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[Body Builder]

Paley says that ATL cases permanente weakness of the Achilles tendon and his profesor Catagni says that is a lie, who I believe to?

Hello to this forum as it is my firts post here.

I am the LL veteran known to some of you from the old forum with the same nickname.

I underwent ATL which was my biggest mistake. ATL always causes a reduction to plantar flexion strength but the most difficult for this operation is to completely lengthen both Ach. tendons in both feer the same.
In my case, the left AT is longer than the right one which causes imbalances and sometimes even a small limp.
Also, I am completely sure that both my tendons are overlengthened but especially the left one.

For all these reasons I can completely assure you that Catagni and every other doctor than suggests ATL are completely wrong. In the best scenario you'll have a moderate plantar flexion reduction but most of the times the loss of plantar flexion power may lead to crouch gait and loss of most of athletic abilities like running and jumping.
I'm lucky that my case is not so severe but I still don't have completely normal walking gait most of the times and my left ankle feel vert loose.

Thats why I'll have on 2 months a new operation to shorten my Ach. tendons. I am very positive that my problems will go away when my tendons have again a normal length.

So, keep my words, you and every LL'er. Stay away from ATL!

[TIBIKE200]

Hey bodybuilder.

 i read your diary on the old forum. How are you today so many years post LL? Care to share some thoughts about ll and life afterwards?

[crimsontide]

I  have been warning members for a very long time about ATL. I even posted what Paley had personally written to me

ATL absolutely weakens push off power. There is just no way around this fact. If you get ATL in both legs, the odds of you running again are very slim unless you correct this  strength deficit which is  caused by the  achilles being  both lengthened and narrowed

Unfortunately, achilles shortening is not  guaranteed to fix the issue.  In fact, even though you might get some power back, the odds of you  gaining  your former  push off power are very slim.  Recovery time  for any achilles surgery can be quite long and full benefit might  not be seen for over a year. I was thinking of  achilles shortening but have decided that a special brace made  only in the States will fix my issue.   Achilles surgery just takes too long  from which to recover.



Any Dr that tells you that achilles lengthening does not cause weakening can't be trusted.

[Body Builder]

I  have been warning members for a very long time about ATL. I even posted what Paley had personally written to me

ATL absolutely weakens push off power. There is just no way around this fact. If you get ATL in both legs, the odds of you running again are very slim unless you correct this  strength deficit which is  caused by the  achilles being  both lengthened and narrowed

Unfortunately, achilles shortening is not  guaranteed to fix the issue.  In fact, even though you might get some power back, the odds of you  gaining  your former  push off power are very slim.  Recovery time  for any achilles surgery can be quite long and full benefit might  not be seen for over a year. I was thinking of  achilles shortening but have decided that a special brace made  only in the States will fix my issue.   Achilles surgery just takes too long  from which to recover.



Any Dr that tells you that achilles lengthening does not cause weakening can't be trusted.

The biggest reason of tendon weakening after atl is the added length which decreases the tension of the gastrocnemius and the plantar flexion power.
If the length is back to normal, most of the power will be back. In people who had overlengthened tendons after achilles rupture, when they did achilles shortening they gained back more tham 80% of their previous power and they felt again normal which is the most important thing for me.
I don't care for having 100% my power back, I just want to feel stable and walk completely normal and I am optimist that I'll be there after the shortening surgery.
Yes, it takes time but much less than atl and after all, I'm willing to be back to normal at all costs.
But I completely agree with you, people stay away from atl .

Tibike, yes I'm willing to write about my current condition when I find the time.
But I'm generally ok, not good but not bad either. If I didn't have the problems with my tendons I'd maybe more than 90% compared to my preLL condition.
LL is risky but most of the times noway so much as many people here think.

[onemorefoot]

Bodybuilder, what would you recommend me if I want tibial lengthening and my Achilles tendon is stiff because of the use of high shoes.

[Body Builder]

Bodybuilder, what would you recommend me if I want tibial lengthening and my Achilles tendon is stiff because of the use of high shoes.

I recommend you first of all to lengthen at a slow rate, not more than 0.5 mm per day, especially after 3 cms.
Also, when your tendons become stiff (at about 5-6 cms lengthening) you should stop.
Finally, if the equinus is really bad, you can do a gastrocnemius fascia release which is another surgery that causes minimum complications compared to atl and usually fixes small to moderate equinus problems.
But you should avoid atl at all costs, even if that means that you would have a slight equinus for all your life.

