Limb Lengthening Forum
Limb Lengthening Surgery => Limb Lengthening Patients Experiences => Topic started by: SirStretchAlot on May 02, 2021, 05:11:01 PM
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After learning so much from everyone on this forum, I thought I should give back by starting a dairy with Dr Betz. I will give a full analysis of my motivations, why I chose Dr Betz and Betzbone, as well as a cost breakdown. I will also try to post daily/weekly updates and answer any questions curious lurkers may have.
Motivation
1) Dating in the West is difficult when the average adult male is 176cm+. This average can reach 183cm in northern European countries. Women have anecdotally told me that they tend to judge height over appearance and even money.
2) COVID and working from home has given a great excuse to disappear from society for 4 months without suffering economic consequences.
Why Dr Betz
1) Over 3000 surgeries. The most experienced doctor in Europe.
2) Researcher and publisher. Inventor of Betzbone and co-inventor of Fitbone. This adds to his level of expertise.
3) Younger doctors like Giotikas is also a great value alternative. He uses Stryde and is very well educated. I likely would have went with Giotikas had it not been for the Stryde recall.
Why Betzbone
1) Availability. Stryde has been recalled due to corrosion. Precise 2.2 has halted shipping in the EU after losing its CE Mark. The only well-known nails available in Europe are Betzbone and Guichet (same mechanism). There are other less known partial-weight bearing nails available in Turkey and other regions that have stockpiled Precise.
2) Allows for up to 12.3cm in lengthening versus 8cm for Stryde. Although I will likely only lengthen 10cm, this allowance is useful for those who wish to squeeze out every last mm. It is less meaningful to those who do not want to lengthen past 8cm for personal or safety reasons.
3) Full-weightbearing. After Stryde, Betzbone is the only frequently used weight-bearing nail on the market. There seems to be talk of Betzbone snapping in the past. Since then, the nail has been re-designed and it has a much longer track record than Stryde. I've taken the decision to go with Betz given his wealth of surgical and nail design expertise which should result in a lower relative (perhaps not absolute) complication rate, over a less experienced surgeon with lower absolute complication rate.
4) The corrosion issue in Stryde is unlikely going to be fixed as long as it contains a sealed iron compartment. This is not changeable as only ferronous metals respond to the magnetic coil in the external lengthening devise. This is exacerbated in weight-bearing nails as they go through much more and frequent stress, resulting in more influx of bodily fluids into the sealed joints of the nail. Betzbone is cobalt chrome which does not corrode. Personally, I don't see any problems with minor corrosion, but I wasn't going to wait 8 months just to get on a waitlist for Stryde.
Cost
1) Dr Betz costs €54179.69. This includes consultation, X-rays, measurements, nails, the operation, followed by a 14-day hospital stay with physio, food and pain medication. This may be cost-effective compared to Paley in US or Donghoon in Korea.
2) This does not include any post-hospitalization (outpatient) physio, x-rays, medication, and accomodation. This does not matter as much to me as I will be returning to the UK for my rehab, where my private insurance will cover physio and x-rays. NHS will offer discounted medication. And I will be living at my own flat.
3) Please also consider additional costs such as hospital Covid tests, Airbnb, food, train, and flight which added an additional €1500 for a 4-night pre-op stay. The removal procedure in 1.5 years time is €7200.
4) Note that Dr Giotikas from Athens charges €47445 for the whole package and uses Stryde. His package also includes outpatient physiotherapy and medication during lengthening. If you do not have health insurance, and believe in Stryde, definitely consider him. His prices are likely more competitive due to Greece's proximity to Turkey where Dr. Buldu is offering Precise 2 packages for €35000 versus Dr. Giotikas' €42400.
