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[Elevator]

Hello to all. Very common to see this expectation in prospective LL patients, but why?

The vast majority of people are hobby sports people, gym goers, etc. There is no need for them to be at top levels of function for performance (Yes, I understand some have competitive notions). Real top athletes (pro's) are a minute anomaly, their abilities largely facilitated by their genetics.

Most CLL patients will start lengthening after at least age 25, at which point any apparent athletic prowess would have been well noticeable by now. Also, the vast majority of people have already fulfilled their "sports-obsessed" phase of life, other phases will begin, such as career, families.

In terms of bodybuilding, again, top competitors are determined by genetics (and drugs), for the hobby bodybuilder, an adequate physique can still be obtained with sub-optimal function post-LL (training, diet and "supplements").

The powerlifters. Sure, lever biomechanics are of importance here. Once again, if one was a superior performer you would know. Granted, LL would vastly decrease ones ability at squatting. Does it matter?, will you really be competing at the highest level? Any truly obsessed sportsman would not even consider CLL and would be too engrossed in their training anyway. For the hobbyist (i.e sub-par genetics to be pro) numbers will be irrelevant, you can still chase higher relative numbers on your lifts.

Most of your days will be spent in a resting or a still state (sitting, standing) or maybe walking slowly. Fast movements are rarely required outside of sports. At an estimate, 5 hours of the week of sports is approx 3% of your time. So, 100% of the time being taller or 3% of your time performing at your best (which is likely average anyway).

Sorry to sound harsh, but I am genuinely curious as to why there is such common insistence on full athletic recovery with these points in mind. From my viewing of this forum, there is an air of over-inflated sense of expectation/outcome and perhaps fairytale-like approach and response to LL (over-emotionalizing). IMO, it's just a surgery to break the legs, stretch them and be taller. It hurts, has many possible complications but the result is you will be taller and enjoy higher quality of life after. You will suffer during LL and have to trade-off some physical functions, enough to cause discomfort but should eventually recover to the point of complete function of everyday life tasks, but of course not high-level sports.
The question being, is that really so important anyway? (why, if so?)

[LLCaptain]

In the past week or so theres been renewed topics on 100% recovery, but that's where that thought ends. Forget about a full recovery lol.

It's usually a new member who hasn't read a single diary and begins posting trash like: Who is the best LL doctor? Where can I do internals for 5k in India? How many donuts can I stuff in my mouth before I throw up?

[maximize]

Agreed OP. I have no idea why people care about this so much as I have stated before. I may be biased though as I was always short and scrawny growing up and usually among the last 2-3 kids "picked" for teams.

I don't know how many 5'4"-5'7" superstar athletes we have on this site that it's been such a concern.

Athleticism has never been something for me to worry about. I just need to be able to stand and walk briskly for a full day every day in order to work/live.

If I have that nothing else is physically required.

[chineseguy]

why do people care 100% ,   you dont need to do all strength when exercising, moderate exercise is enough.  100% is not possible

[theuprising]

The only thread I saw about 100% recovery was that guy who wanted to go to Guichet and 99% wasn't acceptable to him. Anyone who has been reading the forums a while knows that they won't get 100% back but obviously you would prefer to limit the damage where possible.

[Quincy]

The only thread I saw about 100% recovery was that guy who wanted to go to Guichet and 99% wasn't acceptable to him. Anyone who has been reading the forums a while knows that they won't get 100% back but obviously you would prefer to limit the damage where possible.

I'm "that guy".   I'm glad someone started this thread, and OP makes some great points which I myself had considered.  In truth, a ~90% recovery would not be unacceptable to me.  The reason I was so extreme  in my post is because I wanted to invite the strongest criticism possible to help me with my decision. 

My biggest concern is with lifting weights.  I plan on doing Mark Rippetoe's "Starting Strength" program after my surgery, which involves lifting very heavy weights in Squat and Deadlift.  You're supposed to add weight every workout, and within 6 months to a year squatting upwards of 350 pounds (and continuing up from there ad infinitum).  I'm worried that LL would render me unviable to take on such a program.  The idea of supporiting massive amounts of weight on femurs that were recently broken scares me.

[KiloKAHN]

My biggest concern is with lifting weights.  I plan on doing Mark Rippetoe's "Starting Strength" program after my surgery, which involves lifting very heavy weights in Squat and Deadlift.  You're supposed to add weight every workout, and within 6 months to a year squatting upwards of 350 pounds (and continuing up from there ad infinitum).  I'm worried that LL would render me unviable to take on such a program.  The idea of supporiting massive amounts of weight on femurs that were recently broken scares me.

I seem to recall a study about post-op weight lifting abilities years down the line which determined that most patients came to within 3% of their pre-op strength. Weight lifting potential is affected far less by CLL than something like running endurance it seems.

[Thatdude950]

I'm "that guy".   I'm glad someone started this thread, and OP makes some great points which I myself had considered.  In truth, a ~90% recovery would not be unacceptable to me.  The reason I was so extreme  in my post is because I wanted to invite the strongest criticism possible to help me with my decision. 

