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    Old 12-25-2006, 04:03 PM   #1
    falexis
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    Hamstring lengthening and achilles release in adult

    Hello,

    I am a 28 year old male with spastic diplegia who is considering a hamstring lengthening and achilles release. I have several questions and am hoping to hear from someone who also had this done as an adult versus during the child years. If anyone has anything to share please do let me know

    thanks,
    Frantz

     
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    Old 02-11-2007, 02:05 PM   #2
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    Re: Hamstring lengthening and achilles release in adult

    Hi,

    I am having this surgery done at the end of this month. I have having bilateral hamstring and achilles lengthening. I am 29 and live alone. Was hoping people who had it done could share with me what the recovery is like as I am wondering if I can stay home afterwards..

     
    Old 02-12-2007, 11:14 AM   #3
    Steffers2318
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    Re: Hamstring lengthening and achilles release in adult

    Well, i had my achilles done when I was about 10, but I had the hamstrings a couple summers ago when I was 19. The dr. said perhaps this would mean they wouldn't get contracted again since they are done growing.

    Honestly, I don't know if you can stay at home on your own. I suppose if you don't have any steps it would be manageable. Is there anyone who can come and help you, at least at first?

     
    Old 02-12-2007, 02:18 PM   #4
    falexis
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    Re: Hamstring lengthening and achilles release in adult

    Hi,

    Thanks for the reply. I have one flight of stairs that I need to go up to get into my apartment. For the first couple of days after surgery I am going to stay at a family members house but then I should go home. Is it doable to go up this one flight of stairs. My surgeon told me that I will have short leg casts for the achilles and removable knees splints for the hamstrings (so that I can get into a car etc). People would be able to visit me/help me out at home.

    I would also be interested to know what your experience was like and what gains you may have made. For background I am 29 and walk independently on my heels. Hoping this helps flatten my walking but dont really know what to expect. Any comments you have on that would be great. What is pt/recovery like. etc..

    Thanks

     
    Old 02-12-2007, 03:28 PM   #5
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    Re: Hamstring lengthening and achilles release in adult

    I had short leg casts for the achilles, and casts from my thigh to my ankle (not covering my feet) for the hamstrings. They wanted me to walk around as much as possible with the hamstrings, so as not to loose too much muscle. However, I couldn't bend my knees, so it was impossible to go up stairs, and my dad had to carry me. I'm not sure if you'd be able to since you'll have different casts.

    Both surgeries have helped me stand straighter and walk better (I use a walker/wheelchair). Maybe it's too late since you scheduled your surgery, but you should ask if your doctor is planning on using Botox in conjunction with the lengthening (putting this into the muscle that is cut)...they did not do this with me with the achilles, and the spasms afterward were honestly very painful. But for the hamstrings they did, and I only had spasms for a few days till the Botox kicked in. (Lengthening spastic muscles causes the opposite muscle to kinda freak out and spasm for a while, if you haven't had lenthening before.)

    I strongly recommend going to aquatherapy if you can when you get the casts off (PT in a pool). It helps rebuild the muscles after surgery faster than doing it on "land" because of the added resistance. Your muscles will be weak after the casts-- you may actually need more help then than you will right after surgery.


    Good Luck, let me know how it goes.

     
    Old 02-12-2007, 06:08 PM   #6
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    Re: Hamstring lengthening and achilles release in adult

    Thanks!

    So how long did it take you to recover after the casts came off. The doctor has warned me that I may be on crutches for a while. I will have access to a pool but don't know if I will have aqua therapy. Maybe I can do exercises in there on my own. I have read about the botox injections and need to talk to the surgeon about it. Unfortunately he is out of the country.

    From what the surgeon tells me the splints on my knees for the hamstring are removable so that I can bend my legs somewhat. I guess I don't really know what to expect afterwards. All I know is that is that it should make me better . How long did take to regain all your strength? I guess that is my main concern is getting back to my independent lifestyle as soon as possible.

     
    Old 02-13-2007, 05:13 PM   #7
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    Re: Hamstring lengthening and achilles release in adult

    they're going to let you bend your knees? ouch!!!

    I had the same kind of casts that steffers mentioned for my bilateral hamstring lengthening/release. While I did move from casts to splints a week early, it still REALLY hurt to bend my knees. I could get around fine on my own, and even walked without crutches around the house while still in my casts (not a smart idea, but I was holding onto the wall). The only problem was getting up the step into my house. as I recall we had a ramp built. I used my neighbors pool a lot that summer (swam in waterproof casts, did a lot of my own aquatherapy after the casts came off) and it helped tremendously. I was able to start bending my knees a little in the water which was great for regaining ROM. I actually couldn't fully bend my knees on dry land for about 1-1.5 years post op.

