Soft Tissue Lengthening — Strayer/Volpius Gastrocnemius-Soleus Intramuscular Lengthening

Children's Colorado / Center for Gait and Movement Analysis (CGMA) · CGMA Physical Therapy Team, Children's Colorado

Weight-Bearing

WBAT in short leg cast x 3-6 weeks; healing ~6 weeks

Key Restrictions

Avoid forceful/resisted muscle contraction; no impact until ~6-8 weeks; prevent post-op tissue tightening causing loss of dorsiflexion

Timeline & Phases

Phase 1 (days 1-7): WBAT in cast, positioning, isometrics, SLR; Phase 2 (days 8-21): WB activities with cast; Phase 3 (day 22+): AAROM/AROM DF after cast removal (e-stim), full ankle ROM, heel walking, gastroc-soleus stretching, heel-first initial contact in gait, ankle/LE strengthening with theraband at 6 weeks, proprioception, scar massage ~4-6 weeks

Notes

Pediatric; indication is Achilles tendon contracture with weak triceps surae; distal gastrocnemius tendon/fascia separated from soleus and transected (intramuscular lengthening); Children's Colorado CGMA

Surgeon / Author

CGMA Physical Therapy Team, Children's Colorado

Published

October 2007