[onemorefoot]

The bad thing is that I have used lifts of 5 cm.

[Body Builder]

The bad thing is that I have used lifts of 5 cm.

Me too before LL.

But when I lengthened I didn't have any major ballerina before 6cm lengthening. And although I lengthened 7.5 cm at the end, I'm sure that I'd have fixed ballerina (which was moderate) if I did PT and stretchings for about 5-6 months.
But my moron doctor insisted that I wouldn't be able to fix it so he did ATL to me less than 10 days after I stopped lengthening so I didn't have any time for PT to see if my condition would be improved.
It was a terrible mistake and I regret it almost every day the last 5 years, although many days I'm close to normal. I know that if my tendons were normal I'd have reached more than 90% of my pre LL condition.
Now I'm about 75% which is very moderate. But I'm optimist that achilles tendon shortening will make me normal again so I'm ready for a new tough battle in 2 months.

So don't be afraid about wearing lifts. If you lengthen at slow rates, stretch a lot and lengthen sensibly, you won't have serious problems.

[682]

It was a terrible mistake and I regret it almost every day the last 5 years, although many days I'm close to normal. I know that if my tendons were normal I'd have reached more than 90% of my pre LL condition.

Invaluable advice Body Builder. I have always been wary of ATL lengthening, just for the simple fact that logically it can never be as strong or as elastic as it previously was - it's odd that your doctor did it so rapidly after lengthening, surely it would have been better to see how the tendon reacted with strict PT over several months and then and only then considered it. I hope that your new battle with ATL shortening gives you the desired results, I'm sure they will!

The bad thing is that I have used lifts of 5 cm.

Lifts don't do anything permanent or anything you can't reverse with a good stretching routine. They may make your dorsi-flexion more limited but only for the time being until you decide to address it but it's completely reversible. I wouldn't worry about it.

[The Kaiser]

Me too before LL.

But when I lengthened I didn't have any major ballerina before 6cm lengthening. And although I lengthened 7.5 cm at the end, I'm sure that I'd have fixed ballerina (which was moderate) if I did PT and stretchings for about 5-6 months.
But my moron doctor insisted that I wouldn't be able to fix it so he did ATL to me less than 10 days after I stopped lengthening so I didn't have any time for PT to see if my condition would be improved.
It was a terrible mistake and I regret it almost every day the last 5 years, although many days I'm close to normal. I know that if my tendons were normal I'd have reached more than 90% of my pre LL condition.
Now I'm about 75% which is very moderate. But I'm optimist that achilles tendon shortening will make me normal again so I'm ready for a new tough battle in 2 months.

So don't be afraid about wearing lifts. If you lengthen at slow rates, stretch a lot and lengthen sensibly, you won't have serious problems.

Took you 5 years to fell 75%. How long it took you to walk normal and no one can notice that you had LL?

[Body Builder]

Took you 5 years to fell 75%. How long it took you to walk normal and no one can notice that you had LL?

No, it took me about 2 years to be about 75% and then the progress was minimum or not at all.
And also, sometimes I am close to 80% while some other times (thanks god much less) I'm close to 70%. That's why because with loose tendons like mine when the tension with gastrocnemius is good (after a lot of workout etc) you feel much better while after some days of minimum walking the tension is much less which causes a worse gait and a push off power reduction.

So, my condition is not always the same due to the difference in tension I have many times, something I'm almost sure that tendon shortening will fix or at least improve a lot.

Finally, it took me about 1,5 years after frame removal to walk normal without a (at least visible) gait.
But if i haven't done atl I'm sure that I'd walk completely normal in about half a year after frame removal.

[The Kaiser]

No, it took me about 2 years to be about 75% and then the progress was minimum or not at all.
And also, sometimes I am close to 80% while some other times (thanks god much less) I'm close to 70%. That's why because with loose tendons like mine when the tension with gastrocnemius is good (after a lot of workout etc) you feel much better while after some days of minimum walking the tension is much less which causes a worse gait and a push off power reduction.

So, my condition is not always the same due to the difference in tension I have many times, something I'm almost sure that tendon shortening will fix or at least improve a lot.

