I'll say this: if I had infinite time and money, I think I would have gone with Betz (germany) or Dr. Jean-Marc Guichet (milan Italy and also France locations available I think), then stayed in their area, and then paid extra if need be to get physio 5+ days a week (I think Paley does 5-6 times per week) + would pay for a location with a pool/hydrotherapy. If I had infinite time and money, I think I woulda done 7-8 femurs with Betz or guichet, waited a year, then come back did 5cm on tibia, then either stop or continue or rebreak (depending on x-rays/range of motion) to do 2-2.5 more on tibia by rebreak.
I do think that someone with good enough flexibility / training can sometimes get more than 8cm in one shot on one segment and fully recover -- Betz/guichet have seen 8+ cm in one shot accomplished with them all the time, so it must happen regularly enough. I'm not sure this is a good idea for someone with below average flexibility like me though?
I'm doing a more budget option of G-nail Giotikas + wait a year + Gnail removal with Giotikas + precise tibias with Giotikas + not sure where to go for precise nail removal, aiming for 7 femurs, 5 tibias if I can do it
With Giotikas in Athens, you get physio 4 times per week, which is fine I think probably if you are dedicated
Novotel in Athens does have a roof pool (which I heard feels good to walk in) but its extremely shallow (less than the length of your legs I believe, not sure) and there are unfortunately stairs to reach it (the elevator stops at the floor right before the roof) but I hear that you can get two strong guys who work at the hotel to lift your body up the stairs if you are on a wheelchair from precise
Becker vs Giotikas (Betzbone vs G-nail) - which better?
@SpeedDialer
It‘s different approaches from different Drs.
Dr G does 1.5mm/day in the beginning then goes down to 0.66 quickly. We did 1mm/day then slowly go down to 0.78mm and then depending on your case down to 0.72 or even 0.67 at about 6cm.
The reason why Paley gives PT so often is probably because you are stretched there. In my case stretching is my “home work“ that I vigorously need to do. PT (2x/week -> definitely enough in my case) is only there to help guide you and give strong massages to help loosen up. Also check on your gait and help you with that.
In my opinion this approach is not for everyone because if you aren’t disciplined you are screwed. Maybe to reduce non-compliance Paley wants the stretching to be done by his team.
However, if you do as they tell you; stretch very hard, 4h a day (for 0.75mm/day) everyday without any days off you will have a great result. from what I have seen here with other patients: outcome directly correlates to the amount of stretching the patients did. LL = stretch or quit.
No It band release is bad but I do feel like I can stretch my sides well. I had wide legs at 3cm but they are totally gone now and I can easily close my legs and even have more range of motion while stretching now than before. Maybe it’s just the TFL that I stretched, I don’t know. But the studies that I have seen which showed that “IT band is almost unstretchable” stretched the IT band of corpses. Imo this can’t be one to one directly compared to our situation. We are a living changing organism which has the unique stimulus of elongation. Like I said I am not sure but I did stretch away my wide legs (during lengthening).
I highly disagree with flexibility pre surgery being important at all. I was very inflexible but caught up because I stretched a lot. It’s not so much about what you start with but how serious you take it once it is important (= when the bone gets longer and soft tissues needs to catch up). Before you have normal flexibility for normal functionality. Everyone does. Then you lengthen and everyone, even the most flexible people on earth will become too tight. If you are super flexible maybe it starts at 4cm. For most it starts at 3cm. For me it started at 2.5 or something.
Doesn’t really matter though because then it’s important to stretch hard. If you don’t stretch your preflexibility won’t safe you.
Paley also confirmed this and said stretching pre surgery is only good for getting into it.
I think both Doctors are good options but I would highly recommend everyone to get a weightbearing option. The clicking in the beginning is definitely worth it compared to the alternative.
Either is fine but personally if you have the money I’d suggest betz because
A) weight bearing from day 1
b) less time overseas before returning home
C) 20+ years of experience
Quote from: RealLostSoul on November 11, 2022, 04:25:59 PMI highly disagree with flexibility pre surgery being important at all. I was very inflexible but caught up because I stretched a lot.
