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[randomguy]

So I've read on this forum that for some LL doctors Achilles tendon lengthening(ATL) is not a problem, while others advise against it.

It says on Catagni's thread that 70% of his tibiae patients needed ATL after 2-5 cm of lengthening: http://www.limblengtheningforum.com/index.php?topic=783.0

I wonder what it is like with other doctors? Is ATL a standard procedure for lower legs lengthening? Can ballerina feet not be avoided by any other means? My understanding is that stretching must not be enough if Catagni does ATL for such a great percentage of his patients.

What is the likelihood I could do without ATL if I set my upper limit to 5 cm? I would like to avoid it.

Cherrs

[ub40]

I did 5.5 and I have pretty bad ballerina issues. I mean it's been 8 months of stretching and I can finally touch my heels to the ground now but it's still not where it should be.

I've noticed improvements on a week to week so I'm not freaking out and I'm confident I could get them to an acceptable level. There was another patient here that did 7.5 cms and experienced 0 ballerina so it has a lot to do with your physiology

[randomguy]

Thanks ub40.

Who did you lengthen with and what measures did you take to prevent ballerina feet in the first place?

I take it the problem doesn't just develop overnight. Was there a point during your lengthening when you saw it coming? Can you stop lengthening when you see you have reached the limit of your physiology?

Also, why did you not have your Achilles lengthened?

Cheers

[ub40]

Thanks ub40.

Who did you lengthen with and what measures did you take to prevent ballerina feet in the first place?

I take it the problem doesn't just develop overnight. Was there a point during your lengthening when you saw it coming? Can you stop lengthening when you see you have reached the limit of your physiology?

Also, why did you not have your Achilles lengthened?

Cheers

I did external with Dr Mitkovic. External method. I started feel pain around the 1.5 cm range which was very sudden compared to other people. My problem is I wasn't very flexible prior to the surgery, coupled with muscular legs due to my line of work. My biggest advice to you is be flexible prior to the surgery, not only will you have less risk of pain and misalignments. Your recovery will be better.

Around the 4 cm mark I had noticeable ballerina and knee bend. But thankfully I'm on the right track now

[randomguy]

Thanks ub40.

So what was Mitkovic's view on ATL? Why was it ruled out?

[ub40]

He's done atl lengthening once for a non cosmetic patient who did an insane amount to fix height discrepancy. He told me it's unnecessary but according to him it's not a big deal and he would have no issues doing it if it were required.

My biggest concern with it is some of the negative feedback from some of the members here mainly crimsontides. I wouldn't do it, but if I stop seeing progress on my stretches I might have to look at my options

[randomguy]

Thanks ub40.

So 70% of Catagni's tibiae patients needed ATL after 2-5 cm of lengthening and Mitkovic thinks it's not necessary. I wonder whose approach gives better recovery.

A few more questions as I'm really curious about Mitkovic's approach and how he compares to Catagni and Salameh

Did Mitkovic evaluate/asked you to improve your flexibility before the surgery? I met Guichet in February and really liked the fact that he wants you to prepare.

Have you been doing stretching only or was there something else Mitkovic advised to prevent ballerina? I noticed some devices have something like a strap attached to the bottom and that goes under your foot and keeps it stretched all time.

You mentioned you have muscular legs. Is that bad for lengthening? According to Guichet, the more muscle mass the better.

Cheers

[crimsontide]

achilles lengthening on one leg is bad enough, on two its really bad

Ask Paley, since he's very honest about atl

The Achilles will  never be anywhere near as strong... only way to gain some power back is to shorten it again

[Peaceout]

achilles lengthening on one leg is bad enough, on two its really bad

Ask Paley, since he's very honest about atl

The Achilles will  never be anywhere near as strong... only way to gain some power back is to shorten it again

what is the exact way to prevent the need to get atl ? Lengthening small amounts?Being flexible enough?

[crimsontide]

being lucky, or not getting ll

[notimportant]

I would say 4.5 cm or so but that doesn't guarantee 100% success.

[Whereintheworld?]

Catagni opts for achilles lengthening as it makes overall recovery (walking normally) progress much faster.
As to whether or not the achilles will consequently be weaker, I'm not sure. I do know that achilles lengthening/release procedures are fairly common in the U.S. (obviously most are completely unrelated to LL) and I think there are different approaches to the surgery.

When I had turned 5.4 cm(actual gain of 5 cm), the doctor was impressed with how flexible I had remained. However, during the last cm (5 to 6), my achilles tightened up significantly.
I was only able to avoid achilles lengthening because I continued physio for another 3 weeks after I stopped turning.

*I did stretches for about 2 months prior to surgery

[randomguy]

@Whereintheworld? so is it possible to stop lengthening when you see ballerina feet developing? I would like the doctor to tell me: We either stop here or you'll need ATL if you want to gain more

[crimsontide]

One thing is a fact

  achilles lengthening weakens the leg.  That's not an opinion, but a fact...   

Think about in terms of levers.. The achilles is  stretched, thinned,  and made less taut ,while the material remains the same. There is no way the achilles will be as strong after the surgery. Ask Paley

[Whereintheworld?]

@Whereintheworld? so is it possible to stop lengthening when you see ballerina feet developing? I would like the doctor to tell me: We either stop here or you'll need ATL if you want to gain more

At the 5cm mark, I was told that I could probably gain one more cm without having to have ATL so long as I began physio- they were right.
You'll probably be seeing your doctor at least once a month during lengthening during which times I'm sure he will be able to tell you how your achilles is doing.
Some on this forum have mentioned that, for them, ballerina foot came suddenly.
If you're worried about tightening up between doctor visits, a good test is to stand up straight with your back against a wall, barefoot, and try to touch your heels to the floor.