Surgical treatment
Your questions about the operation
Length of the procedure, anesthesia, pain, scars, returning to walking, driving, and sports: the answers to the questions patients ask most often before an FHL tenolysis.
Before the operation
Why had I never heard of FHL before visiting this site? FHL is a new paradigm, accepted by a large proportion of foot professionals such as podiatrists. It remains, however, poorly known in the medical and orthopedic world. We strive to fill this gap, notably with this site and several publications in scientific journals.
Is it a major operation? Do you cut the tendon? No, this operation is not considered a major one. The tendon is not cut but freed: the only structure divided is the pulley, a fibrous structure that impedes the gliding of the tendon. Occasionally, small bony bumps are also smoothed away with a small burr.
How long does the operation take? 20 to 30 minutes for one side, 40 to 60 minutes for both sides.
How am I positioned? In the prone position, that is, lying face down: the procedure is performed at the hindfoot. You will be placed in this position in the operating room.
Is general anesthesia required? Not necessarily. The details of the anesthesia are discussed with the anesthesiologist several days before the procedure, during a dedicated appointment. General anesthesia is not mandatory: the procedure can, for example, be performed under anesthesia of the lower part of the body. Several options exist.
During the procedure
Is there a risk of damaging the Achilles tendon? No. We pass in front of the Achilles tendon to release the FHL tendon, with no risk of harming it.
After the operation
Is there pain on waking? Pain is mild and easily controlled with basic pain medication.
How long do I need to stay in the hospital? As a rule, one postoperative night is enough and ensures good pain control and an uncomplicated recovery. Physiotherapy treatment is prescribed before you go home, so that you can do the exercises yourself at home.
Will there be unsightly scars? No, the scars are generally very discreet and small — less than one centimeter long on each side of the Achilles tendon.
When are the stitches removed? 8 to 10 days after the operation.
Will I need crutches? No, as a rule you will not.
When can I walk with full weight-bearing? Immediately after the procedure.
Returning to activities
How long will my recovery take? On average, you will be able to return to work about 10 days after the operation, after a period of relative rest.
When can I drive again? To resume driving, you must be able to operate the pedals quickly and easily, all without pain. This varies from person to person, but it generally takes 5 to 10 days.
When can I play sports again? Most patients can return to a low-impact sport (golf, walking…) 3 weeks after the operation. Cycling is possible from the 4th week. You can then begin an exercise program to return to your favorite activities — the timeline depends on each individual and on the desired activity. Most of our patients return safely to their usual activities.
What do you mean by “exercise program”? The purpose of the FHL release is to restore a physiological gait and better balance. Appropriate rehabilitation is necessary to learn to use the foot and the entire lower limb correctly again.
A specific question?
Every situation is unique. The precise details — anesthesia, time off work, return to sports — are discussed with the team during the preoperative consultation.
Next step
Discuss it in consultation
The mobility assessment at the Centre du pied confirms the surgical indication and provides an opportunity to answer all your questions in person.
At a glance
Duration
20-30 min (one side)
Hospital stay
usually one night
Full weight-bearing
immediate
Stitches
removed at 8-10 days
Work
~10 days
Light sports
from 3 weeks