Both Rozbruch and Paley say stretching pre-surgery isn't needed but something doesn't add up for me. Sure - you have to stretch a lot during the lengthening part, but I just don't see how it's contradicting. Paley literally said stretching only have short term impact on flexibility, but that's obviously not the case post surgery, right? So I find it a bit confusing...
Quote from: hippo60 on November 12, 2022, 10:32:45 PMBoth Rozbruch and Paley say stretching pre-surgery isn't needed but something doesn't add up for me. Sure - you have to stretch a lot during the lengthening part, but I just don't see how it's contradicting. Paley literally said stretching only have short term impact on flexibility, but that's obviously not the case post surgery, right? So I find it a bit confusing...
It‘s because the lengthening is a unique situation for the body to adapt to. If you stretch before as a normal person the muscle gets looser but doesn‘t have to adapt to a different length, so it goes back to normal after a few hours. When the bone is elongated you need to stretch to tear up the muscle so it can adapt to the new length.
The more flexible you are pre surgery the later the tightness hits you but it‘s minimal. My doctor told me very very flexible people may get it at 4cm while the average person gets it at 3cm.
It really isn‘t necessary tbh. You have the first few cm where you should be conditioned into stretching (before you are getting tight) anyways.
Quote from: RealLostSoul on November 13, 2022, 12:53:07 PMIt‘s because the lengthening is a unique situation for the body to adapt to. If you stretch before as a normal person the muscle gets looser but doesn‘t have to adapt to a different length, so it goes back to normal after a few hours. When the bone is elongated you need to stretch to tear up the muscle so it can adapt to the new length.
The more flexible you are pre surgery the later the tightness hits you but it‘s minimal. My doctor told me very very flexible people may get it at 4cm while the average person gets it at 3cm.
It really isn‘t necessary tbh. You have the first few cm where you should be conditioned into stretching (before you are getting tight) anyways.
Yeah that was my gut feeling - you mostly delay when you get that tightness, but it's coming either way. Not entirely sure I'm following "When the bone is elongated you need to stretch to tear up the muscle so it can adapt to the new length.".
Quote from: hippo60 on November 14, 2022, 01:54:11 PMYeah that was my gut feeling - you mostly delay when you get that tightness, but it's coming either way. Not entirely sure I'm following "When the bone is elongated you need to stretch to tear up the muscle so it can adapt to the new length.".
Wait that‘s the most important fact of LL, let me rephrase it.
The bone gets longer -> soft tissue needs to get longer too. to do this you stretch the muscle so it lengthens. When you hold it in stretch for at least 2 min the myofilaments get “torn up” and the muscle longer so to speak and in lengthening patients they then adapt to the new length instead of adapting back to the origin length.
Quote from: RealLostSoul on November 14, 2022, 11:05:48 PMWait that‘s the most important fact of LL, let me rephrase it.
The bone gets longer -> soft tissue needs to get longer too. to do this you stretch the muscle so it lengthens. When you hold it in stretch for at least 2 min the myofilaments get “torn up” and the muscle longer so to speak and in lengthening patients they then adapt to the new length instead of adapting back to the origin length.
Yeah I understand, but the process of muscle tearing & recovering happens regardless of LL, right? That's what threw me off a bit...
Quote from: hippo60 on November 14, 2022, 11:34:23 PMYeah I understand, but the process of muscle tearing & recovering happens regardless of LL, right? That's what threw me off a bit...
Not really for elongation, no. I mean yea you can change it even as a normal person with very hard work (yoga eg does it too) but it’s nothing on the scale compared to what the muscle needs to accomplish for LL
Quote from: RealLostSoul on November 15, 2022, 12:41:06 AMNot really for elongation, no. I mean yea you can change it even as a normal person with very hard work (yoga eg does it too) but it’s nothing on the scale compared to what the muscle needs to accomplish for LL
Yeah 100% - it's similar just way more extreme
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