Finally, it took me about 1,5 years after frame removal to walk normal without a (at least visible) gait.
But if i haven't done atl I'm sure that I'd walk completely normal in about half a year after frame removal.

1.5 years after removal to walk normal?!! so if you did internal femur i guess 1 year + 1 year after to remove the frame, that's mean 2 years to walk normal!! did you do internal femur?

[Body Builder]

1.5 years after removal to walk normal?!! so if you did internal femur i guess 1 year + 1 year after to remove the frame, that's mean 2 years to walk normal!! did you do internal femur?

No, with internal you could start walking a little after you stop lengthening, so I think that after 3-4 months from when you stop lengthening you'll walk normal.

I did tibia with external monorails fixators that weren't weight bearable so that, plus atl, made my rehabilitation much longer.

When I do femur LL with internals I'm completely sure that my experience will be much much easier.

[0184946]

Hello BB, I was actually really considering opting for ATL to rid of the worries of ballerina but after what u are saying here. I'm shook.
Do you reckon one would be able to walk normally with lifts once fully consolidated assuming no complications? Appreciate the knowledge you've dropped.

[Body Builder]

Hello BB, I was actually really considering opting for ATL to rid of the worries of ballerina but after what u are saying here. I'm shook.
Do you reckon one would be able to walk normally with lifts once fully consolidated assuming no complications? Appreciate the knowledge you've dropped.

You mean if someone can walk normally with lifts if he has ballerina foot after LL? Yes, with lifts you can walk almost normal even if you have equinus problem but with this behaviour your equinus will never get better.
To get rid of ballerina you need a lot of walking with flat shoes and much stretching.
In 80% of cases the problem will be resolved after some months.
For the other 20%, you can choose to do atl or live with very stiff tendons and never walk completely good without lifts.

If I could turn back time and tried a lot to get rid of ballerina and still couldn't fix it (because my moron doctor did atl to me in less that 10 days after I stop lengthening and I didn't have time to do pt and try to get rid of equinus with pt), do you know what I'd choose?
To have a small equinus than doing atl and have loose ankles, and much less tension is gastrocnemius muscle which make your walking feel weak and unstable, even people who see you can't understand anything most of the times.
It is much better to have a stiff feeling compared to this loose feeling I have right now.
So for another time, avoid atl AT ALL COST.

[ktala91641]

Hi Bodybuilder,

I too have ballerina in my right leg and I tried hard to fix it with stretching, standing etc., It's been 6 months since frame removal.
But, it is not going away at all. Now, I am considering to go for AT lengthening. I wanted to undergo this surgery with the best doctor so that it I don't end up in further complications like over lengthening.
Which doctor did you choose for Achilles Shortening surgery ?
And, I heard that per-cutaneous AT lengthening is better than Open AT lengthening as per-cutaneous TA lengthening does not over lengthen the tendon. What is your opinion on this ?

And, I wish you the best for your Achilles Shortening surgery.

Thank you   

[Body Builder]

I can't tell my doctor because I decided not to mention when I did LL and atl.
But afterall I wouldn't suggest him to you because he did a bad job with atl in my occasion and my left tendon is clearly overlengthened.
I don't know if my right tendon was overlengthened too or some weakness I feel is just the normal feeling that people have after atl but even if both my feet were like my right one, which is somewhat normal, I still wouldn't suggest this surgery because even if everything goes perfect you still have weakness and the rehabilitation takes a lot of time.
Also I think that if your one foot is healthy and you do atl only in the other one, you'll feel the difference of push off power more and maybe this will even lead to a weird gait in walking. But I am not sure about that as i did atl in both feet

Finally, pecurtaneous small cuts are maybe better than opes z plasty surgery but it is less precise and if you have a big bf it won't solve your problem as it is only for minor equinus problems.

Do you have a lot of problem with your current condition? Can't you walk normally if you put 2-3cm lifts on your heels?
I think than some small equinus is better than walking with a feel of weakness and I would choose to work my dorsiflexion for at least a year before taking my final decision.
I would have gone for atl only if after this time I still have had a big bf (20 degrees and more) and I had terrible problem with walking.

I suggest you to keep doing pts and if nothing improves in 6-7 months, then we can have this talk again