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[pownzorgeek]

You are 100% right¡ I have to update on this. Yesterday my right leg clicks were being very difficult. I was twisting what visually looks like almost 90 degrees lol, it looked like a snapped leg. However, it was my mistake. I was not being able to keep my knee relaxed, so the mechanism was not working as it should, needing a crazy twist to get the click. This time, I close my eyes and focused on leaving my legs as it was dead, and just used my hand to push slowly. This time, the click was very easy with the usual twist, and I did not have the problem I described earlier regarding clicks at the same time.

At this point I can see that is a matter of technique. You can get a click with bad tecnique, but you will cause yourself lots of pain. When done properly, the pain is low. It's not easy to get it right though, and you have to try a lot. Future G Nail patients can DM and I can help with videos. Maybe I will upload one here blurring my face, showing how to click.

So if you are relaxed, how easy is it to accidentally click while sleeping/even just stretching? And how easy do you rate the chance of accidentally clicking when someone will start doing sports again with the nail in their leg, like running, swimming, or just gym?

[DonBones]

So if you are relaxed, how easy is it to accidentally click while sleeping/even just stretching? And how easy do you rate the chance of accidentally clicking when someone will start doing sports again with the nail in their leg, like running, swimming, or just gym?

Accidental clicking during sleep - can happen, but you'd have to click a hundred times on one side and not the other to create a noticeable discrepancy. Regular x rays would reveal a discrepancy before it gets to it.

Regarding accidental clicking during sports, that can't happen so long as you wait until the bone is consolidated before you do sports again, which your doctor will recommend regardless. At that point the rotation that triggers the click can't physically be done anymore.

[tallmen]

following

[V21]

I hit 1.5 cm today. As I get more experience, clicking is easier. I do would like to ask Giotikas if 3 sessions of clicking are really necesary (5 morning, 5 afternoon, 5 night), because I know with Betzbone patients do 2. Anyone has any info in this matter? I ask because I feel that the tough clicks are the first two, then it's very easy, and it would be less painful to do 8 and 7 clicks than doing 5, 5 and 5.

Since there is no PT on weekends, I have been training all morning. It's necesary to have lots of discipline: when I do nothing for 1-2 hours, pain and tighness come back. As soon as you are on the move, you will be fine. Another important thing is that Giotikas will provide stationary bikes next week.

[canterk]

can you share your training routine? I read many diaries and a lot of people say they stretch for hours per day. but i am curious how these "hours" are actually divided. surely, you dont stretch for 2 hours straight right? or am I wrong?

I am imagining you do 5-10 minutes of stretching every hour or something similar but would appreciate a clear answer to this.

Thanks for sharing

[V21]

can you share your training routine? I read many diaries and a lot of people say they stretch for hours per day. but i am curious how these "hours" are actually divided. surely, you dont stretch for 2 hours straight right? or am I wrong?

I am imagining you do 5-10 minutes of stretching every hour or something similar but would appreciate a clear answer to this.

Thanks for sharing

I do 3 workouts per day. They last around 30 mins: 3 strenghtening exercises (variants of leg raises) and 3 strecthing exercises with bands (quads, harmstrings and IT Bands). Besides that, I strecht like 15 mins every hour or so. For example, if I'm watching a movie with my gf, I do light stretches at the same time.

[SpeedDialer]

What are your thoughts on gnail vs precise 2.2?

https://www.athensbjr.com/methods-of-bone-fixation-in-limb-lengthening/#1586804812157-43dd5a1a-d6dc

Gnail lets you lengthen 1 cm immediatly it seems. But it has clicking / pain from clicking. Worth it? Is gnail cheaper than precise 2.2?

[tallmen]

What are your thoughts on gnail vs precise 2.2?

https://www.athensbjr.com/methods-of-bone-fixation-in-limb-lengthening/#1586804812157-43dd5a1a-d6dc

Gnail lets you lengthen 1 cm immediatly it seems. But it has clicking / pain from clicking. Worth it? Is gnail cheaper than precise 2.2?

I am having a hard time deciding b/w precice and gnail. How did you choose b/w them? I am gonna get the surgery in December.

[SirStretchAlot]

G-nail doesn't lengthen 1cm immediately. Giotikas and Guichet choose to do this during the surgery. Betz did 5mm for me during the surgery.

As someone who is in his final stretch of lengthening, I'd pick G-nail with Guichet hands down because G-nail is weightbearing while precise is not. This means:

1) Less muscle atrophy due to you being able to walk throughout the entire lengthening phase, leading to much better recovery.

2) You can lengthen at home and work or hangout with friends instead of staying in Athens doing nothing.

3) You can choose to lengthen more than 8cm if you wished, and with a 1cm boost, you can finish lengthening 2 weeks earlier, further hastening your return to normal life.

The only reason why you would use precise is if you have a moderate lengthening goal (5-7cm) and trust its publically available data. Guichet data isn't as transparent.

[V21]

I would be terrified about breaking the nail if I had choosen Precice. There is no way to respect its weight limits: standing from toilet, bed, taxis... specially taxis, the drivers are quite rough here and you are on your own, so you have to put weight on your legs to get in and out. Before surgery I thought transfer from wheelchair would be easy... bullsh*t.

More news: Today I used the antigravity treadmill for the first time. It's amazing, and I think it will help me a lot in recovering normal gait. A bad thing is that surgical pain has been worse the last couple of days. I must power trought it, but it's quite hard not being able to rest at all. I'm at 1.7 cm today.

[Want-3-inches]

Hey V21, can you share your xrays?

[V21]

Hey V21, can you share your xrays?

Yeah, I will upload them all. The first ones are on 13th September. That day will be key to check if all is good (nail, bone growth...). I wanted to say that I just received some bags I bough via amazon, bags where you can put hot water. They have been really useful¡ As I said, these last two days I have been in pain, and the bags have helped relax my muscles. In fact, I was able to sleep for an hour right now.

[LU213]

So you can order things and receive them quickly in Greece via Amazon.gr?  I am trying not to pack too much and go over the weight limits.

[SpeedDialer]

"2) You can lengthen at home and work or hangout with friends instead of staying in Athens doing nothing."

Thanks!!! You are a Greece citizen or you flew back home? Does Giotikas allow it?

[SirStretchAlot]

"2) You can lengthen at home and work or hangout with friends instead of staying in Athens doing nothing."

Thanks!!! You are a Greece citizen or you flew back home? Does Giotikas allow it?

I'm based in the UK, and Giotikas was fine with it. I would still stay in Athens for a week to memorize the physio routine, so your legs don't end up widening too much at home .

[SpeedDialer]

Thank you!! So Athens or UK residents can fly back home but generally people who live in other countries cannot?

[V21]

So you can order things and receive them quickly in Greece via Amazon.gr?  I am trying not to pack too much and go over the weight limits.

There is no amazon.gr, but you can order in amazon.co.uk. I also think it's stupid to go home really soon after surgery, cause learning to click properly is not easy.

[SpeedDialer]

Wow! Thanks for the detailed information.

What are your thoughts on the clicking pain and accidental clicks with gnail?

[V21]

When done properly, clicks are not painful. The problem is that, now that we are walking more and more, our legs get stiff and sore, so we can't properly relax the knee when clicking. Because of that, the last two days I had a lot of pain clicking. I found out that hot water before clicking helps the leg to relax, but it still hurts. I need to find a way to properly relax my muscles, because last week I was having 0 pain clicking.

Today I'm 2 weeks post op and was able to work for a few hours, so it's definitely possible. Giotikas also sent today stationary bikes to use at home. He says that biking before clicking will warm up the leg and help a lot, so I will try this too.

[DonBones]

When done properly, clicks are not painful. The problem is that, now that we are walking more and more, our legs get stiff and sore, so we can't properly relax the knee when clicking. Because of that, the last two days I had a lot of pain clicking. I found out that hot water before clicking helps the leg to relax, but it still hurts. I need to find a way to properly relax my muscles, because last week I was having 0 pain clicking.

Today I'm 2 weeks post op and was able to work for a few hours, so it's definitely possible. Giotikas also sent today stationary bikes to use at home. He says that biking before clicking will warm up the leg and help a lot, so I will try this too.

I usually stretch for 45 minutes before the clicking

[V21]

I usually stretch for 45 minutes before the clicking

Wow, that helps? Last week I was stretching like 5 mins before clicking and 0 pain. This week is being really bad, so I will try now. I will strecth a lot and also use hot water again, let's see how it goes. Thanks for the tip.

[Antonio111111]

What's the main difference between gnail and betz nail?

Which one has better weight bearing and better clicking mechanism?

[SpeedDialer]

What are the most common places / situations people hurt their legs when living at home w/ an internal weight bearing nail like gnail?

Ex: what physical setups/situations seem safe but you are actually at risk of hurting your legs or accident?

[V21]

What are the most common places / situations people hurt their legs when living at home w/ an internal weight bearing nail like gnail?

Ex: what physical setups/situations seem safe but you are actually at risk of hurting your legs or accident?

Getting up from toilet

[SirStretchAlot]

@SpeedDialer
Everyone can fly home, though I'd stay for at least a week, to make sure you're healthy and learn the physio routine.

@Antonio111111
They're nearly identical, but I'd go with Gnail since both Guichet and Giotikas do ITB releases, which makes recovery much easier when you go 5cm+

@V21
Stretching and clicking in hot bathtub are ways I used to reduce clicking pain. Also, don't slow down clicking below 0.78mm/15clicks or resistance will grow.

[V21]

Hey guys, I have some bad news. Let's see if someone can helo.
This week was going really well: my gait was very good for 2 weeks post op, my flexibility is still as good (or better) than pre-surgery...

However, on Wednesday, clicks started to be harder and harder. In the beginning, I thought it was cause I was recovering my muscles and they were resisting or something, so I just kept pushing and taking the pain. However, the clicks have become harder and harder every day. I was not able to click the right leg on Friday, so the nurse came to help. We did massage, bike, hot water... nothing worked. Just by pure will (and maybe desperation) I kept pushing the leg and finally clicked. I have a video of this: you can see me screaming and crying, but pushing trought until it cicked. The thing is that the twist is not normal: when Giotikas showed me how to do it in hospital, the twist was maybe 25-30 degrees. Now I need to twist 90 degrees or more to get the click. I think you can imagine the crazy pain it causes. It's important to say that this is also happening to the other G Nail patient.

For now I consider the following reasons:

The bone is growing too fast. That would explain why each day the click requires more and more twist. However, it seems very unlikely at 2-3 weeks post op.

Each click cause tightness in knee and it's being acumulated. I don't think this issue is being adressed in PT: my flexibility in quads, harmstrings etc is great, but the knee is getting tighter with each click.

I just have too much muscle. Just because of walking a lot, my quad muscles are almost as big as they were pre surgery.

In any case, tomorrow I have X rays and meeting with Dr. Giotikas. I'm not a weak person, and I'm fighting with all I have, but this is just torture. I scream with every click, and sometimes I feel I will pass out. I don't know how much longer I can keep like this. Also regarding time: last week I did my clicks in 40 minutes. Now they take 4 hours. Dr. Giotikas agrees that this is not normal, and tomorrow will do the clicks with me to check what's happening. I just hope he finds a solution, cause I'm really discouraged. The other patients is also in a similar situation. The funny thing is that the rest is going well: dont have much pain during the day, I walk and bike a lot, I sleep decently... it's just the clicks.

[eric.cartman]

Hey guys, I have some bad news. Let's see if someone can helo.
This week was going really well: my gait was very good for 2 weeks post op, my flexibility is still as good (or better) than pre-surgery...

However, on Wednesday, clicks started to be harder and harder. In the beginning, I thought it was cause I was recovering my muscles and they were resisting or something, so I just kept pushing and taking the pain. However, the clicks have become harder and harder every day. I was not able to click the right leg on Friday, so the nurse came to help. We did massage, bike, hot water... nothing worked. Just by pure will (and maybe desperation) I kept pushing the leg and finally clicked. I have a video of this: you can see me screaming and crying, but pushing trought until it cicked. The thing is that the twist is not normal: when Giotikas showed me how to do it in hospital, the twist was maybe 25-30 degrees. Now I need to twist 90 degrees or more to get the click. I think you can imagine the crazy pain it causes. It's important to say that this is also happening to the other G Nail patient.

