Personalised Post-Gastrocnemius Lengthening Protocol

Introduction:

You are preparing for gastrocnemius lengthening surgery to address tightness in your calf muscle, which may have caused discomfort or restricted your mobility. This protocol provides essential information on what to expect during your recovery, as well as potential risks and complications. Each patient’s recovery process is unique, so please consult your surgeon with any specific concerns.

What is gastrocnemius lengthening?

Gastrocnemius lengthening is a surgical procedure to relieve calf muscle tightness by increasing its flexibility. This is often necessary to alleviate symptoms related to conditions such as:
– Achilles tendinopathy
– Plantar fasciitis
– Foot deformities
– Calf contractures

Commonly Asked Questions

1. Will I need a cast after surgery?
No cast is required following gastrocnemius lengthening surgery. Most patients can walk immediately after surgery, but it is essential to avoid overexertion during the first few weeks to ensure proper healing.

2. How long before I can walk normally?
Walking may be uncomfortable in the first 1-2 weeks. However, you are encouraged to start walking shortly after surgery, with full comfortable walking typically returning within 2-3 weeks.

3. Can I drive after surgery?
Driving is allowed as soon as you can walk comfortably, usually within 2-3 weeks after the operation. Ensure you can safely control the pedals before resuming driving.

4. When can I return to work?
If you have a desk job, you can typically return to work within 2-3 weeks. For physically demanding jobs, it may take up to 6-8 weeks. Your surgeon will advise you based on your recovery progress.

5. When can I return to sports?
You can resume light activities like walking or gentle stretching after the first few weeks. Most patients return to sports and more vigorous exercise 3-4 months after surgery, depending on rehabilitation progress.

6. Will I need physiotherapy after the operation?
Yes, physiotherapy is essential for regaining strength and flexibility in your calf muscle. Your physiotherapist will guide you through a tailored rehabilitation program to ensure a smooth recovery.

Risks and Complications

As with any surgery, there are risks involved with gastrocnemius lengthening. While complications are rare, it’s important to be aware of the potential risks:

– Infection: Any surgery carries a risk of infection. Keeping your wound clean and following your surgeon’s post-operative instructions will help minimise this risk.

– Bleeding and Swelling: Mild bleeding or bruising is normal. Elevating your leg and using ice packs can help reduce swelling. Excessive bleeding or swelling should be reported to your doctor.

– Nerve Damage: While rare, there is a small risk of nerve injury during the procedure. This could lead to numbness or tingling in the leg or foot, which may be temporary or permanent.

– Calf Muscle Weakness: Some patients may experience weakness in the calf muscle following surgery. This usually improves with physiotherapy and rehabilitation exercises.

– Calf Muscle Atrophy: A reduction in the size of the calf muscle (atrophy) can occur if the muscle is not adequately exercised post-surgery. Physiotherapy will help prevent muscle atrophy and restore strength and function.

– Scarring: A scar will form where the incision was made. While scars typically heal well, some patients may develop thicker scars (hypertrophic or keloid).

– Tightness Recurrence: In some cases, the calf tightness may recur after surgery, particularly if proper stretching and rehabilitation exercises are not followed.

– Blood Clots (Deep Vein Thrombosis): Post-operative immobility can increase the risk of blood clots forming in the legs. Early mobilisation and specific exercises can reduce this risk. Inform your surgeon if you have a history of blood clots.

Recovery Timeline

First 2 weeks:
– Elevate your leg to reduce swelling and avoid excessive standing or walking.
– Keep your dressings clean and dry.
– Begin gentle exercises, such as toe movements and leg lifts, to improve circulation.

2-6 weeks:
– Gradually increase your activity as walking becomes more comfortable.
– Attend follow-up appointments to check healing progress.
– Start physiotherapy to regain flexibility and strength.

6-8 weeks:
– Continue physiotherapy exercises, gradually increasing the intensity as advised.
– Most patients return to work within this period, depending on the nature of their job.

3-4 months:
– Gradually return to regular activities, including sports, as flexibility and strength improve with rehabilitation.

Post-Operative Care Tips

– Pain Management: Mild discomfort is common after surgery and can be managed with over-the-counter pain medication or those prescribed by your doctor.

– Swelling Control: Keep your leg elevated, especially in the first few days post-surgery, and use ice packs to minimise swelling.

– Exercise: Gentle stretching and strength-building exercises, as advised by your physiotherapist, will help restore muscle function and prevent complications like atrophy.

Important Contacts
If you have any questions or concerns during your recovery, please contact Dr Wever.