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[dexter1930]

50.50/47.64mm

Hi guys, I have just arrived home from my ITB release surgery. Following are points of note:

Procedure
1) The technical term for "wide legs" from leg lengthening is "post-operative fixed abduction deformity of hip joints".

2) Most ITB releases are "full", meaning that the entire width of the band is cut. This is completely safe. However, the length of the band (perpendicular to the width) is not cut because your legs and knees may lose lateral control. This is despite a length cut will reduce wide legs further.

3) I have experienced a 50%~ reduction in "wide leg" and was able to walk immediately after I woke up. The best part is I can already walk further than I could pre-operation.

4) Left leg is pain free. Localized pain 5/10 when moving and 2/10 when sitting still on my right. I am not taking any painkillers. It has not affected Betbone clicking.

5) They could not reuse the incision from Dr Betz. This is means I will have an additional deep scar in each leg. 

Doctor/Hospital
1) Dr. Giotikas is fantastic. He is reacheable instantly through Whatsapp and is extremely knowledgeable. He noted that significant abduction is very predictable and unlikely to be completely addressed with PT.

2) Compared to Kreiskrankenhaus St. Ingbert (Betz), Mediterraneo Hospital (Giotikas) is larger and more advanced given it's in Greece's capital instead of a small town in Germany. Even though the food wasn't that much better, all nurses and staff spoke English, which is a significant plus for international patients.

Conclusion
1) It is pertinent to mention that leaving wide legs to go on can lead to many complications. Our glutes compensate for lack of strength by widening our stance. This is why overweight people walk with wider legs. By allowing your legs to stay wide (due to tight ITB), it significantly weakens your gluteus muscles. This will give you a very ugly gait, and your butt will hurt when sitting on harder surfaces. Knee pain will also worsen as they're under pressure to bend in and downwards (Knock knees).

2) For those seeking to lengthen more than 5cm, I strongly recommend a surgeon who performs ITB release. For weight-bearing nails in Europe, the only alternative is Dr Guichet who uses a very similar nail to Betz but performs ITB release. He works in Milan and London.

3) If weight-bearing isn't your sole priority, then I would definitely go Giotikas with Precise (available in EU by August). You get more, and better service, for a lower price. Had I done the release during the initial operation, it would be free and I would not have needed to go through another general anesthasia, incision and flight -- recipies for more infection/scars/complications.

If you are one of the unlucky ones who has pain clicking in at least one leg, and have tight IT Bands, Betz would be a poor consideration. Remember, TFL is a very small muscle, and the ITB does not respond to stretching well. It's not something hard work can completely overcome. My wide legs reduced my mobility as much as non-weight-bearing nails did. It is definitely not an "optional" procedure for many.

how does the dr stitch those IT band peaces? thanks

[SirStretchAlot]

how does the dr stitch those IT band peaces? thanks

Hi, I added a lot more technical detail to the procedural section. Essentially the band will stick back to the tendons/ligaments around it and connect/heal by itself over time.

[SirStretchAlot]

52.06/49.20mm

Hey guys, it's third day after ITB release and...

1) The surgical wound pain has completely subsided.

2) There is no lateral (ITB) resistance to closing my legs. Hamstring is the only limiting factor.

3) It has made clicking slightly easier. (Less resistance)

4) Sporadic knee pain gone (ITB was pulling on my knees)

I would consider the surgery a complete success and would recommend anyone who wishes to lengthen >5cm to do it!

[Johnp86]

That is great news! So if you plan to lengthen maximum 5cm and you experience pretty bad  wide legs, it can resolve pretty quickly during consolidation phase ?

[SirStretchAlot]

That is great news! So if you plan to lengthen maximum 5cm and you experience pretty bad  wide legs, it can resolve pretty quickly during consolidation phase ?

Not quickly. Perhaps 3 months. For me, probably 6 month if I stop at 5cm. If I am going for 8cm, surgical release is mandatory for return of function.

[Johnp86]

Ok thanks. Hard to understand why Dr Betz doesn’t provide post IT band release on some patient that really need it. Even if you have to pay more, this should be an option. Good luck for the rest of the lengthening, almost there man

[SirStretchAlot]

Ok thanks. Hard to understand why Dr Betz doesn’t provide post IT band release on some patient that really need it. Even if you have to pay more, this should be an option. Good luck for the rest of the lengthening, almost there man

He refuses even at patient request because he doesn't want to damage good tissue. However, he does not understand that for some patients exercise cannot overcome this. He's 70 years old, and won't change his mind.

My ITB release was full, meaning that my band as well as intermuscular septum was severed. A blood-gello substaince will first form cover the area, followed by scar formation, then band recovery. There's almost no repercussion as it's a nerve-less tissue.

53.10/50.24mm

Interms of lengthening, there's good and bad news.

