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Lengthening the Achilles Tendon: June 26, 2012

As many as half of stroke patients will experience a muscle tightening or what’s called a contracture.  The complication can leave them unable to fully stretch an arm or leg. 

A stroke in 2009 left Sue Burke unable to put her foot down.  Walking was a struggle.

“I was walking on the side of my foot; I couldn’t put my heel down.  And through all the therapy, my therapists were almost giving up on me because I couldn’t put my foot flat, and it was very painful,” says Burke.

“It’s more common than you think.  This is something that anytime you have a stroke and you have unusual losses of certain muscle groups you can get contractures, and they range all up and down the scale.  Hers was obviously a little more on the severe end of things,” says Dr. Jason Nemitz, a foot and ankle orthopedic surgeon on Lee Memorial Health System’s medical staff.

After years of hobbling through life, Sue was getting nowhere.

“Essentially, her foot was stuck in a flexed position and also inverted, the term for it is equinovarus.  And the simple solution was to release, or lengthen, these tendons that were too tight,” says Dr. Nemitz.

The procedure itself was a stretch, surgically speaking. Doctors performed a percutaneous Achilles lengthening. They started by making three small incisions followed by three tiny notches in her tendon. The result was immediate.

“It’s pretty dramatic.  I mean, the foot is stuck flexed; you get the notches in and you just bring the foot right up so that by the time she left the operating room, 15 to 20 minutes later, she was cast in a position that her foot hadn’t seen in three years,” says Dr. Nemitz.

Today Sue has both feet firmly planted on the ground and plans that don’t involve sitting around.

“I’m planning on being able to get in the pool this summer with my grandchildren and I’m planning on being able to walk around where we’re going to stay up in Maine,” says Burke.

In lengthening her Achilles tendon, Sue hopes to put this painful experience behind her.