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The Trouble With Toes: What To Expect From Achilles Tendon Surgery For Toe Walkers

by Bonnie Gordon

Toe walking is a common symptom of Autism spectrum disorders. It is a physical condition where children on the spectrum walk primarily on their toes, keeping their heels off the floor. This type of step can hinder the child's natural Achilles tendon growth. The tendon connects the heel to the calf muscle, so if it's tight or short, it can make it hard or painful to walk properly. If your child is facing treatment for a short Achilles tendon, it's helpful to understand what's ahead. Here's a look at what you need to know about your child's upcoming treatment.

Surgery Overview

If the Achilles tendon length is preventing your child from walking properly, his or her pediatrician may suggest lengthening surgery to stretch the tendon. There are several ways to do this surgery. The surgeon may place nicks in the surface of the tendon to stretch it, loosen the tendon from the calf to increase movement, or detach, stretch and reattach the tendon. In either case, your child will then have to have rehabilitative therapy for a full recovery.

The First Stage of Therapy

The very first stage of therapy starts right after the cast is placed following surgery. The primary focus of this therapy will be to teach your child how to function with the cast. You'll have a series of stretches and range of motion tasks to do at home, too. For example, your child may have muscle toning exercises to do for strengthening thigh and buttocks muscles, leg raises and some weight-bearing tasks for the leg that was operated on.

The Second Stage of Therapy

Once the cast is removed, your child will start the second phase of therapy. This stage requires more active work. During this process, he or she will start stretching the foot at the ankle through flexing exercises. Sometimes, the rehabilitation specialists will use electrical stimulation like a TENS unit to help encourage nerve response and healing.

As the recovery process progresses, your child's rehabilitation specialist will help your child to gradually put weight on the affected foot. This will also shift into training for proper heel-to-toe steps. Since your child has walked on his or her toes for so long, this may be a skill that has to be learned all over again. Finally, there will be some stretches for the calf and ankle that are designed to maintain the length and condition of the tendon.

Complete recovery from surgery on the Achilles tendon may take months depending on the case. The rehabilitation services that follow surgery are essential to strengthen the muscle and tendon in that area for the best results.