Good: Had the easiest clicking yet. Both legs were done in 20min. If you're in clicking hell, it does get better!

Bad: As I crossed 5cm, I have had my first taste of neuro pain. It's not extreme but very presistent, and cannot be alleviated through repositioning. Muscle relaxants aren't effective, so I'm back on painkillers. It's really getting my mood down too...

Can anyone recommend good ways to alleviate this neurotic pain/discomfort? I've been advised to use Gabapentin and extra Paracetamol, but Gaba is prescription so I'll have to talk to my doc.

[RB]

Sounds like it was a success, great news! I'll be doing my ITB release tomorrow now so hopefully I have a similar result.

Did the ITB release help you improve your duck ass since they are interrelated? Mine has improved during consolidation but is still present when I put my legs all the way together so I'm hoping the release can alleviate that.

And as for the neuro pain, I was prescribed Pregabalin and it worked great, although it took about 1 week of taking it to have a noticeable effect.

[SirStretchAlot]

Sounds like it was a success, great news! I'll be doing my ITB release tomorrow now so hopefully I have a similar result.

Did the ITB release help you improve your duck ass since they are interrelated? Mine has improved during consolidation but is still present when I put my legs all the way together so I'm hoping the release can alleviate that.

And as for the neuro pain, I was prescribed Pregabalin and it worked great, although it took about 1 week of taking it to have a noticeable effect.

They're interrelated because they're stretching the same tendons. Duckass is just people shortening their hip flexors to narrow their legs. If you stand upright, you will notice your legs widen again.

The reason for this is your hip flexors. You will feel a severe stretch when you try to stand still and push your hips forward. This happens because the wide legs were hiding our inflexible hip flexors.

My release surgeon told me that it would not be a complete close post-op either. Hamstrings are the most responsive to stretching. Hip flexors are harder, so it will take a few weeks for us to stretch them back.

[chasing_higher_dream]

Congrats on the successful IT band release surgery. I wish you luck for the upcoming last mile of lengthening.

- Could you please tell me how many approx cms do you still have wide legs after this surgery? Can you bring your legs together touching each other (even by force)?
- Also, at what rate are you lengthening currently?
- For how many hours in a day do you stretch?

[SirStretchAlot]

Congrats on the successful IT band release surgery. I wish you luck for the upcoming last mile of lengthening.

- Could you please tell me how many approx cms do you still have wide legs after this surgery? Can you bring your legs together touching each other (even by force)?
- Also, at what rate are you lengthening currently?
- For how many hours in a day do you stretch?

All good questions

1) Pre-op 60cm, now 40cm. Note that this is with an additional cm of lengthing post-op. The actual narrowing is probably close to 50%.

2) I can most definitely force my legs together to touch. However, it will be with bent knees and hips back (typical duck ass). It's probably easier to walk with wide legs.

3) Currently lengthening between 10-15 clicks per day. (0.5-0.78mm)

4) I stretch 2 hours a day.

55.70/52.84mm

Having done the ITB release has definitely eased my wide legs significantly. It has however also revealed the amount of work I have to do on my hamstring and hip flexors. Increased stretching has definitely elevated my pain levels throughout the day.

I don't expect my wide legs to narrow significantly from my current 40cm state, as I am still lengthening, hence a moving goal post. However, I am definitely finding more effective ways to target-stretch my hip abductors, the main bottleneck to my wide-legs.

[SirStretchAlot]

58.04/55.18mm

Hi everyone, an update about the ITB release.

The ITB release occurs near the knee to prevent muscle herniation (muscles leaking out of the ITB fasciae), which alleviates a lot of ITB pressure near the knee. However, I still have significant abduction due to the ITB being tight near my upper thigh. This is because the ITB has muscles and tissues attached to it throughout your thigh, and a release near the knee, only partially releases the ITB near the upper thigh. I would advise all those who are about to do an ITB release, know that this is not an "on/off" switch to wide legs. It allows a previously unstrechable band to now be stretchable. Significant effort still has to be invested. Releasing it early will benefit you much more, as I now have to make up for past work.

As for the legs themselves, pain and discomfort especially during sleep has increased as I approach 6cm. It cannot be alleviated by switching sleeping positions. The only solution I found was to click less, so I am now consistently clicking 10 times per day (0.5mm).

[RB]

58.04/55.18mm

Hi everyone, an update about the ITB release.

The ITB release occurs near the knee to prevent muscle herniation (muscles leaking out of the ITB fasciae), which alleviates a lot of ITB pressure near the knee. However, I still have significant abduction due to the ITB being tight near my upper thigh. This is because the ITB has muscles and tissues attached to it throughout your thigh, and a release near the knee, only partially releases the ITB near the upper thigh. I would advise all those who are about to do an ITB release, know that this is not an "on/off" switch to wide legs. It allows a previously unstrechable band to now be stretchable. Significant effort still has to be invested. Releasing it early will benefit you much more, as I now have to make up for past work.