My biggest concern is with lifting weights.  I plan on doing Mark Rippetoe's "Starting Strength" program after my surgery, which involves lifting very heavy weights in Squat and Deadlift.  You're supposed to add weight every workout, and within 6 months to a year squatting upwards of 350 pounds (and continuing up from there ad infinitum).  I'm worried that LL would render me unviable to take on such a program.  The idea of supporiting massive amounts of weight on femurs that were recently broken scares me.

It should scare you. I sound like a broken record but again - there's been no evidence of a post LL squat or dead over 225 pounds, let alone 350.

I deadlift 440 and squat close to 400. It took me nearly two years of training with a healthy body to get there. After a year of LL most patients are still struggling to do more than walk. I can say with a fair amount of confidence that if you do LL you'll never lift over 350 pounds on a squat or dead.

[Elevator]

Thanks for all replies.

@LLCaptain: True! Those new to LL seem to have grand ideas. If only it were that easy...

@maximize: Exactly how i feel too. I would trade athleticism (not basic function) for being taller in a heartbeat! 5'4"-5'7" superstar athletes! Maybe in wrestling, lifting, soccer(?) and marathon running. But remaining short so one can play in a local league, I don't get it either...

@chineseguy: Exactly, moderate training should be more than enough for most people to remain fit and in shape.

@theuprising: That's right. It was only one recent thread which sought "100%" recovery, but it raises an interesting point as to what exact level of post-LL activity people find acceptable or expect to achieve. To you, what should one expect?

@Quincy: Very glad also you are in the thread now. Interesting you say ~90%. How would you define this? Would you expect to play sports regularly after LL? As you say, your biggest concern is with weights. What is your goals in the gym? To lift competitively or to build an attractive physique? I think for the latter very heavy compound lifts are not necessary. Isolation exercises, more controlled motion of the rep, supported (e.g. seated ), maybe less weight more reps (equal overall volume). This should be adequate for building an attractive physique. Also, I think it is fair to say, anyone who does LL is cautious about even climbing stairs, never mind massively weighted ROMs. I'd like to hear your thoughts...

@KiloKAHN: Interesting to note about that study. I would imagine controlled lifting would be possible at high weights. I'd imagine it is the impact of motion that is difficult post-LL. I wonder is there any similar studies concerning running, etc. The question is, would it matter (to the majority) that they can no longer run fluidly for long periods of time. It seems a worthwhile trade-off IMO for being taller. What do you think?

@Thatdude950: Well said. I also have never seen a decent weighted squat post-LL. Also agreed, that simply walking comfortably (with fluid gait) is a challenge one year post-op. I would say that if one has very strong ambitions of lifting monstrous amounts of weight then forget LL. My point is, is that really that important, i.e. it's MUCH better to be taller than be able to lift >350lbs on a DL/squat.

I don't know if my main point was acknowledged but what I am arguing is not of the unattainability of "100%" recovery but rather, in a choice between being taller and performing decently in sports, it is IMO MUCH more desirable to be taller, and also, considering one has already enjoyed a period of sports/lifting is it even so important AT ALL that they return to these activities and why?

I personally believe a 30- 50% recovery of performance function is adequate. Ability to run/jog at 30- 50% speed for even only 10-20% of previous duration is enough for me. Once joint ROM allows a normal gait for walking/standing/sitting then this is enough.

Of course, we have sports enthusiasts here which I would love to hear from, notably
CRIMSONTIDE
SWEDEN
PADDY10TELLIES

What do you think?

[applesandoranges]

It depends on the individual and how much lengthened. I'd say doing 3-4cm internal femur for someone with a 170cm frame will have much better results than just 30-50% return in performance. More like 70-90%.

[paddy10tellys]

Hi Elevator. I'm 56 so my perspective is viewed with a long lens. I played county rugby as a schoolboy but gave up at 25 because I was too small. I did Shotokan Karate for 32 years (3rd Dan) -> cruciate repairs/cartilage removal/hernia repairs/slipped discs. Six-a-side soccer was the best! Now I play tennis & golf. I would swap all of that for height. I would much rather be average height than an average sportsman. If I can persuade Dr Guichet to operate on me I would be happy to do his bootcamp & afterwards I would keep trim by eating modestly & going down the gym & that would be enough. My knees & back hurt anyway as is the case for most people over 50. You just get on with it & adapt. Things change. Being old sucks & you shrink! Being old & small sucks more, too many -isms. I just want to be taller for the next 30 years.

[goodlucktomylegs]

Hi Elevator. I'm 56 so my perspective is viewed with a long lens. I played county rugby as a schoolboy but gave up at 25 because I was too small. I did Shotokan Karate for 32 years (3rd Dan) -> cruciate repairs/cartilage removal/hernia repairs/slipped discs. Six-a-side soccer was the best! Now I play tennis & golf. I would swap all of that for height. I would much rather be average height than an average sportsman. If I can persuade Dr Guichet to operate on me I would be happy to do his bootcamp & afterwards I would keep trim by eating modestly & going down the gym & that would be enough. My knees & back hurt anyway as is the case for most people over 50. You just get on with it & adapt. Things change. Being old sucks & you shrink! Being old & small sucks more, too many -isms. I just want to be taller for the next 30 years.