Personal Stats
Pre-op Height: 171cm
Post-op Goal: 181cm
Age: 29
Weight: 67kg
Ethnicity: East Asian
Location: UK
Fitness: Defined arms and waist. Been lifting 3 times a week for the past 5 years
Flexibility: Average, but has been making progress over the past 4 months by incorporating hip flexor, quadriceps, and hamstring stretching into my daily routine. It has also been recommended to stand whenever possible (ie. working on a standing desk) to train the muscles.
Dairy
Day 0: After arriving in Frankfurt, I took a personal tour of the city and sat on a 2.5 hour train ride to Sankt Ingbert. It's a small town, and when I arrived I was unpleasantly surprised by the crudeness of the hospital and consultation office. The fascilities were basic. I had to pay €182 for a PCR test out of pocket. The nurses and even the anesthesiologist were not proficient in English, so I had to use Google Translate on many instances. Dr Betz said it didn't make much of a difference to him whether I used regional or general anesthesia. The anesthesiologist however recommended general anesthesia, as regional may be inadequate and urethra connections may have to be made. Finally, the hospital visit was disorganized. I had to find my own way to the X-ray room (Röntgen). After that my handler Daniela became very helpful in guiding me to the office where my measurements were taken. I enjoyed a 3-hour consultation with Dr Betz. He knew the answer to every single question I had.
My surgery is tomorrow. I'll try to write an update if I'm conscious. Wish me luck!
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Congratulations on setting everything up LL Forum and best of luck. Thank you for sharing your experience with us.
I know you have put a lot of work and time into planning this, as anyone who goes into LL does, but I would personally advise you to keep an open mind regarding the 10 cm goal on femur. It is a lot to do on one segment. Remember that all the nerves, muscle etc. are stretched about that one point where Betz makes the distraction in your bone. As other diaries have told us in the past, it becomes really hard to walk normally again past the 6-7 cm range. It is a lot of permanent pressure the soft tissue experiences at that point so a lot of stiffness.
Anyway, I hope you are comfortable and I am sure you will do well. It will be interesting to read about the physio and lengthening in the UK.
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Hello LimbLengtheningForum.
Nice to see one more Betz diary.
In my opinion, a 10 cm lengthening goal is a bit too much. I would recommend staying under 8 cm. Max 9 cm. The reason being proportions and safety.
Since you were active before surgery this would definitely help.
Btw, I have few questions:
1. What is your wingspan?
2. Did you book the date with Dr. Betz for surgery beforehand? If yes, when? Or was it on the spot after the consultation?
3. Which size of Betzbone nail (10/11/12/13 mm?) is Dr. Betz going to use for you?
4. Is covid test mandatory before going to do surgery in the hospital?
5. Till which date are you staying in Germany?
Maybe if our dates collide there is a possibility that we could meet :)
All the best with your surgery mate. I am rooting for you.
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All the best mate, hoping everything goes smoothly for you. I had my surgery with Dr. Betz in March and am currently lengthening. Reach out if you have any questions!
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Hi LimbLengtheningForum, I had the exact same feeling with the hospital and the anesthesist woman was pretty rude. Had to pay for an extra PCR test because the one I did was too old.. did it 48 hours before as requested. Anyway I cancelled my surgery 2 days before and lost 3k.. but I didn't feel comfortable staying in this hospital plus wasn't as ready as I tought mentaly. Surgery was scheduled for the end of March.
Anyway Dr Betz was very kind and totally understood my feeling, so if I plan to do it one day, will totaly go for Betz and get more information about the confort clinic which seems way better option.
wish you the best and looking forward to your diary.
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Hi! I think very similarly to you about the nail dilemma. I think it is a reasonable choice. Good luck
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@chasing_higher_dream
1) Wingspan: 177cm
2) I booked with Dr. Betz for July, but someone cancelled their nail removal due to COVID. I originally requested for ASAP, so when they asked if I wanted to take the canceller's place, I jumped on it.
3) Good question. Dr Betz mentioned it in passing. I'll confirm tomorrow.
4) Covid test is mandatory everytime you enter the hospital. I had to wait an hour for my test since it was Monday morning.
