My son Ethan’s ATL Journey

Who would voluntarily sign their healthy, active, smart, 7-year old son up for surgery that take away the rest of his summer, prohibit him from going to summer baseball camp, and play fall football……this mom right here.  And no, I am not bragging about it, but I did not find a lot of information about healthy children that has opted to have Achilles tendon lengthening surgery.  Here is my story.

Ethan was born with flat feet, which at the time didn’t concern me.  As he was learning how to walk, my concern became increasing as it seemed that the bone above where his arch should be appeared to be falling to the ground and he was walking on the inside of his feet (not toe-walking) instead of the center.  I took him to his first Podiatrist. The doctor assured us that he needed these plastic, hard inserts in his shoes and his arch will develop, and he will be fine.  We did what the doctor ordered and he eventually grew out them, so we took him back to get larger ones.  By the time he was 5 years old, I still haven’t seen an improvement and by now, the inserts we rubbing callouses and blisters where his arch should be.  I now took him to his second Podiatrist.  In not so many words, he just blew us off.  Not a happy camper, I just knew something was not right.  Finding out that Podiatrists are not medical doctors, I stopped right then.  I made him an appointment with a Pediatric Orthopedic Specialist. BINGO!

Ethan was 6 years old when we started the 12 week therapy because his Achilles tendons in both legs were short. (At this time, we were seeing the PA).  They said that if Ethan does not get his tendons lengthened, as active in sports as he is, both would rupture when he was older from overextending.  He would need to quit sports immediately to avoid that trauma or try to lengthen them.  If you knew my son, quitting is not an option.  He is kinda obsessed with sports.  After the 12 weeks of therapy and night time braces, he was somewhat looser, but the PA said to give him a year with the brace and stretching and come back to see if it was helping.   We took his advise and wore the braces and stretched throughout the year. (***tip for night time braces:  if they are too hot, buy a frog togg, cut it to fit inside the braces, and wet it before bed…that thing will now be cold***). One year later.

This brings us to this summer.  We went back for his checkup, and the Doctor saw him this time.  He couldn’t even get Ethan’s feet 5 degrees below neutral.  Failure.  He said (and I quote), “He has remarkably short Achilles tendons”. He needs lengthening surgery, nothing else will work. Oh and about his flat feet, the doctor said that Ethan has been compensating for his short tendons, that he has stretched all of his ligaments in his feet and they are not tight enough to hold up an arch.  He will wear a brace around his arch that will come below his ankle bone for years to come.

So, we have scheduled his surgery for July 12, 2012.  4 weeks in a wheel chair, 4 weeks in walking casts, and then braces.  Please say a little prayer and I will document his joruney as it unfolds and let you know if it’s worth everything he is about to endure.

9 Responses to “My son Ethan’s ATL Journey”

  1. That is a heartbreaking story. As a mother myself, I understand the pain you are going through in having to watch your son go through this. I wish you and your son the best and I pray for a speedy recovery. Hopefully this surgery will fix all his problems and he’ll be a better athlete than ever.

  2. Good luck to both/all of you. My new podiatrist has discovered that I’ve been doing a similar compensation for my right AT, which was surgically repaired short (intentionally) almost 10 years ago. Details at achillesblog/normofthenorth , top page I think.

    I hope the AT lengthening helps his ligaments and foot joints recover their “designed” stability quickly, despite the doctor’s pessimism. I doubt that many health professionals have seen many similar cases. . .

  3. Leslie and Ethan,
    We will be keeping you and your family in our prayers at the center and at home. I pray that God will give the doctors wisdom in helping you to overcome this minor setback. God is in the business of healing and I know that He will make all thing right.
    We love ya and miss you,

  4. Hi There my Son is 7 years old and has also just been advised that his Achilles needs to be Lengthened. I am trying to find out if someone has had the operation and how it affected there Future.. because my son is really good at sport and not sure if he will ever be able to play again

  5. Hi Jarvis
    I had my Achilles lengthened in Sept last year. I will point out that I have being have leg issues for quite sometime and so have a number of things wrong with my right leg, in addition to the Achilles, so some of my timeframes will seem quite long.

