A gastrocnemius slide surgery is indicated for patients who have a contracture (tightness) in their outer calf muscle (the gastrocnemius), and have failed non-operative management. Often a regular calf stretching program and use of orthotic devices in your shoes can lead to successful non-operative management of symptoms. However, in some instances surgical treatment is indicated. Gastrocnemius contracture results in the inability to bring the ankle joint past a neutral position (right angle to the lower leg) with the knee straight. Rather than “walk on their toes” most people naturally and unconsciously “compensate” by having more motion through the joints in front of the ankle. This midfoot compensation often leads to increased repetitive pressure to various structures in the foot during standing and walking. Therefore, the presence of a contracture may lead to painful conditions of the foot.
The outpatient procedure takes approximately one hour and is performed under general anesthesia. A small incision (approximately 1/2 inch) is made on the inside area of the lower leg and the gastrocnemius tendon is exposed. Several tiny rows of incisions or a single incision is made across the tendon to allow it to stretch and lengthen. Patients will now have the same ankle motion with their knee straight that they previously had with their knee bent. The skin incision is sutured closed and a dressing is applied.
Lab work and EKG may be scheduled prior to surgery. You are encouraged to stop smoking before surgery to prevent lung complications or delayed healing. Please bring your surgical boot to surgery. Anti-inflammatory medications, aspirin and blood-thinning medications should be stopped one week before your surgery unless otherwise specified by your family doctor. These medications affect your blood clotting ability and could increase your risk for bleeding.
Please wear the surgical boot when you walk until you are seen for your first post-op appointment. The boot may be removed for hygiene purposes only for the first two weeks. The dressing over the incision may be removed after 48 hours and you may shower. Do not submerge your leg in water until the incision is healed and free of any scabs. Do not apply any lotions or antibiotic ointments to the incision. Keep the incision covered with clean dry gauze until you are seen in your doctor’s office 3 weeks after surgery. Your sutures will be removed at that appointment. You must wear your boot while sleeping for the first two weeks after surgery.
The average recovery period is approximately 6 weeks. Patients may be allowed to return to a sedentary job within a few days after surgery. Patients with labor intensive jobs that require prolonged standing or squatting/kneeling or stair/ladder climbing may not be able to return to work for approximately 8 weeks or may return sooner with restrictions on these types of activities. You may not drive for 3 weeks if your surgery was on the right side.
For additional information about treatment, we have included this complete patient eduction sheet as a pdf to view, download and print: