natural growth during puberty vs ll

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Why do you not have a full recovery though if the stretched tissues eventually do catch up with the bone growth?

What I'm saying is yes, you definitely do not have a full recovery, but can someone please explain to me the physiological reasons behind it?

For a layperson catch up growth would seem to equal full recovery although this is obviously not the case so I'm trying to understand why..............

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Your body simply isn't use to having a longer leg and it probably will never 100% adapt. Guys who have LL write about how their leg feels unruly and unbalanced after finishing LL, and how it's harder to maneuver it after due to the extra length and weight. I think this is alleviated if you only lengthen a safe amount (3-5 cm) but I still think it has some effect. Your changing your bodies core balance after all.

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Which area do you think developments are most likely to be in -

a.finding a method of distracting the bone slowly enough for soft tissues to grow in unison ie. comparable to puberty, or

b.finding more sophisticated ways of helping soft tissues recover

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Quote from: Ostentician on May 20, 2020, 08:00:46 AMYour body simply isn't use to having a longer leg and it probably will never 100% adapt. Guys who have LL write about how their leg feels unruly and unbalanced after finishing LL, and how it's harder to maneuver it after due to the extra length and weight. I think this is alleviated if you only lengthen a safe amount (3-5 cm) but I still think it has some effect. Your changing your bodies core balance after all.

But that would happen to puberty tall people too, not only people who did CLL.

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Quote from: Polvorón on May 20, 2020, 12:03:45 PMBut that would happen to puberty tall people too, not only people who did CLL.

It's true that people who are naturally tall also have issues with balancing and finding it harder to maneuver their bodies due to their longer legs and higher center of gravity. That's why having shorter legs can be an advantage for certain sports/certain positions in sports, although being tall also has many advantages (it's why shorter athletes like Messi learn to use their shorter legs as they gives him better agility and a lower center of gravity compared to many taller players).
It's also a possible reason, as I remember someone in the forum mentioning, why there are so many falls in NBA games which has a lot of tall players. The only difference between naturally tall people and those who did LL in that regard is that the naturally tall people had more time to adapt to their body since they reached their height in their teenage years.

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Quote from: Aquahoma2 on May 18, 2020, 02:43:43 AMSorry, guys, a very stupid question follows. I am just a little bit confused by your discussion.

It's clear that when you stretch your broken bones, the bone tissue grows in between the parts of bone. But what really happens to all the other tissue, i.e. muscles, nerves, vessels, etc.? Do they grow too, or just remain in an unnatural stretched position forever? I supposed that they are stretched at first, and then grow essentially to the position that would be normal if you had had this bone length originally.

The body actually creates new tissue cells during limb lengthening, it's not only existing cells stretching. However, if I recall correctly, the process is still inferior to the natural growth of the body during adolescence. The tissue isn't able to adapt to the longer bone as well as if it had been natural growth. Someone in the forum posted an email from an LL doctor about that question and the doctor said that when natural growth is finished, there probably is an unknown genetic trigger that tells the body cells to stop growing naturally, and since we can't activate that trigger with distraction osteogenesis, the result will not be as good.

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thanks Iwannabetaller, that seems to answer my question. Hopefully there will be more research into reprogramming the body back to a state of 'natural' growth during ll.

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Soft tissues can grow, look at people with stretched earlobes, some people have really big holes, some enough to put a drink can inside. Also, sometimes people get their skin burned and lost, and that skin is recovered through distraction of surrounding skin.

My advice is to take X rays, and if the bone is not consolidating too fast, decrease the elongation rate, I have read here that this makes the process better.

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Soft tissue can grow, but the growth process during LL is inferior to natural growth of soft tissue during childhood/puberty. That means the soft tissue will be stretched and won't perform as well as it had originally. I have found the statement from an LL doctor I talked about earlier, and I remembered correctly. It was from Dr. Birkholtz:

Quote3) Soft tissue is one of the largest issues in regards to limb lengthening. Is there a medical consensus on why soft tissue doesn't adapt the same way it does during natural bone growth? We are all aware that after growth plates fuse no more growth can occur even under the same hormonal conditions but why does the same issue of growth of soft tissue occur where they technically have no 'end point' similar to plate fusion? Could one not accurately reproduce the hormonal conditions in soft tissue growth to mimic that found in natural growth? I believe I have read some studies that refer to issues with cell reproduction of soft tissue in regards to this.

The main difference in soft tissue adaptation to growth during normal growth vs CLL growth, is the rate at which it occurs. It seems like one of the ways that soft tissue adapts to growth is because of a constant distraction force which triggers gene expression and provides soft tissue growth. In normal growth, this rate of elongation is quite slow and as a result the tissues grow at the optimal rate and can 'keep up'. In limb lengthening we have to speed up the process because the bone will consolidate prematurely if we stretch too slowly. If we could drop distraction rates down to 0.1-0.3mm per day, we will probably have soft tissues that will adapt better. In addition there is probably some form of genetic trigger that switches off after normal adolescent growth, similar to a growth plate closing. Lastly, the predominant protein in soft tissue is collagen. It does become less supple as time goes on, and this is a result of aging. This causes more resistance to stretching as well.

Although distraction histiogenesis does cause new tissue to form (ie grow properly), there is an element of elongation through stretching. One of the reasons why realistic lengthening goals should be borne in mind.

I think that with current technologies available, athletic potential is definitely affected regardless of lengthening amount. Whether it is noticeable in an individual would depend on factors like pre-op status, flexibility, genetics, lengthened amount, technique etc etc.

http://www.limblengtheningforum.com/index.php?topic=4227.msg65432#msg65432

Sorry to break it to you, but LL will be a compromise between becoming taller and losing some physical performance/integrity.

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thanks that's really helpful and answers my question precisely. Hope there are developments in this area.