Foot & Ankle Problems: gastrocnemius recession VS Achilles (2022)

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  • Foot & Ankle Problems: gastrocnemius recession VS Achilles (5)11-01-2014, 10:36 AM #1

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    gastrocnemius recession VS Achilles lengthening

    I had a gastrocnemius recession done 18 months ago and now my new surgeon wants to do a Achilles lengthening this next week. Can you tell me the difference. Is the pain and recovery the same or different? Thanks in advance.


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    Foot & Ankle Problems: gastrocnemius recession VS Achilles (12)11-01-2014, 11:07 AM #2

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    Re: gastrocnemius recession VS Achilles lengthening

    Quote:

    Originally Posted by macykay

    I had a gastrocnemius recession done 18 months ago and now my new surgeon wants to do a Achilles lengthening this next week. Can you tell me the difference. Is the pain and recovery the same or different? Thanks in advance.

    I don't know I believe I had both done, I don't have my list near, I had 20 procedures that took 6 and a half hours to finish. I wish I could give you an answer. I have been 6 weeks non weight bearing now and have 9 more to go but as my surgeon said I had a lot of procedures done. I pray you find the answers you are looking for. Good luck!Foot & Ankle Problems: gastrocnemius recession VS Achilles (21)


    Foot & Ankle Problems: gastrocnemius recession VS Achilles (22)11-01-2014, 04:06 PM #3

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    (Video) Anatomy Of The Gastrocnemius Muscle - Everything You Need To Know - Dr. Nabil Ebraheim

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    Re: gastrocnemius recession VS Achilles lengthening

    Quote:

    Originally Posted by macykay

    I had a gastrocnemius recession done 18 months ago and now my new surgeon wants to do a Achilles lengthening this next week. Can you tell me the difference. Is the pain and recovery the same or different? Thanks in advance.

    So funny that you should post this because I was wondering the same thing just this morning. I see that a lot of people on here have the achilles lengthening with the tendon transfer, rather than the gastroc recession. I need to remember to ask my OS next time I see him.

    __________________
    1/16/14-FDL tendon transfer, calcaneal osteotomy, Gastroc Recession
    6/4/15-Naviculocuneiform arthrodesis, removal of scar tissue, Evans osteotomy, Achilles lengthening


    Foot & Ankle Problems: gastrocnemius recession VS Achilles (36)11-01-2014, 07:21 PM #4

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    Re: gastrocnemius recession VS Achilles lengthening

    Achilles' tendon lengthening is a very fast surgery where the surgeon makes 2-3 small incisions just above the base of your heel while a second doctor gently stretches or lengthens the Achilles by bending the ankle towards the shin. The leg needs to be in a cast for 6-8 weeks and held at a strict 90 degree ankle while the tendon heals in its new lengthened position. It is a fairly easy procedure for a surgeon with minimal healing for the patient.

    For gastrocnemius recession, the gastrocnemius muscle is cut and left to reattach to the soft tissues in your leg. This surgery requires a larger incision I the back of the calf, and it also tends to swell more. Due to the location of the Sural nerve in your calf, this surgery carries a higher risk of damage to the Sural nerve. Arthroscopic gastrocnemius recession carries a much higher incidence of possible damage to the Sural nerve, whereas the open procedure is safer with a good surgeon. As above, the patient needs to be casted and NWB for 6-8 weeks.

    Some surgeons will differentiate in terms of amount of time being casting, doing NWB, and returning to activities.

    K

    __________________
    Just In Time 44

    May 2016 - Tarsal Tunnel Release surgery
    July 2014 - Talonavicular Fusion and Achilles Tendon Lengthening, same foot


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    Foot & Ankle Problems: gastrocnemius recession VS Achilles (50)11-01-2014, 10:55 PM #5

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    Re: gastrocnemius recession VS Achilles lengthening

    I pray you are doing better and feeling better.

    QUOTE=Justintime44;5325693]Achilles' tendon lengthening is a very fast surgery where the surgeon makes 2-3 small incisions just above the base of your heel while a second doctor gently stretches or lengthens the Achilles by bending the ankle towards the shin. The leg needs to be in a cast for 6-8 weeks and held at a strict 90 degree ankle while the tendon heals in its new lengthened position. It is a fairly easy procedure for a surgeon with minimal healing for the patient.

    For gastrocnemius recession, the gastrocnemius muscle is cut and left to reattach to the soft tissues in your leg. This surgery requires a larger incision I the back of the calf, and it also tends to swell more. Due to the location of the Sural nerve in your calf, this surgery carries a higher risk of damage to the Sural nerve. Arthroscopic gastrocnemius recession carries a much higher incidence of possible damage to the Sural nerve, whereas the open procedure is safer with a good surgeon. As above, the patient needs to be casted and NWB for 6-8 weeks.

