Soft Tissue Lengthening — Tendo-Achilles Lengthening (TAL) Percutaneous

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 weeks; healing ~6 weeks

Key Restrictions

Avoid forceful dorsiflexion; avoid forceful/resisted muscle contraction; no impact until 6-8 weeks

Timeline & Phases

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

Notes

Pediatric; indication is Achilles tendon contracture; 3 percutaneous incisions at MTJ, calcaneus insertion, and midpoint (50% AT each); Children's Colorado CGMA

Surgeon / Author

CGMA Physical Therapy Team, Children's Colorado

Published

October 2007