Gastrocnemius Recession

Intramuscular & Endoscopic Approach

Gastrocnemius recession, also known as a Strayer Procedure, is a surgery performed to treat tightness or contracture of the gastrocnemius muscle, a major muscle in the calf. Our experts perform both intramuscular and endoscopic gastrocnemius recession procedures. Schedule an appointment with our Foot/Ankle physicians today.

What is a Gastrocnemius Recession?

Gastrocnemius recession is a procedure that lengthens the muscles and tendons at the back of the leg, relieving tightness in the calf. This allows the heel to shift downward into a more natural position. Gastrocnemius recession surgery treats conditions such as flatfoot, plantar fasciitis, Achilles tendinitis, and equinus (toe walking).

There are two primary types of procedures used for gastrocnemius recession: intramuscular surgery and endoscopic surgery. Intramuscular surgery involves making a small incision in the calf and manually lengthening the gastrocnemius muscle. Endoscopic surgery, on the other hand, involves using a small camera and specialized instruments inserted through small incisions to perform the procedure. Both techniques have proven to be effective in treating gastrocnemius contracture, and the choice between them depends on the severity of the condition being treated.

Why Is a Gastrocnemius Recession Performed?

Gastrocnemius recession is performed to lengthen the muscle-tendon complex, reducing tension from the calf to the plantar fascia. This can alleviate conditions like plantar fasciitis and Achilles tendon problems.

It is also effective for treating midfoot and forefoot issues caused by a tight calf muscle, such as compression and arthritis in the midfoot or rapid forefoot weight transfer. By addressing these interconnected problems, gastrocnemius recession provides significant pain relief and improved foot function.

How To Prepare for a Gastrocnemius Recession

Preparing for a gastrocnemius recession involves several essential steps that help ensure a smooth and successful surgery. Before the procedure, patients will typically have a preoperative evaluation with their orthopedic surgeon to discuss their medical history, current medications, and any relevant allergies. It is crucial to disclose all information accurately to ensure patient safety.

In terms of dietary instructions, patients may receive specific guidelines from their surgeon regarding fasting the night before surgery. It is essential to follow these instructions closely. Additionally, patients may be advised to temporarily stop certain medications or supplements that can interfere with the surgical process or increase bleeding risks. It is essential to communicate openly with the surgical team, follow their instructions diligently, and address any concerns or questions before the scheduled procedure.

What Happens During a Gastrocnemius Recession?

A gastrocnemius recession procedure is typically performed under general anesthesia. The patient is positioned lying face down on the operating table, with the leg to be operated on exposed and accessible. The process is slightly different depending on the type of gastrocnemius recession surgery being practiced.

Endoscopic Gastrocnemius Recession

During an endoscopic gastrocnemius recession, the surgeon makes a small incision in the calf muscle. Through one of the incisions, a specialized endoscope, which is a thin tube with a camera attached to it, is inserted into the gastrocnemius. This allows the surgeon to visualize the inside of the calf muscle without needing a large open incision. Through the other small incisions, specialized surgical instruments are inserted.

Using the endoscope for guidance, the surgeon carefully detaches a portion of the gastrocnemius muscle from its attachment to the Achilles tendon. This allows the muscle to be lengthened. The surgeon may either remove a small segment of the muscle or make incisions to achieve the desired lengthening.

After the muscle has been appropriately lengthened, the surgeon reattaches it to the Achilles tendon using sutures or other fixation techniques. The small incisions are then closed with sutures or adhesive strips, and a sterile dressing is applied.

Intramuscular Gastrocnemius Recession

During an intramuscular gastrocnemius recession, the surgeon makes a small incision in the calf muscle, specifically in the medial portion of the gastrocnemius muscle. Through this incision, the surgeon carefully detaches a portion of the gastrocnemius muscle from its attachment to the Achilles tendon.

Once the muscle is detached, the surgeon proceeds to lengthen it by either removing a small segment of the muscle or by making lengthening incisions. This effectively reduces the tension within the muscle-tendon complex. The surgeon ensures that the desired lengthening is achieved to address the patient's specific needs.

After the muscle has been appropriately lengthened, the surgeon reattaches it to the Achilles tendon, ensuring a secure and stable connection. The incision is then closed with sutures or staples, and a sterile dressing is applied to the site. Depending on the case and surgeon's preference, additional procedures such as plantar fascia release or other related corrections may be performed simultaneously.

After a gastrocnemius recession surgery, the patient is taken to the recovery area for close monitoring and will typically require a period of immobilization, such as wearing a cast or walking boot, to protect the surgical site.

Are There Risks Associated With a Gastrocnemius Recession Procedure?

As with any procedure, there are some gastrocnemius recession risks. Although uncommon, possible side effects and complications may include infection at the surgical site, bleeding, blood clots, adverse reactions to anesthesia, nerve or blood vessel injury, scarring, delayed wound healing, or a reaction to sutures or other materials used during the procedure.

There is also a small risk of recurrence of the original condition or the development of new foot or ankle problems. It is important for patients to discuss these risks with their surgeon before the procedure and to follow all postoperative care instructions to minimize the likelihood of complications. Our Resurgens physicians take precautions to minimize these risks and employ their expertise to ensure the safest and most successful outcomes for their patients.

Post Gastrocnemius Recession Recovery

After the gastrocnemius recession, the incisions are closed and bandaged. The healing process is usually about six to eight weeks. You may be required to wear a postoperative shoe, walking boot, or splint depending on your needs and whether any additional procedures were performed during the surgery. Physical therapy may be needed to rebuild calf strength and help with your gait and balance. This is typically started two weeks after the procedure and is continued until you meet your healing and mobility goals.

If you are struggling with pain in the foot or ankle due to an issue with the gastrocnemius muscles in the calf, gastrocnemius recession may help. Get moving again and schedule an appointment with our Resurgens physicians today!

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