As for the legs themselves, pain and discomfort especially during sleep has increased as I approach 6cm. It cannot be alleviated by switching sleeping positions. The only solution I found was to click less, so I am now consistently clicking 10 times per day (0.5mm).

Interesting point about the ITB release. I've had a slightly different experience in that since my release my legs have basically come all the way in instantly but I am guessing this is partly due to the fact that I did the release 4 weeks into consolidation (and as such am no longer clicking and making the ITB tighter) and spent a lot of time prior to the release stretching the hamstrings. My legs are all the way in with the crutches, however are still slightly wide when walking unassisted due to weak glutes I'm guessing. But the difference is night and day compared to before.

I think you will have similar improvement during consolidation when the surrounding muscles are no longer being lengthened.

Not long to go with clicking either mate, hope the rest of the journey is smooth for you.

[SirStretchAlot]

Interesting point about the ITB release. I've had a slightly different experience in that since my release my legs have basically come all the way in instantly but I am guessing this is partly due to the fact that I did the release 4 weeks into consolidation (and as such am no longer clicking and making the ITB tighter) and spent a lot of time prior to the release stretching the hamstrings. My legs are all the way in with the crutches, however are still slightly wide when walking unassisted due to weak glutes I'm guessing. But the difference is night and day compared to before.

I think you will have similar improvement during consolidation when the surrounding muscles are no longer being lengthened.

Not long to go with clicking either mate, hope the rest of the journey is smooth for you.

That is great to hear. I think your pre-op work definitely helped.

Did you happen to do your release near the knee as well?

[RB]

That is great to hear. I think your pre-op work definitely helped.

Did you happen to do your release near the knee as well?

Yeah it was released near the knee, slightly higher up from the side of the kneecap. The surgeon said it can also be released near the hip but that it wouldn’t provide as much relief doing it that way.

[SirStretchAlot]

Yeah it was released near the knee, slightly higher up from the side of the kneecap. The surgeon said it can also be released near the hip but that it wouldn’t provide as much relief doing it that way.

Yeah, my PT just said that the band near knee is the thickest, and that it's thinner near the upper thigh. I guess nothing really relieves us from the need to stretch prolifically.

60.64/57.78mm
1) Increased stretching has allowed me to keep up with lengthening. Wide legs are around 48cm. The ITB release definitely provided relief and made my band more stretchable, but it unfortunately has not come in completely for me as it had for RB.

2) On the bright side, clicking has suddenly become easier around 56mm. I've been able to click both legs within 10min, without painkillers. This has given me back so much time throughout the day.

[SirStretchAlot]

73.64/70.78mm

Hey guys, haven't updated my diary in a while since most things have stayed the same. A few things to note.

1) Clicking pain is minute, but still there.

2) General leg discomfort has increased, and painkillers do not really solve the problem. I need 10 hours of rolling-in-the-bed sleep to get what I got before in 8 hours.

3) Widelegs/duckass has stayed the same.

I have a feeling the last 2cm will be much harder, even at 0.5mm/day.

[PerfectBody]

I have a feeling the last 2cm will be much harder, even at 0.5mm/day.

Congrats on 3 inches! We started around the same time and you have an inch on me.

Holy   though are you doing 9cm?

[chasing_higher_dream]

First of all, congrats on reaching the last mile of the lengthening journey.
I am glad that you are doing good overall.

Btw, did you request a prescription from Dr. Betz for the painkillers for the nerve pain you mentioned earlier?

[SirStretchAlot]

@Perfect Body
Yeah, I'm going for 9cm. I met a Betz patient in the hospital who did it with minimal complications. The recovery will be a bit slower though.

@chasing_higher_dream
Yeah I did. Betz said he would only prescribe those in emergencies so he's not prescribing me those for now. I found that adequate sleep is the best way to fight muscle weakness and nerve pains. I only use the pills before I sleep.

[RB]

Not long to go mate you are in the home stretch!

[SirStretchAlot]

@RB
Thanks! 1.5cm more to go

78.58/75.46mm
Good and bad developments have occured in the past weeks

1) I found a sleeping position which removes pain/sores/discomforts almost entirely. Essentially you need to let your legs bend as if you're sitting a chair. The back then needs to slope upwards or your back will hurt due to inflexible hip flexors. I achieved the prior by hanging my legs off of a bed edge, and the latter by stuffing a thick duvet in shape of a slope below my back. I have received 9 hours of uninterrupted sleep consistantly for the past week.

2) Pain during clicking for me has returned. More bothersome than the pain is the amount of force I have to put into twisting my leg. This is likely due to the hardening callus as it has already been 106 days post-op. I will get an x-ray in 2 weeks to confirm, but I am still lengthening as planned.

