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[SpeedDialer]

Did gnail femurs

Finished lengthening about 1 month ago. Did less than 8 cm, but more than 6 cm

Right leg/right hip is more sore than left leg

I can walk without crutches but not normally

Upper body is swaying from side to side when I try walking. This is especially true in walking when the left leg is in the air and the right leg is on the ground (probably because my right leg is weaker/more sore? My body gets the instinct to be more to my right / be more on top of my right leg in this instance. I interpret this as my right leg not being so strong so my body tries to stay on top of the right leg to stabilize/balance in this instant.)

I'm practicing walking on land + trying to strengthen glutes and hip flexors in the swimming pool. And practicing some sideways walking + forward walking in the swimming pool. At PT, they are having me do balance training, manual stretching on me, treadmill, bicycle

1. When I'm alone and practicing walking in a hall, should I be doing anything specific to help with the gait? I'm just trying to imagine my head being straight/attached to the ceiling by a wire to try to visualize being straight. Not sure if that actually helps for this swaying side to side motion

2. Should I also be doing some exercises in bed?

I haven't really been told anything yet except practice walking on your own + stretch on your own. Just sort of wondering if there is something more targeted or specific I could be doing to help with this upper body swaying side to side issue 

[lessthanavg8300]

Did gnail femurs

Finished lengthening about 1 month ago. Did less than 8 cm, but more than 6 cm

Right leg/right hip is more sore than left leg

I can walk without crutches but not normally

Upper body is swaying from side to side when I try walking, especially when the left leg is in the air and the right leg is on the ground (probably because my right leg is weaker/more sore?)

I'm practicing walking on land + trying to strengthen glutes and hip flexors in the swimming pool. And practicing some sideways walking + forward walking in the swimming pool. At PT, they are having me do balance training, manual stretching on me, treadmill, bicycle

1. When I'm alone and practicing walking in a hall, should I be doing anything specific to help with the gait? I'm just trying to imagine my head being straight/attached to the ceiling by a wire to try to visualize being straight. Not sure if that actually helps for this swaying side to side motion

2. Should I also be doing some exercises in bed?

I haven't really been told anything yet except practice walking on your own + stretch on your own. Just sort of wondering if there is something more targeted or specific I could be doing to help with this upper body swaying side to side issue

You're swaying from side to side because your bones are not consolidated.  Think about a toothpick inside a plastic straw and juggling it around.  Thats your legs right now and your body is trying to stabilize with that situation going on.

If you want to speed up recovery maybe take some peptides (BPC157 and TB500).  Thats what Ill be doing.

[SpeedDialer]

You're swaying from side to side because your bones are not consolidated.  Think about a toothpick inside a plastic straw and juggling it around.  Thats your legs right now and your body is trying to stabilize with that situation going on.

Is that really the reason though? Wonder if there are any second opinions from some femur LL veterans or gnail femur veterans

I really really doubt it is the bones that is the problem

Some datapoints that are affecting this thought above from people I've met in person:

- guy in Athens at 3 cm clearly not consolidated but walked normally unassisted (which itself is not usual for people to walk unassisted so early). He has since lengthened some more so he was definitely not consolidated.

- guy in Athens at 3 months 7.5 cm not consolidated at that 3 month mark but walked normally unassisted + could do stairs unassisted

If the bones not being fully consolidated was really the main problem, I seriously doubt we would be seeing the above

[Michael J. Assayag, MD]

You're swaying from side to side because your bones are not consolidated.  Think about a toothpick inside a plastic straw and juggling it around.  Thats your legs right now and your body is trying to stabilize with that situation going on.

If you want to speed up recovery maybe take some peptides (BPC157 and TB500).  Thats what Ill be doing.

The swaying gait is due to weak gluteal muscles and tight IT bands.… it’s called a trendelenburg gait. It hs nothing to do with bone consolidation. I see fully healed femurs with a persistent sway due to lack of adequate rehab.

[lessthanavg8300]

Is that really the reason though? Wonder if there are any second opinions from some femur LL veterans or gnail femur veterans

I really really doubt it is the bones that is the problem

Some datapoints that are affecting this thought above from people I've met in person:

- guy in Athens at 3 cm clearly not consolidated but walked normally unassisted (which itself is not usual for people to walk unassisted so early). He has since lengthened some more so he was definitely not consolidated.

- guy in Athens at 3 months 7.5 cm not consolidated at that 3 month mark but walked normally unassisted + could do stairs unassisted

If the bones not being fully consolidated was really the main problem, I seriously doubt we would be seeing the above

Becker told me walking sway is caused by this just yesterday.  And showed how the nail is somewhat lose inside the bone (not super lose but there is definitely movement).  Its not a perfectly snug fit so your bodies center of gravity is in confusion mode and trying to catch a balance. Its like standing on a chair that has a bit of wobble to it instead of solid ground.

People probably differ in their recovery depending on how snug the nail is and how coordinated they are.
 

[lessthanavg8300]

The swaying gait is due to weak gluteal muscles and tight IT bands.… it’s called a trendelenburg gait. It hs nothing to do with bone consolidation. I see fully healed femurs with a persistent sway due to lack of adequate rehab.

