What is Endoscopic Gastrocnemius Recession?

Endoscopic gastrocs recession is keyhole surgery used to lengthen the calf muscle. People with tight calf muscles are prone foot problems. Endoscopic gastrocs recession involves cutting the superficial layer of the calf muscle allowing it to lengthen.

What are the Indications?

A tight calf muscle causes the heel to rise earlier in the walking cycle leading to more time spent on the ball of your foot. This can overload the forefoot and midfoot as well as the heel itself. Common problems associated with a tight calf muscle include metatarsalgia, midfoot arthritis, plantar fasciitis, Achilles tendinopathy, hindfoot problems, diabetic foot ulcers and Charcot arthropathy. If non-surgical treatment such as physiotherapy to stretch the calf have failed, surgery can be considered. Endoscopic gastrocs recession can be performed in conjunction with other procedures if indicated.

What Does it Involve?  

You may need to temporarily stop certain blood thinning or diabetic medications prior to surgery. You will be informed of this but if you are unsure of your requirements please ask.

The procedure is day surgery and is done under a general or regional anaesthetic. Your leg will be bandaged and you will be given a CAM boot which must be worn continuously until your follow up appointment. You may walk in the boot but should keep your leg elevated as much as possible to reduce swelling. 

How Long is Recovery?

You will have a follow up appointment in 2 weeks for suture removal and will then be able to walk without the boot. Your leg will feel a little weak at this stage. The foot pain being treated may still be present but should gradually improve as you start walking without a tight calf muscle. Strength will improve but 10% loss of strength can be expected in the long term. The procedure is not recommended for athletes for this reason. Maximal recovery may take 6-12 months.

As you recover you may experience calf pain. This is usually due to scar tissue stretching at the surgical site. Blood clots can also present as calf pain so if you are concerned please contact Dr Freihaut’s rooms and an ultrasound will be arranged. Small minor clots below the knee are common but major clots require strong blood thinning medication.

Is Physiotherapy Required?

Generally not.

What are the Risks?

Risks include but are not limited to infection, blood clots, weakness, injury to nerves and blood vessels.