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[Uppland]

What really stands in the way of complete (or close enough) recovery, is the soft tissue always so damaged that it just won't adapt -ever?

If that's the case then I guess there really isn't much to do.

If it's a biomechanical issue however, wouldn't staying within a certain "normal" ratio mean that the patient had the potential, at least, to recover completely?

[maximize]

I am guessing it can be a combination of both.

For those who end up with misalignments of bones or joints after, a truly complete recovery will be impossible without further surgery.

Additionally, no doubt excessive/aggressive stretching forces during lengthening can cause damage to muscles/tendons/ligaments leading to microscopic scarring/fibrosis that impairs function.

I think the best solution for the first issue is to make sure your surgery is well planned and executed. Dr. Monegal has sent me an article by Dr. Baumgart from 2009 on what Dr. Baumgart calls the "Reverse Planning Method" for leg lengthening. It is intended to minimize misalignments post operatively and maintain the axis, regardless of method used. If a surgeon uses this method, sticks to it, and executes it properly, there seems to be no reason to ever have misalignment or varus/valgus after surgery. I will attempt to summarize its key tenants on this board in another post when I have the time.

Regarding the second issue, I think the solution is pre-stretching and maximizing pre-operative flexibility. Flexibility takes months to years to get. It might take an average guy months to years to be able to do the splits for example. However, during leg lengthening, you are stretching the soft tissues just as much but within the span of one to two months. People pop tramadol to mask the pain (as one must) but the reality is the tissues are tearing on a microscopic level. I think theoretically if you are able to maximize your flexibility before hand, the stretching/tearing forces during lengthening can be minimized.

[Uppland]

Thanks maximize that is good advice, what is the best way to increase flexibility though, can I hire an expert to help?

[maximize]

Lots of stretching, yoga, pilates, or other flexibility based routines. Tonnes of stuff on Youtube or Google for it. Take it slow. Don't overdo it.

What you'll find is flexibility takes a long time for most people to attain. Personally, my goal is to be able to do (1) a sideways/front split and (2) touch my head to my knees bending forward before getting chopped up. It just makes sense to me that I should have at least that first. I have no idea how long that will take to attain or if it's even reasonable.

But the point is the muscles/tendons/ligaments will have to stretch either way. Better to stretch them slowly in advance than tear them up in the span of a month or two post-op.

[programdude]

Mainly takes time, and unfortunately in my case will likely need the rods out. It is indeed hard to imagine running the same way I used to, but there are others I lengthened with who were doing so months ago, so clearly its not impossible.

[crimsontide]

program,

the rods hurt?? do they harm walking ability?

[spaller2015]

m

[Alittletooshort]

My orthopaedic who uses the precise for deformaties and differnces in leg length, told me that everything above 2-3cm will result in an incomplete recovery. He just said that you can compensate it with muscle mass and overall health but only up to a certain point.
According to him the bio mechanics are responsible for the loss of function.
He said something about a reduced force transmission due to the longer segment.

[Uppland]

My orthopaedic who uses the precise for deformaties and differnces in leg length, told me that everything above 2-3cm will result in an incomplete recovery. He just said that you can compensate it with muscle mass and overall health but only up to a certain point.
According to him the bio mechanics are responsible for the loss of function.
He said something about a reduced force transmission due to the longer segment.

I guess that makes sense, after all your muscles will be carrying more bone without increasing in size themselves.

[Sean Connery]

Lots of orthopedists have their own opinion about these kind of things. Unfortunately it's just that, an opinion, because as of now none of these opinions are backed up by published data or studies. There probably is some loss of athletic potential but we still don't know if it's biomechanics, surgical trauma, ratio change, or what. I've spoken to a couple orthopedists who say complete recovery is possible, it just takes years. But I always account for slightly less than the maximum perfect outcome one can achieve and will go into this expecting someone of a decrease in abilities.

[Uppland]

Lots of orthopedists have their own opinion about these kind of things. Unfortunately it's just that, an opinion, because as of now none of these opinions are backed up by published data or studies. There probably is some loss of athletic potential but we still don't know if it's biomechanics, surgical trauma, ratio change, or what. I've spoken to a couple orthopedists who say complete recovery is possible, it just takes years. But I always account for slightly less than the maximum perfect outcome one can achieve and will go into this expecting someone of a decrease in abilities.

It might be that recovery is a much longer process than any of us think, Christopherbuilder had it done 12 years ago and is, in his words, 100% recovered. I also think MDoW said that even though he did the surgery five years ago he is still improving as he trains.

[maximize]

Chris Bulder was a trainer for Guichet before he had it done. I guarantee that guy was among the absolute best preop condition of any of Guichet's patients. Probably had amazing flexibility preop and great muscle conditioning. I bet his surgery/recovery was a breeze.

[Medium Drink Of Water]

I think biomechanics is what's holding me back from being 100%.  I don't feel any soft tissue damage.  My static stretching ability is about the same as before LL.  It's just that the legs are longer and therefore more unwieldy now.

The less you lengthen, the less of an issue biomechanics will be, but I don't think there's a "safe" amount that lets you be completely immune from such issues.

[Uppland]

I think biomechanics is what's holding me back from being 100%.  I don't feel any soft tissue damage.  My static stretching ability is about the same as before LL.  It's just that the legs are longer and therefore more unwieldy now.

The less you lengthen, the less of an issue biomechanics will be, but I don't think there's a "safe" amount that lets you be completely immune from such issues.

Surely a skilled doctor must know what ratio is tolerable and what isn't?

If I measure my tibiae and femur I'll know how much I can lengthen either one to stay within a acceptable range, no?

[Medium Drink Of Water]

It depends what you mean by "tolerable" and "acceptable".  I'm very happy with my 7.5cm and wouldn't go back and do less if I had the option.

There might be a ratio or number you can stick to that'll let you get back to 100%, I don't know for sure, but it's probably not going to be very much lengthening.