     
    Old 02-13-2007, 09:13 PM   #8
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    Re: Hamstring lengthening and achilles release in adult

    JellyRJFan,

    So you were pretty mobile. I live alone right now and will probably come back to my place after a few days of staying at my sisters. Interesting that you could not fully bend your knees for so long post op. How long did you do therapy for (officially) after the procedure? If I might ask, are/were you an independent walker before the lengthenings? How difficult was it getting up the steps? Were you just too weak or was it impossible?

    Thanks for sharing and I look forward to hearing from you.

     
    Old 02-14-2007, 06:20 AM   #9
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    Re: Hamstring lengthening and achilles release in adult

    Hey,

    I had aquatherapy for six weeks after the casts and had a good amount of strength back, my dr. was actually surprised. I had to stop the aquatherapy because I had to go back to college, and once I got there I could tell I wasn't as strong as I had been...I had regular PT at a different place, for I guess another 6 weeks.


    I also could not bend my knees after the casts, but my dr. said that was from having them straight and not moved in the casts for so long (they kind of atrophied in that position). That got better fairly quickly though, maybe a couple weeks, and maybe if you move them from the beginning that won't happen to you.


    Ask your PT for tips on things you could do in a pool that would be helpful.

    Last edited by Steffers2318; 02-14-2007 at 06:21 AM.

     
    Old 02-14-2007, 03:30 PM   #10
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    Re: Hamstring lengthening and achilles release in adult

    I probably had official therapy for 2 months post op (regular PT) and then continued with my parents for several more months. I was an indepedent walker before hand, but my legs were badly contracted to the point where I couldn't straighten them at all. Now I have a lot of weakness and hyperextension, but I can still walk. If I hadn't had the surgery I'm not sure I would be able to walk on my own at this age. It was just hard to get up the steps because I couldn't bend my knees. if I wanted to raise my feet of the ground I had to do so from the hip, and you can only get so much clearance swinging from the hip. I can get up stairs pretty easily now with a railing, but I do prefer the elevator

     
    Old 02-15-2007, 09:13 PM   #11
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    Re: Hamstring lengthening and achilles release in adult

    Hi,

    JellyRfan is the hyperextension a result of overlengthening. My doctor mentioned that as a risk but said he would be conservative in the lengthening to try and avoid that. How does hyper extension manifest itself (please excuse my ignorance). One more question - did any of you have to wear any type of AFOs or braces after the casts came off. What was that like. Were you able to wear regular shoes with them. Currently, my shoes only last me about a month. One of my goals for after the surgery is not to drag my feet so that I can spend less money on shoes. Did any of you have a similar issue?

    Thanks

     
    Old 02-16-2007, 11:35 AM   #12
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    Re: Hamstring lengthening and achilles release in adult

    I'm not exactly sure, but over lengthening could be the cause. I know that it's because of weakness in the hamstrings, and anytime you lengthen something it's going to be weaker. I don't usually hyperextend when I walk, just when I stand. Knees locked, butt out, stomach out, shoulders back, if that makes any sense. So my back is curved like a C. This is because of lumbar lordosis, which was also caused by the lengthening. Since my muscles are still spastic yet weak, my hamstrings are pulling down on my back which causes it to curve. I don't really mind it though. It's better than being as contracted as I was before, but it's really tiring so I can't stand very long.

    I definitely go through shoes a lot slower after the surgery. They've lasted me up to 6 months, however recently I have been dragging my right heel so they're starting to wear out quicker.

     
    Old 02-19-2007, 09:21 AM   #13
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    Re: Hamstring lengthening and achilles release in adult

    Hi there,

    Another question for both of you. My surgeon mentioned that after the short leg casts come off I will need crutches for a while. How long did each of you need crutches. He said it varies greatly from person to person and could be a week or it could be up to 3 weeks.

    Thanks

     
    Old 03-04-2007, 09:49 AM   #14
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    Re: Hamstring lengthening and achilles release in adult

    Hi All,

    I had the surgery on Wednesday the 28th and came home on Friday the 2nd. I am bit surprised at home much mobility I have with a walker and crutches. I am trying to use the crutches as much as possible. I have short leg casts on both legs and knee immobilizers that I should wear throughout the day but take them off to bend my knees and when I am walking. So far so good. My friends say that they notice some increased flexibility and range of motion already.

    One thing that has changed was that I was originally only going to wear the short casts for 3 weeks and the surgeon said that might now be closer to 6. So that is a bit of a bummer. Based on what I have seen so far I have high hopes for the amount of improvement I can hope to see?

    One question, the short leg casts do not seem to be at a 90 degree angle which makes standing straight tough for me. I mentioned this to the resident and he said that while the cast is not at 90 degrees my feet/ankles are. On my right leg the cast seems to be at a worse angle so I if i plant my foot down my leg is leaning back? Did any of you have this?

    Thanks,

     
    Old 03-04-2007, 11:39 AM   #15
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    Re: Hamstring lengthening and achilles release in adult

    Falexis, I've had that too anytime I've been in short leg casts. They are probably just trying to get a little extra stretch for your achilles.

     
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