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What Is Achilles Tendon Lengthening?

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  • Written By: Kathy Heydasch
  • Edited By: O. Wallace
  • Last Modified Date: 17 August 2014
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Achilles Tendon Lengthening refers mostly to a surgical procedure whereby the tendon is stretched to allow a child or adult to walk flat-footed without a bend in the knee or to relieve chronic pain. The procedure is designed to lengthen a tendon that has not formed properly or has been injured. There are several methods of lengthening the Achilles tendons, with the most mild being physical therapy and/or a brace, and the most aggressive being surgery.

There are three main types of surgery for Achilles tendon lengthening. The first is called a Gastrocnemius recession, and is used only for very mild cases. This procedure targets only the gastrocnemius muscle and attempts to loosen the muscle fibers that are attached to the tendon.

The second type of Achilles tendon lengthening is called percutaneous tendon lengthening, where a surgeon will make several cuts in the tendon. The human body can repair these tears naturally with the production of more muscle tissue, which will add overall length to the tendon. This type of surgery does not allow the surgeon to have much control over the degree of lengthening.

The third and most common type of Achilles tendon lengthening is called z-plasty lengthening. In this case, a surgeon makes a z-shaped cut in the tendon, stretches it to a pre-specified length, and then sutures the tendon back together. This procedure allows the greatest control over the length and enlargement.

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Recovery time for these surgeries is usually four to six weeks in some kind of walking cast, during which time there is limited mobility and aggressive physical therapy to allow the tendon to heal properly. If symptoms are mild, surgery may not be worth the risks. Sometimes, however, chronic pain can last a lifetime and a relatively quick and easy surgical procedure could alleviate this discomfort.

Problems with the Achilles tendon can be caused by a number of factors, including genetics, injury and birth defects. When the Achilles tendon is too short, the foot stays in a bent position, with a flat foot forcing the knee to bend or else a person endures considerable pain. Other symptoms might be abnormal toe positions, frequent discomfort in the back of the foot, and poor posture. Muscle spasticity can also be corrected using Achilles tendon lengthening.

Whereas ligaments connect bone to bone, a tendon connects muscle to bone. The strongest tendon in the body is the Achilles tendon, named after a warrior in Greek mythology. The Achilles tendon contracts when necessary to move the bones that allow people to walk, jump, run or stand on their toes.

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anon927896
Post 4

I have Tendinosis and this is caused by my short achilles. No doctor wants to perform surgery! The doctors said it would be worse for me.

pleonasm
Post 3

@MrsPramm - Potentially, yes, I suppose, but in reality there's no way I'd want to risk it. An Achilles tendon tear is extremely painful and often people end up needing surgery for it anyway.

If possible, I would suggest that people try to lengthen their tendons with gentle stretching over time, but people who have serious problems, like kids who were born with short tendons, really do need the surgery.

MrsPramm
Post 2

@clintflint - I remember when those shoes that are designed to make you feel like you're walking in sand came out, and they had a warning that women who wear heels need to be careful, because they could potentially rip their Achilles tendon if it was too tight. The shoes were designed to make your foot angle in the opposite direction to where it would be going in heels, so there was a real danger of injury.

Although, considering that these Achilles tendon lengthening surgeries seem to mostly consist of cutting the tendons, I wonder if ripping it by accident might not be a cheaper way to eventually recover full motion!

clintflint
Post 1

This kind of Achilles tendon injury is often caused in women by wearing high heels too often. Because they keep shortening the Achilles tendon when they are wearing the heels eventually it grows that way and it becomes too short to straighten properly.

You have to be wearing heels all day every day, but there are plenty of women who do this, of course and then they end up getting to the point where they can't wear anything except heels, because wearing other kinds of shoes straightens out the tendon too much.

I've even heard that some of them refuse the surgery because they don't really see it as a problem. I think that people should just see heels as an occasional accessory, myself, since they are so bad for you. Wearing them all the time is a health hazard.

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