Achilles Tendon Lengthening Surgery

Preparation

Qualification for surgery is based on clinical examination and imaging studies.

Each case requires individual assessment and careful treatment planning. The choice of treatment depends on:

• degree of tendon shortening,
• underlying cause of the condition,
• patient’s age,
• activity level,
• foot function,
• walking pattern,
• severity of functional limitations.

Achilles tendon lengthening may be considered in cases of:

• Achilles tendon contracture,
• limited ankle dorsiflexion,
• toe walking,
• abnormal gait patterns,
• excessive stress on the foot and ankle,
• chronic pain associated with tendon tightness,
• foot deformities resulting from shortening of the calf muscle-tendon complex,
• lack of improvement following conservative treatment,
• selected neurological and orthopaedic conditions.

In many cases, the problem involves not only the tendon itself, but also overall gait biomechanics and lower-limb function.

Convalescence

Recovery after Achilles tendon lengthening requires gradual progression of activity and a structured rehabilitation programme.

Depending on the extent of the procedure, recovery may include:

• temporary immobilisation or use of an orthosis,
• partial weight-bearing restrictions,
• exercises to improve ankle mobility,
• gradual restoration of muscle strength,
• gait retraining,
• rehabilitation supporting a safe return to daily activities.

Properly guided physiotherapy plays a key role in restoring normal foot function and maintaining long-term treatment outcomes.

Patients undergoing surgery may also benefit from a special 10% discount on rehabilitation at KCM Clinic, allowing treatment to continue in a comprehensive and coordinated manner.

The recovery plan is always tailored individually to the patient’s condition, surgical technique, functional needs, and rehabilitation progress.

Precautions

A shortened Achilles tendon does not always require surgery.

In many cases, conservative treatment involving physiotherapy and exercises designed to improve tissue flexibility and function may be effective.

Conservative treatment is primarily considered when:

• limitation of movement is not permanent,
• significant structural changes have not yet developed,
• the problem is related to overuse,
• improvement can be achieved through rehabilitation.

Surgical treatment is generally considered when:

• the contracture is permanent,
• ankle dorsiflexion is significantly restricted,
• rehabilitation does not provide sufficient improvement,
• abnormal biomechanics result in pain and overloading,
• the condition interferes with daily activities.

The primary goal of treatment is not merely to increase range of motion, but to restore the most natural foot function possible, improve gait biomechanics, and enhance comfort during everyday activities.

Benefits

The aim of Achilles tendon lengthening is to improve movement biomechanics and reduce excessive loading caused by tendon tightness.

In appropriately selected cases, patients may experience:

• increased ankle range of motion,
• improved walking comfort,
• greater freedom of movement,
• reduced stress on the foot and ankle,
• relief of pain associated with abnormal tendon tension,
• improved lower-limb function,
• better gait quality,
• enhanced comfort in daily activities.

Achilles tendon lengthening may help restore proper function of the entire lower limb, reduce excessive mechanical stress, and improve mobility.

Treatment outcomes depend on the severity of the contracture, the underlying cause, the surgical technique, and the rehabilitation process.

What is Achilles tendon lengthening?

Achilles tendon lengthening is a surgical procedure performed to correct shortening or contracture of the Achilles tendon.

The goal is to improve ankle mobility, restore more natural foot function, improve gait biomechanics, and reduce excessive stress on the foot and ankle.

What does the procedure involve?

The procedure involves controlled lengthening of the Achilles tendon through partial surgical division and adjustment of tendon tension.

The aim is to achieve appropriate tendon length and tension so that the foot and ankle can function more physiologically.

What surgical techniques may be used?

Depending on the indication and severity of the condition, the procedure may be performed using a percutaneous or open technique.

The percutaneous technique is minimally invasive and uses small skin incisions. The open technique may be used in more complex cases requiring broader correction.

When is Achilles tendon lengthening considered?

The procedure may be considered in cases of Achilles tendon contracture, limited ankle dorsiflexion, toe walking, abnormal gait patterns, excessive stress on the foot and ankle, chronic pain caused by tendon tightness, foot deformities, lack of improvement after conservative treatment, and selected neurological or orthopaedic conditions.

Why does Achilles tendon shortening occur?

Achilles tendon contracture may develop as a result of chronic overuse, previous injuries, prolonged limitation of mobility, certain neurological disorders, developmental abnormalities, or abnormal foot and lower-limb biomechanics.

Excessive tightness may gradually reduce ankle dorsiflexion, alter gait mechanics, and increase stress on the foot and ankle joint.

What results can be expected?

In appropriately selected cases, patients may experience increased ankle range of motion, improved walking comfort, greater freedom of movement, reduced stress on the foot and ankle, relief of pain related to tendon tightness, and improved lower-limb function.

Treatment outcomes depend on the severity of the contracture, underlying cause, and rehabilitation process.

How is the surgical technique chosen?

The choice of technique depends on the degree of tendon shortening, the cause of the condition, the patient’s age, activity level, foot function, and walking pattern.

Each case requires individual assessment and careful treatment planning.

What does recovery after surgery involve?

Recovery requires gradual progression of activity and structured rehabilitation.

It may include temporary immobilisation or use of an orthosis, partial weight-bearing restrictions, ankle mobility exercises, gradual strengthening, gait retraining, and rehabilitation aimed at safe return to daily activities.

Is rehabilitation important after Achilles tendon lengthening?

Yes. Properly guided physiotherapy plays a key role in restoring normal foot function, improving gait mechanics, rebuilding strength, and maintaining long-term treatment outcomes.

When is rehabilitation enough and when is surgery needed?

Rehabilitation may be sufficient when the limitation of movement is not permanent, significant structural changes have not developed, the problem is related to overuse, and improvement can be achieved through exercises.

Surgery is usually considered when the contracture is permanent, ankle dorsiflexion is significantly restricted, rehabilitation does not provide sufficient improvement, abnormal biomechanics cause pain and overload, or the condition interferes with daily activities.

Is Achilles tendon lengthening the same as Achilles tendon rupture repair?

No. These are different procedures.

Achilles tendon lengthening is performed for tendon shortening or contracture. Its goal is to increase range of motion and improve gait biomechanics.

Achilles tendon rupture repair is performed when the tendon has been torn. It involves suturing or reconstructing the damaged tendon to restore strength and function.

What is the main goal of Achilles tendon lengthening?

The main goal is to restore the most natural foot and lower-limb function possible.

The procedure aims to improve ankle mobility, reduce excessive mechanical stress, improve gait quality, and enhance comfort during everyday activities.