Muscle Releases

Disclaimer: This fact sheet is for education purposes only. Please consult with your doctor or other health professional to make sure this information is right for your child.

Definition

Any part of the muscle can be cut or lengthened in order to allow it to stretch further than it usually can. Common sites are at the muscle itself, at the tendon and at the sheath which surrounds the muscle. This is usually required if a muscle is "contracted" or cannot be stretched to where it should go.

A number of muscles can be released to allow for more movement at the joint. The most common muscles which are released are: psoas (hip flexors), hip adductors, hamstrings and calf muscles. After the muscle is cut, it is slightly weaker when it heals. The muscle however, will still be able to contract and move and generate power. Positioning is vital after surgery so that the muscles heal in the best position.

Some releases are named after surgeons who have discovered the technique and made them popular. Most common in Cerebral Palsy orthopaedic surgery is:

• Frost - Release of Tibialis posterior muscle (which turns the foot in).
• Strayer - Release of the Calf muscle in the middle of the muscle.
• Vulpius - Release of the Calf at the muscles near the Achilles tendon.

Weight Bearing

No restrications.

Plasters

For calf and hamstrings lengthening a short leg or long leg plaster cast may be applied to maintain best position while the muscle is healing.

Orthoses

An Ankle foot orthoses is usually worn after coming out of a short leg plaster.

Zimmer splints may also be used to keep the knees straight for as long as possible.

A hip abduction brace may be required when hip muscles are released.

Special Instructions

To allow the muscles to heal in a lengthened position, it is necessary to make sure stretching exercises are done daily especially in the first 2 weeks after surgery.

Equipment

If long leg plaster casts are necessary, a long leg board will be required on your child's wheelchair.

If a hip abduction brace is necessary, the wheelchair needs to be adjusted to accommodate for the brace.

An Occupational therapist can help you with these adjustments.

Rehabilitation and Orthopaedic Combined Service The Children's Hospital at Westmead Cnr Hawkesbury Rd & Hainsworth St, Westmead Locked Bag 4001, Westmead, 2145 Tel: (02) 9845 0728 - Fax: (02) 9845 3685 http://www.chw.edu.au/prof/services/rehab/rehab_ortho/