    I had my right leg operated on, and through keyhole surgery the surgeon made three incisions into my Achilles, from what I recall they are about 1.5inch apart and went about halfway through the Achilles. I was then placed into a plastercast for 2 weeks and then a fibreglass cast for 6 weeks. Tips: Get a wheelchair, he will love going about in that - He will probably need to keep the leg elavated for a while so you can get extensions to add to the wheelchair to help with this. The pain for the first two weeks was not great, had a lot of heel pain. My doctor was able to help me here and gave me some medication directed soley at that. If he goes into a fibreglass cast stay away from the heater - fibreglass is a conductor of heat and it does and will burn.
    After the fibreglass cast came off I was placed into a moonboot and I had to wear this for ages - mainly because of some other concerns they had regarding my leg. I did start physio as soon as I was allowed to wear the moonboot. I did exercises to help build up the other muscles in the leg, just to get it all going again.
    It has been about 11 months since I had the op, and my recovery is going ok (not great as I have recently put a small partial tear into the achilles, but that will teach me from acting like a silly bugger and chasing our new kitten across the floor) but the extra length is great and the consistent pain I had has gone, so to has the issues it was causing in my foot.
    I only know of a couple of other people who have had it done, both adults, but all three of us will say that we are glad we had it done.
    I did seek several opinions from different surgeons prior to the op, just to confirm that there was no other option for me. Did try working with a physio for a length of time to see if stretching would work, but no, I needed the surgery.
    Initially I had a 6cm difference in my calf muscles when i had the op first done, but now it is down to about 3cm and in reality I think it is only me that notices.
    In relation to sport, I am a swimmer. I have definitly returned to the sport. Not back to the original strength I was at prior to the achilles tightening, but it is getting there. I definitly cannot run, but please remember I am 39yrs old and had a number of leg issues so this probably wouldn’t be the case for someone else. Will be happy to answer anymore questions that you have, but you are definitly doing the right thing in finding out how people are after the surgery

    All the best


  6. Do you have an update??? My son is 4 and only walks on his tip toes. I am hearing a lot about the surgery, not sure if we will do it.

    what type of brace did you use. what is the frog togg thing that you write about to cool the feet?


  7. I would love to hear an update as well. My 4 year old is scheduled to have achilles lengthening surgery in three weeks, and it would be great to talk with other parents who have a had their children experience this. I especially would like some advice about the recovery period. you can reach out to me directly at jennastoltz @ gmail. Thanks!

  8. My son is 10 years old and an avid (obsessed) basketball player. Due to his tight Achilles Tendons and Gastroc muscles, he has always been a toe walker and experienced pain. He has always “powered through” for the sake of not wanting to sit out on any game. We were always told by pediatricians when he was younger, he would outgrow it.

    Now, at age 10, 3 specialists (including pediatric orthropedic and 2 foot & ankle specialists) have evaluated him and have told us the Z-Plasty Achilles Lengthening surgery is the only option that will be effective on Dylan.

    We have done PT (which brought his heel down when barefoot, but completely stiffens the leg in the process), he sleeps in a night splint, and we have already been told serial casting will be ineffective due to his level of tightness. I know if we do not do the surgery, he faces injuries from his ankles up in the future.

    My head and my heart know that I have to take my extremely active child off the court for the better of his future and to hopefully remove his pain as well.
    He is horrified by the idea and devastated (he is not an indoor gaming kid - he only wants to be outside running and shooting hoops and exercising.

    I am on this blog desperately trying to connect with other people who have gone through this journey and RECOVERY with their children. Doctors say he can return to sports in 10-12 weeks (per leg). We would not do both legs at once.

    Can anyone share their experiences with me of how your child responded to this surgery and what the journey through recovery truthfully was in your experience?
    I would be so grateful,

  9. We have had a couple of similarly situated parents here, as well as a few teens or twenty-somethings telling their own stories. kevin’sMom is close to one ID, and Suzanna is close to another - though I’m not sure either is close enough for a computer!
    My FIL had the same problem ~80 years ago, and got a much simpler surgical fix, both sides at once. They just surgically ruptured his ATs, immobilized his ankles at “neutral” - not the usual toe down “equinus” position - and let his body connect the two severed AT ends while he was immobilized and NWB (in a wheelchair, I assume). He went on to serve in the Canadian Air Force in WWII and lead a long and active life, though his main sport was golf BH the time I met him.
    I don’t get a vote on this, but I’d vote for two surgeries at once. Lots of youngsters are scary on crutches, and vulnerable in a cast, and impatient as all get out. Around a month post-op he should be padding around in two boots, and walking slowly in shoes around 2 months post-op. By about 3 months he’ll be moving past the risk of rerupture, and then every week should be better and more normal than the last. Adding a few more impatient months to the process sounds much harder to me (a non-parent, though still remarkably child-like at almost 69!).

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