    Some surgeons will differentiate in terms of amount of time being casting, doing NWB, and returning to activities.

    K[/QUOTE]

    Thanks now I know I had both done,I had 20 procedures in six and half hours done, does the scar on the calf look any better after it heals? Mine is healing but seems to be sinking into leg wei d looking maybe just because of the non weight bearing and loosing my muscle there.

    Hope you are healing well. I have nine more weeks non weight bearing a total of fifteen weeks, my surgeon said he did 20 major procedures and they have to heal..

    At least I have a can walker boot that goes to my knee now, I also can sleep without it. I am always scared of hurting it during my sleep..

    (Video) Gastrocnemius Tightness - Everything You Need To Know - Dr. Nabil Ebraheim

    Still non weight bearing for another nine weeks though, I literrally broke down during at my last postop my surgeon hugged me and said we would get through this and I was his first patient that had to have that many procedures done at one time he also said it was one of the longest surgeries thus far in his career. He told me he fixed a lot and that it was going to take time to heal. I just hate being laid up I know everyone here can rebate. At least I still have my foot and one day hopefully I will be able to walk without pain and a bad !imp!

    I am also going to try to make cancer hats, my surgeons nurse told me about a kit you can buy that makes it easy to do its sort of like a loom the only extra thing I had to buy was yarn Iam going to give it a try tomorrow iIwill !et you know how it goes. While being laid up iI may as well help others Igot the kit at a super walmart.

    Last edited by tawk2; 11-01-2014 at 11:05 PM.Reason: tried to fix some typos


    Foot & Ankle Problems: gastrocnemius recession VS Achilles (58)11-02-2014, 06:53 AM #6

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    Re: gastrocnemius recession VS Achilles lengthening

    Good for you that you can do projects. I am sure that is rewarding. My complete triple arthrodesis revision was 2 weeks ago and the meds don't allow me to focus for long. That includes reading and Tv. :-(. I am doing lots of research on my 3rd surgery that is scheduled for this Friday and I must say it all looks scarey. I am trying to hold out hope for a complete recovery but at times it is hard. The amount of hardware that is in my foot overwhelms me. Life has no rewind button so we have to move forward. Thanks for your comments and happy healing to you.


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    Foot & Ankle Problems: gastrocnemius recession VS Achilles (64)11-02-2014, 07:54 AM #7

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    Re: gastrocnemius recession VS Achilles lengthening

    I wish you all the best in your recovery. It has got to be difficult and scary to go through two surgeries in close proximity. My heart goes out to you. I told my ten year old son that I now had a stainless steel foot and that it was much stronger. He thought that was cool.

    The hardware is giving your foot the support and strength it needs to heal and get stronger every day. Our foot/feet could no longer do it alone. I guess we are not bionic women, but hopefully this challenging and difficult journey will make us much stronger in the end (more than just our foot). That is what I need to believe, especially on the more difficult, painful days. Those first few weeks after surgery are the toughest. My positive thoughts and prayers go out to you as you heal a little more each day. You are not alone. We are here to help and support each other along the way.

    I wish you well.

    K

    __________________
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    May 2016 - Tarsal Tunnel Release surgery
    July 2014 - Talonavicular Fusion and Achilles Tendon Lengthening, same foot


    Foot & Ankle Problems: gastrocnemius recession VS Achilles (77)11-02-2014, 06:04 PM #8

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    Re: gastrocnemius recession VS Achilles lengthening

    Macykay,

    I've had both done and was told the gastroc release was quicker to heal. I was casted for neither which makes sense since you don't want it to scar down with scar tissue.

    I never felt either one really so I can't say one is easier to recover from pain-wise but I'd say the bigger difference in range of motion increase for me was with the Achilles lengthening.

    Good luck! Foot & Ankle Problems: gastrocnemius recession VS Achilles (85)

    __________________
    Microfracture, OATS, Distraction arthroplasty x2, Subtalar fusion, Achilles lengthening, Tarsal Tunnel release x3, Total Ankle Replacement, Peroneal Tear/Subluxation Repair/Groove Deepening


    Foot & Ankle Problems: gastrocnemius recession VS Achilles (86)11-02-2014, 06:25 PM #9

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    (Video) Endoscopic Gastrocnemius Recession

    Re: gastrocnemius recession VS Achilles lengthening

    Kimberp, Are you saying that you never had cast after either of these surgeries? What about weight bearing? I was just told that my surgeon now wants to add achilleas lengthening to my upcoming surgery and I am not sure it is needed. Never felt tight nor had limited motion. How do I know?