There could be multiple things going on no?  Surely walking on nails that move pre-consolidation isnt going to be great for a walking gait.

[SpeedDialer]

The swaying gait is due to weak gluteal muscles and tight IT bands.… it’s called a trendelenburg gait. It hs nothing to do with bone consolidation. I see fully healed femurs with a persistent sway due to lack of adequate rehab.

Thank you!!!

I sort of wonder if Height Journey's exercises might be good for gait?





Right now I don't have access to a gym ( I could pay for a membership I guess). But I do have access to a swimming pool that I paid membership for. I could attempt to mimic some exercises I guess

HeightJourney (on this forum + on youtube) seems to like:

1.  zero weight (empty bar) romanian deadlifts (maybe I'll do this in the water? will be alot easier though, not sure how helpful)

2. one legged leg press in an attempt to even out the strength of the two legs (I could try uh... one l
legged squats in the water while holding onto the wall for balance I guess?)

3. adductor/abductor machine (I feel I can just do an easier version of this using swimming pool water as resistance, closing and opening legs against the water as resistance)

4. standing calf raise machine -> I can't really mimic this in the water, its not enough resistance when the water is holding alot of my body weight. Hm.. I mean I could technically do unweighted calves raises on stairs while holding onto the rails for support I guess? Actually I could do just "lean forward while holding wall" angled calf raises without any elevation

5. reverse walking on treadmill-> I can do this in the water, though the type of resistance is somewhat different than on land. In water-> (more lateral/sideways resistance from the water, less net downward force if the water is holding up my body)

As far as IT bands, I'm not sure what to do. At PT when they stretch my IT bands, the PTs tell me that my IT band has full range of motion (due to an IT band release that was done 4 months ago during the main surgery, not my actual IT band stretching effort) --and that when they do the IT band stretch on me, my tighter hamstrings (from just lifting up my leg a bit) actually ends up accidentally giving them more resistance than the IT band

Or maybe idk from the video on Trendelenburg Gait, maybe I need to strengthen my abductors (practice spreading the legs with more force? Sideways walking? not sure)



Ah wait there's this:

[OzBoy39]

Thank you both to Speedialer for this thread and to Dr. Assayag for the insight.
I have the exact same issue on my right side of the body. Extremely weak abductors (and painful adductors too).

My PT here in Aus is working on that with me. One problem we believe we found though is also that some “fascia” (muscle, ligament, tendon… who knows) seems to be going over the screw in the upper femur and therefore when making repeating movements of my hip in a forwards-upwards and back motion it triggers pain. Same deal when I try to apply a strong force to it. As in trying to use the single leg to do steps.

I think the work on the abductor is actually improving my condition… or at least the feeling is changing (not always for the better, but something is changing indeed).

Best excercise so far is simply doing some “clams” laying on one side, squeezing the heels together, bent knees and then lift the upper leg laterally.

I’ll keep working on them and see how it progresses.

[leonazul99]

Got the same right sided Tredelenburg, working on it with new físio in Phillipines.  Told in Greece due to weak gluteus on R.  Also my físio here said quads are supposed to be 2x as strong as hamstrings or it will affect gait.  So they had me start quad strengthening exercises as well.  I was told my quads are not tight but hamstrings remain tighter than normal which can also affect gait.  Doing treadmill at hotel and my físio said I am to wean off crutches for faster recovery. I went to físio without them today.  I feel I only need them on the streets to give myself space or for longer distance walks.  Continue to take daily multivitamin and calcium/magnesium/D3 supplement.

[SpeedDialer]

Hey guys,

A physical therapist in Athens (guess I'll omit his name but you probably know who it is) gave me a few suggestions:

1. Intentionally step/walk a bit slower but also intentionally use more power from your glutes to decrease the Tredelenburg gait. Ex: to use some mental energy to intentionally use your glutes a bit more when walking

2. Practice balancing on one leg with your upper body straight (not slanted like Tredelenburg) in front of a mirror-- with you right next to that mirror. For safety you can have your hands in the air near the wall in case you fall. You'll be able to see your body's slant in the mirror to help you correct it / train the muscles

To the Athens patients, we miss you guys already

[SpeedDialer]

I'm somewhat curious about this

For gnail, people in Athens have been saying that the clicking on the right leg is generally harder than the left leg. More pain, more issues (was my experience as well) -> So it makes complete sense to me that the right leg has more gait problems than the left leg for most people (according to what they say at least)

But a betzbone patient told me for betzbone, it may be possibly harder to click on the left leg for femurs -> yet it seems from this thread that even for betzbone patients, the right leg still may possibly be a bigger problem for this gait issue

And I talked to a precise femur patient who only did 4 cm (no clicking, in theory both legs should be about the same difficulty to lengthen) -> but this patient also said they are having more issues with balance on the right leg

Would need a bigger sample size, but it still looks like a pattern of more right leg gait issues

So I wonder if there is component of what is going on that is independent of the nail type