For now I consider the following reasons:

The bone is growing too fast. That would explain why each day the click requires more and more twist. However, it seems very unlikely at 2-3 weeks post op.

Each click cause tightness in knee and it's being acumulated. I don't think this issue is being adressed in PT: my flexibility in quads, harmstrings etc is great, but the knee is getting tighter with each click.

I just have too much muscle. Just because of walking a lot, my quad muscles are almost as big as they were pre surgery.

In any case, tomorrow I have X rays and meeting with Dr. Giotikas. I'm not a weak person, and I'm fighting with all I have, but this is just torture. I scream with every click, and sometimes I feel I will pass out. I don't know how much longer I can keep like this. Also regarding time: last week I did my clicks in 40 minutes. Now they take 4 hours. Dr. Giotikas agrees that this is not normal, and tomorrow will do the clicks with me to check what's happening. I just hope he finds a solution, cause I'm really discouraged. The other patients is also in a similar situation. The funny thing is that the rest is going well: dont have much pain during the day, I walk and bike a lot, I sleep decently... it's just the clicks.

hey man, Sorry to hear! Sounds like you are going through a rough patch. Given that your surgery was only a couple of weeks ago, plus you had a 1cm initial distraction, it's unlikely to be premature consolidation. After your x-rays tmrw, you'll know for sure. Knee pain is normal as your quad/hamstrings tendons are pulling eveywhere whenever you lengthen - they will eventually settle down and give in.

As what I hear, many ppl go through pain issues around 2cm and 5cm mark - no idea why. You might have to just push through it. Hang in there!

[Arcon]

I think @sirstretchalot also mentioned he had pain before he started feeling better.. Hang in there bro!!!

[Super-JR]

Unfortunately pain is part of the procedure, in a few week it will be easier. Just hang in there brother, you can do this!!!

[V21]

Guys, I'm not talking about normal pain. In fact, pain is just a consequence of the main issue: clicks require each day more twisting. Last week I twisted 25 degrees and got the click. Then 35, 50, 60... now I have to twist 90 (which is crazy, seems like you are dislocating your leg) in order to get the clicks. In fact, in the right leg yesterday I wasn't able to click even with a 90 degree twist. So it's not a matter of pushing on despite of pain, it just doesn't click.

The other patient thinks this is because our knees and parts of our quads are tight and preventing the mechanism to work. The strong bone formation, although unlikely, could also explain this. I'm also getting paranoid about some kind of nail malfunction. To be honest, I'm quite depressed, cause I have complied and done everything well. The idea of this effort and discipline just to get 2 cm makes me want to vomit.

In any case, I realise I might be getting paranoid, and I just have to wait for the X rays these afternoon. I trust the doctor and I hope he provides a solution for me and the other G nail patient. Thanks for your messages of encouragement. I will update as soon as possible.

[tallmen]

Guys, I'm not talking about normal pain. In fact, pain is just a consequence of the main issue: clicks require each day more twisting. Last week I twisted 25 degrees and got the click. Then 35, 50, 60... now I have to twist 90 (which is crazy, seems like you are dislocating your leg) in order to get the clicks. In fact, in the right leg yesterday I wasn't able to click even with a 90 degree twist. So it's not a matter of pushing on despite of pain, it just doesn't click.

The other patient thinks this is because our knees and parts of our quads are tight and preventing the mechanism to work. The strong bone formation, although unlikely, could also explain this. I'm also getting paranoid about some kind of nail malfunction. To be honest, I'm quite depressed, cause I have complied and done everything well. The idea of this effort and discipline just to get 2 cm makes me want to vomit.

In any case, I realise I might be getting paranoid, and I just have to wait for the X rays these afternoon. I trust the doctor and I hope he provides a solution for me and the other G nail patient. Thanks for your messages of encouragement. I will update as soon as possible.

If it's in both legs than nail failure is unlikely. If it's just in one leg than you might have a nail dysfunction.