clubfoot (talipes equinovarus): To correct deformity and allow the heel to touch the ground properly.
  • Spastic hemiplegia or diplegia: To relieve muscle stiffness caused by neurological disorders.
  • Post-injury or post-surgery contracture: When the Achilles tendon becomes tight after immobilisation or trauma.
  • Toe-walking in children: To help achieve a normal walking pattern when caused by tendon tightness.

Achilles lengthening surgery can also be beneficial for people with the following problems:

  • Chronic Achilles tendon tightness that limits ankle movement or causes discomfort.
  • Foot drop resulting from nerve or muscle weakness.
  • Recurrent heel ulcers due to excessive pressure on the heel from a tight tendon.
  • Severe flat feet (pes planus) caused or worsened by tight calf muscles.
  • Contractures following burns or injuries that restrict ankle flexibility.
  • Pain during walking or running caused by overstrained calf muscles and reduced tendon flexibility.

What are the benefits of physiotherapy for people who have had Achilles lengthening surgery?

Achilles lengthening surgery often requires a structured period of rehabilitation to restore strength, flexibility, and function. Physiotherapy plays a vital role in this process and offers several benefits, including:

  • Improved range of motion: Helps restore normal ankle movement after the tendon has been lengthened.
  • Strengthening of calf muscles: Rebuilds the muscles surrounding the Achilles to support walking and daily activities.
  • Enhanced balance and coordination: Reduces the risk of falls and improves overall mobility.
  • Reduced stiffness and swelling: Encourages proper healing and prevents post-surgical complications.
  • Gradual return to normal activities: Guides patients safely through walking, exercises, and eventually more strenuous physical activities.

What does physiotherapy involve for people who have had Achilles lengthening surgery?

The physiotherapist will use a variety of treatments and techniques to support rehabilitation following Achilles lengthening surgery. These may include:

  • Stretching exercises: To gradually improve flexibility in the Achilles tendon and calf muscles.
  • Strengthening exercises: Targeting the calf, ankle, and foot muscles to restore stability and function.
  • Gait training: Helping patients walk correctly and safely, especially after cast removal.
  • Balance and proprioception exercises: Improving coordination and reducing the risk of falls.
  • Manual therapy: Hands-on techniques to reduce stiffness, improve circulation, and aid tissue healing.
  • Use of supportive devices: Such as protective boots, braces, or orthotics to ensure safe mobility during recovery.
  • Patient education: Guidance on safe exercises, weight-bearing limits, and strategies to prevent re-injury.

Summary

The Achilles tendon is often shortened due to a neurological condition, which can be very restrictive and affect walking and daily activities. Achilles lengthening surgery involves a surgical procedure to lengthen the tendon and improve mobility. Physiotherapy plays a crucial role in rehabilitation following surgery. Initially, physiotherapy focuses on breaking down scar tissue and restoring movement in the Achilles tendon. Gradually, the tendon is strengthened, and the individual is carefully guided back to everyday activities. For more information on Achilles lengthening surgery, please visit acephysiosports.com or call +65 81535374.

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