    Foot & Ankle Problems: gastrocnemius recession VS Achilles (91)11-02-2014, 06:55 PM #10

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    Re: gastrocnemius recession VS Achilles lengthening

    Macykay,

    No, I was never casted for either. Had the surgical dressings and stitches for 2 weeks and then was weight bearing.

    If I am reading correctly, you've already had a triple fusion, correct? Usually the achilles lengthening is done to give you more motion which you don't have with a fusion, so I am confused why he wants to do it. I would find out what he hopes to achieve by doing it.

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    Foot & Ankle Problems: gastrocnemius recession VS Achilles (99)11-02-2014, 11:03 PM #11

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    Re: gastrocnemius recession VS Achilles lengthening

    Now I'm a little confused. My understanding from my surgeon is that patients need to be casted for 6-8 weeks on average for Achilles' tendon lengthening (PQ TAL) and gastrocnemius recession. The tendon and the gastrocnemius muscle need time to heal before you can start PT and ROM exercises. A two week splint indicates a different surgery to me, but I could be wrong.

    So now I'll present another perspective. My surgeon nearly always couples a TN fusion or triple Arthrodesis with either a PQ TAL or gastrocnemius recession. I didn't think mine was particularly tight either, but he recommended it as he said my PTTD affected and tightened my heel and stretching (something like that). But, I am dealing with the complication of Sural nerve damage with numbness on my heel, outside ankle, and outside bottom of foot. Also, when I touch near the small healed incisions above my heel, it feels like an electric shock going part way up my calf. I just started doing research about the prevalence of this complication, and it seems to range from 4-18%. The prevalence is somewhat higher with gastrocnemius recession. It's been 3.5 months for me. I am hoping the Sural nerve damage will resolve within 6-9 months on its own, but there is no guarantee. Luckily, it does not cause me more pain as it does with some patients. It's just numbness, making it trickier to feel my foot to walk. I am stll hopeful that it will heal.

    In one journal article I read, if percutaneous Achilles' tendon lengthening is done under guided ultrasound, the incidence of Sural nerve damage is much less.

    Please ask more questions of your surgeon.

    K

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    May 2016 - Tarsal Tunnel Release surgery
    July 2014 - Talonavicular Fusion and Achilles Tendon Lengthening, same foot


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    Foot & Ankle Problems: gastrocnemius recession VS Achilles (113)11-03-2014, 06:41 AM #12

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    Re: gastrocnemius recession VS Achilles lengthening

    Justintime44, Thanks for sharing your knowledge with me. I had my first triple arthrodesis and gastrocnemius recession 18 months ago. It was done by a Podiatrist and completely misaligned along with 2 non unions. My R foot went out to the right as in a ballet 1st position. After 17 months of pain and walking crippled I had a complete revision by an Orthopaedic Dr.on 10-17. After a 4 hour surgery he had to close due to swelling. I am now going in this Friday so he can finish the surgery. He wants to do a fusion where the big toe meets the foot and also achilleas lengthening. For the last 18 months I have had numbness and the same electric shock running up my leg and foot when I touch the outside of my foot. Even though it is a weird feeling I can live with this if it never gets better. I just want to walk and get my life back. I am 60 years old and single. I live in a large two story home and have a knee scooter on both floors but have to crawl up and down the stairs. I have wonderful adult children, and many friends and neighbors but am starting to feel like a burden to them if this doesn't end soon. This board has been extremely helpful and at times scarey.


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    Foot & Ankle Problems: gastrocnemius recession VS Achilles (119)11-03-2014, 10:03 AM #13

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    Re: gastrocnemius recession VS Achilles lengthening

    My heart goes out to you. I understand feeling like a burden to family and friends. I feel that way too. My nearly 78 year old mother has been staying at my home 5 days per week, helping to care for my ten year old son and me while I recover. I thought I would need her for about 3-4 weeks, but it has been nearly 16 weeks. I am very thankful for her help, but I also feel bad, like a tremendous burden. My friend/roommate that I live with does help some, but unfortunately, my mom does even more than I used to do for my home. It's so challenging.

    Like you, I just want this foot thing to be over, healed, and ready to walk without terrible pain. It has been a long journey. I'm ready to move on.

    Thank you for telling me more about you and your journey. You live alone in a home that has stairs. That must be very challenging and at times frustrating. I hope that your family and friends can help you, too, especially those first weeks after surgery. This will be your third surgery, which has got to be daunting. You know a lot about what to expect. I will send positive thoughts your way and hope for an excellent outcome. It sounds like you are in good hands with your surgeon. I was so sorry to hear that the first surgery was botched by a podiatrist. Most people on this board prefer to see an OS because of their more extensive medical training.

    I wish you well.

    K

    __________________
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    May 2016 - Tarsal Tunnel Release surgery
    July 2014 - Talonavicular Fusion and Achilles Tendon Lengthening, same foot


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