Post-Surgery Pain After Achilles Tendon Lengthening Procedure

Achilles tendon lengthening surgery

Hello, doctor.
About a month ago, I underwent an Achilles tendon lengthening surgery and had a cast applied.
My doctor told me that since I have a cast, I wouldn't need rehabilitation.
It has been about a month now, and the wound no longer hurts, but there is a slight discomfort near my calf close to the heel.
I would like to know what might be causing this.
I am scheduled to have the cast removed in about two weeks, but my parents believe the wound is healed enough to remove the cast early so I can start walking and adapting.
I haven't been wearing the cast at home for the past couple of days.
Could this cause any problems? Thank you for your help.

JACK, 20~29 year old female. Ask Date: 2017/06/29

Dr. Shi Guozheng reply Orthopedics

1.
Soft tissue reattachment typically takes six weeks to heal, and pain may still persist during this time.

2.
A six-week cast immobilization is necessary to ensure complete healing of the ligaments.
Removing the cast too early may result in ligament rupture, so caution is essential.

Reply Date: 2017/06/29

More Info

After undergoing an Achilles tendon lengthening procedure, it is not uncommon to experience some discomfort or pain in the calf area, particularly near the heel, even after the initial healing phase. This pain can be attributed to several factors:
1. Healing Process: The Achilles tendon and surrounding tissues undergo significant changes during the healing process. While the incision site may feel fine, the underlying structures, including the tendon itself, may still be healing. This can lead to sensations of tightness or discomfort as the tendon adjusts to its new length.

2. Scar Tissue Formation: Post-surgical healing often involves the formation of scar tissue, which can sometimes lead to discomfort or a pulling sensation in the area. Scar tissue can be less flexible than the original tissue, leading to feelings of tightness or pain.

3. Muscle Adaptation: After a tendon lengthening procedure, the muscles in the calf may need time to adapt to the new length of the tendon. This adaptation can cause temporary discomfort as the muscles adjust to their new functional dynamics.

4. Inactivity: If you have been in a cast for an extended period, the muscles in your calf may have weakened due to disuse. When you start to move or put weight on the leg, you may experience discomfort as the muscles begin to engage again.

Regarding your decision to remove the cast early, it is crucial to follow your surgeon's recommendations. The cast is designed to immobilize the tendon and allow it to heal properly. Removing it prematurely can lead to several complications:
- Increased Risk of Re-injury: The Achilles tendon is still vulnerable after surgery, and removing the cast too early may increase the risk of re-injury or complications, such as tendon rupture.

- Improper Healing: The cast helps maintain the proper alignment of the tendon during the healing process. Without it, there is a risk that the tendon may not heal correctly, which could lead to long-term functional issues.

- Delayed Recovery: If the tendon does not heal properly due to premature removal of the cast, you may face a longer recovery period, requiring additional interventions or therapies.

In summary, while some discomfort in the calf area is expected after an Achilles tendon lengthening procedure, it is essential to adhere to your doctor's advice regarding the cast and rehabilitation. If you have concerns about your pain or the healing process, it is advisable to consult your surgeon or a physical therapist. They can provide guidance tailored to your specific situation and ensure that your recovery proceeds safely and effectively.
As you prepare to have your cast removed in two weeks, consider discussing a rehabilitation plan with your healthcare provider. This plan may include gradual weight-bearing exercises and physical therapy to strengthen the calf muscles and improve flexibility, which are crucial for a successful recovery.

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