Hi paddy
Dr guichet operates only femurs.
All u want are tibias ,i dont think he will perform tibial lenghthening

[paddy10tellys]

He wrote this to me,

"Femoral lengthening should be performed first as it heals far better than tibias. Tibia may take over one year to heal, while femur take generally far shorter. Both at the same time is too much demanding from your body and risky. Sequential or repeated lengthening can be performed, and one of our patients got 18 cm of gain (7 inches) in 2 surgeries. The second level of bones/surgery is performed for security after full recovery, in general 9-12 months after the first one."

Also in Oct 2013 "Zeo" posted this on the old forum:

Re: My Consultation With Dr. Guichet
« Reply #26 on: October 23, 2013, 06:08:25 AM »
Quote from: SysOp on October 14, 2013, 10:47:31 AM
He does not do currently internal tibia lengthening. I'm sure he can do external tibia lengthening for you.

I asked Dr. G a few days ago through his website something along the lines of "I heard that you do not currently do internal tibia lengthening. If so, when will you start doing it?" he just responded today

"Dear SIr,

I was the first in the world to do tibial lenghtening with nails in 1993, and went on since that time. Please visit completely my website.

If you wish an appointment for an evaluation clinic, please let me know; Next available days are 8 November and 6 December in Milano, Italy.

Please reutrn the joined form completed with a copy of your passport (bring ALL originals with you at the consultation).

Yours sincerely,

Jean-Marc Guichet, MD, PhD, Doct. Sci.
SELARL du Docteur Jean-Marc Guichet
Centre Phocea, 14 Bd Ganay
13009 Marseille - France
Office: +33.491.777.547
Office (mobile): +33.664.163.890
Fax: +33.491.777.547
E-Mail: mbbsecretaire@gmail.com
Web: www.allongement-os-grandir.com "

[paddy10tellys]

Also, I will only accept that Dr G doesn't do tibia's if I he says so himself, to me, in person...

[Elevator]

@applesandoranges: Yes, true. Conservative amounts (I believe up to 4cm) should retain the likelihood of "acceptable" post-LL function. Problem is 4cm is not very much and could necessitate 2 surgeries (tibia and femur). Still, I wonder if even with <4cm people are as high-level function as before or close to it. I think a good mentality pre-LL is to expect the 30-50% recovery and any more will be a bonus. Low expectation patients will be more satisfied post-LL than those with high expectations.

@ paddy10tellys:
Your perspective is a highly valuable insight to us all here. You have a very active history of many different sports and at a high level for a long period of time, and even considering all of this you said it best with, " I would swap all of that for height". Even at 56 it remains most important (Note to others here: long term regrets will not be valid). That is the central point I was trying to make here, being that in one's pre-LL evaluation, to be taller is vastly more desirable than partaking in competitive sports. Also very interesting in your post you listed your high-achieving sports (rugby and karate) but the more social and seemingly less serious sport of 6-a-side soccer is the best and most enjoyed for you. I think this will be true that even a low level of sports-function post-LL will be enough for people to enjoy the social aspect of sport, which I think will be most important, as most will not be elite performers anyway.
Anyway, best of luck with your LL endeavours!

[abo]

What is the main reason for not being able to return to 100%? pre-operation? iv heard somone talking about knee problems?

Could this stuff if it devolpes be on the right track to do so? http://www.nytimes.com/2016/03/24/health/acl-tear-reconstruction-surgery-boston-childrens-hospital.html?_r=0 http://gajitz.com/3d-bio-pen-lets-surgeons-fix-injuries-by-drawing-on-them/

[Lgazer]

Knee problems and other problems. You won't be the same. If you are 40 it doesnt matter, because you've practiced this in the past or you weren't interested anyway but if you are 18 or less... it's very sad.

[chineseguy]

is it possible to ride a bike after this surgery?roller skating? skate board? is it possible to hike a mountain after this?

 i very love skating and i always walk mountain up

[Knik]

is it possible to ride a bike after this surgery?roller skating? skate board? is it possible to hike a mountain after this?

 i very love skating and i always walk mountain up

I hope too but I think that with time and practice we can find much of our faculties

[Manlet]

Will i still be able to exercise enough that i can have muscular legs, rather than skinny chicken legs? Lol...

[paddy10tellys]

When I had my ACL repair my surgeon said I could just accept my knee is   & stop doing sport. I said repair it. I still do sport that involves pivoting/twisting/sprinting - ok, not so good, but hey, I still have fun. My surgeon said your future is knee osteoarthritis & total knee replacement. I said, "So is yours..." If you live long enough then your chances of developing cancer/dementia/heart disease/stroke/something dreadful approach 100%, eventually. Be happy now, in the present. You don't have to be Messi, Federer, Bolt to enjoy sport, you just need to enjoy life & if you are short & cannot accept it... cll is your path. Just walk it.

[Cheez]

I for one (41 years old) had the idea for LL already ten years ago, but wouldn't want to do it, since I loved going skateboarding so much. Over the last years I reduced my active skateboarding to almost zero though, and I think now it would be great time to get LL, since most of the sport I do these days is just some fitness at home stuff.