3) The main reason I'm gunning for 9cm is illogical but more emotional. Having suffered from clicking pain on Betzbone, I'd like to at least get 1cm more than Precise so I can justify the suffering. And of course to be close to the 180cm goal. I am still asessing whether I should go for 10cm. Many Betz patients have, but they seem to have started from a higher height, and I don't want any complications from overstretched muscles/tendons.

Regardless, 28 days more until 9cm

[chasing_higher_dream]

<Deleted comment>

[chasing_higher_dream]

Congrats, you are almost at 8 cm.

- When I was in Sankt Ingbert, Daniela did tell me that, in case if the clicking is becoming harder/resistant then they advise patients to click 21 to 23 clicks per day (a bit above 1 mm) for 3 consecutive days. Post this, the clicking again becomes easier and then the rate of clicking can be reduced back to 15 (0.78 mm).

- Last time I checked your X-rays post, your callus looked quite good and dense. Maybe after doing X-rays, you will get a clear picture of how fast your callus is consolidating.

- Once you reach 8 cm and if your function is good, then surely you can proceed further to 9 cm. Maybe 10 cm too, if you really want it.
Initially, my goal too was 10 cm, but then I reduced my goal to 8 cm after talking to few past Betz patients on this forum. They all had the opinion that 10 cm is quite a high amount of lengthening.
Currently, I am at 6 cm and I can see my femurs are longer. At 10 cm, I guess, it can be easy to spot on the longer femurs and will not be subtle anymore. More than this, I am worried about the function in long run (eg. sitting down, getting up, etc). Due to longer femurs, it will tend to put more force on the knees while bending down and up. I would be very much interested to know how patients are doing who have performed 8 cm or more amount of lengthening in a longer run (> 3 years). Though, I can agree, it is very tempting to lengthen more

[SirStretchAlot]

Yeah, I think you're on point with the resistance. My right callus may be consolidating, since I've been on 0.5mm for quite some time. Glad we got mechanical nails.

I have talked to Betz patients who have done 10cm near our height, and their ratios are still satisfactory. However, I think the knee pressure is a concern.

For me it's 9cm for sure, but 10cm only if my body tells me so.

[slender]

1) I found a sleeping position which removes pain/sores/discomforts almost entirely. Essentially you need to let your legs bend as if you're sitting a chair. The back then needs to slope upwards or your back will hurt due to inflexible hip flexors. I achieved the prior by hanging my legs off of a bed edge, and the latter by stuffing a thick duvet in shape of a slope below my back. I have received 9 hours of uninterrupted sleep consistantly for the past week.

You're so close! You can do it!!!!

Quick question about this sleeping position. For you it probably won't do much due to being so close to finishing your lengthening, but do you think that this sleeping position could produce shortening of the hamstrings over months of sleeping in this position? I'd also be concerned with the chance of Deep Vein Thrombosis. Not to try and scare or deter you from it, just wondering what your experience and thoughts has been with it over this past week+.

[SirStretchAlot]

@slender
I believe all comfortable sleeping positions might result in shortening of the tendons. However, we need quality sleep to recover and work.

Thrombosis is a completely different beast. It's a problem mainly with non-weightbearing nails because you're seated much longer. If you're getting weight-bearing nails like G-nail/Betzbone, there is very little possibility of getting blood clots as long as you're hydrated.

[slender]

@slender
I believe all comfortable sleeping positions might result in shortening of the tendons. However, we need quality sleep to recover and work.

Thrombosis is a completely different beast. It's a problem mainly with non-weightbearing nails because you're seated much longer. If you're getting weight-bearing nails like G-nail/Betzbone, there is very little possibility of getting blood clots as long as you're hydrated.

Ah! I meant thrombosis due to the actual sleeping position that you're describing. I was just concerned about the lack of movement/vertical positioning of the legs in the position.

[SirStretchAlot]

@slender
I think we are generally lacking movement when we sleep. My legs tend to hang slanted off the bed rather than vertical. I have not woken up from sores/pains since.

82.22/79.10mm
Am now around the 8cm mark. Several updates.

1) Since going back to clicking 0.78mm/day for the past few days, clicking resistance has reduced significantly. Clicking pain is also gone. I believe 0.5mm/day was too slow as my callus hardened.

2) Clicking at a faster pace has made my legs wider, as my stretching can't catchup.

3) 13 more days until 9cm, and the end of lengthening!

[Zatoichi]

Fantastic achievement and so close to the end. Well done!

From my experience, after three days of not lengthening, the widening forces really dissipate, which makes rehab a lot easier! You can worry about dealing solely with that in 2 weeks!

[chasing_higher_dream]

Congrats on the 8 cm mark

Good to hear that the clicking resistance has gone down. As it's just 13 days to reach 9 cm, you are almost done.