5) I'll stay until May 16.
Hope we can run into each other too!
@TheDream
Thanks for your concern. I'll definitely see how my flexibility is past 6-7cm.
@RB
Nice to see another Betz patient! How many cm have you lengthened and any pain/stifness so far?
@Johnp86
Sorry to hear! I'll try to add more details to my diary. I think things get better after the initial consultation. They should have sent the handler out right away, to smooth the process, though Daniela had 3-5 patients to deal with so it might be hard.
@RealLostSoul
Thanks!
@Medium Drink of Water
Ok I'll give it a try.
Day 1
As it was Monday morning, I had to wait an hour to get my PCR test. This delayed the surgery by an hour. I put on the surgery clothes and was rolled to the surgery room on a bed. The last thing I remember was the anesthesia coming through my right hand causing some pain/cramp. The next thing I knew, I was in my personal hospital room. Dr Betz and Daniela helped me stand up to walk a few steps. I was also able to stand up myself to urinate in a bottle.
The pain was a lot lesser than I expected. Dr Betz used local anesthesia on the wounds. I only felt some pain when turning. I havent used any of the painkillers they've given me (yet). The key problem was that I was nauseous every time I sit up/stand up. This is likely due to the anesthesia causing diziness. I was told it will get better tomorrow as the anesthesia leaves my system. Walk training also starts tomorrow. :) The long journey begins!
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Great to hear it‘s been quite smooth as of now. So you were knocked out via IV drip and not a mask (gas)? This part is the most scary one for me (psychological) haha since I‘ve never had a surgery.
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Glad to see the surgery went well! These next few days will be tough but you will get through it.
I am currently at 4.6cm and I don’t have much pain anymore as the major pains stopped after 4-5 weeks. I have some tightness and slight stiffness but it’s manageable for now.
Let me know if you have other questions and wishing you luck for the rest of your journey. Looking forward to future updates.
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Hi All!
First time contributing publicly. Great to see so many contemporary Betz diaries!
I’ve got my session with Dr Betz booked for next month. It will be interesting to follow everyone’s progress and pick up tips along the way.
SirStretchAlot: Did you have any issues with travel to/in/around Germany and in getting to the clinic?
Good luck on your journey! You’ll do great.
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GOOD LUCK SirStretchAlot!
I am looking forward to reading your diary as my surgery with Betz is scheduled for the 29th of July... :)
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@chasing_higher_dream
I have confirmed with Dr Betz that I used the 13mm nail. There was also an initial surgery gap of 5mm (so I'm already 0.5cm taller).
@RealLostSoul
I believe the mask was only for oxygen. I was pretty sure that I was knocked out by IV. The initial cramp is the main problem. I woke up fully dressed, so I was glad I got general anesthesia. The nausea during day 1 was intense though. Couldn't sit up or eat because of the nausea.
@RB
Thanks! I was just wondering when I can shower. Hopefully my legs will be strong enough tomorrow.
@Zatoichi
Great to see you join in on the action! I personally didn't have any issues travelling around Germany or getting to the clinic. A 40 Euro train ticket takes you from the airport to the local train station with a single connection. Booking your Airbnb between the station and the hospital helps!
@DonBones
Glad to hear! He's the only one around now with weight-bearing nails. I think it's a no-brainer until maybe next year when Stryde is back. I think you've made the right decision!
Day 2
The nausea from anesthesia is now gone, so I could finally eat! The hospital food quality was poor though. For breakfast, I got 2 stale bread. Lunch was slightly better with schnitzel, fries and salad. Dinner was just ham and bread... Most nurses, including my physiotherapist have limited understanding of English. So I have to use Google Translate or just not make certain requests. I took several pills which included supplements and blood thinners. The staff are all very nice but I would say the hospital stay has been a downer overall.
On a more optimistic note, I have been able to walk back and forth in the hallways with crutches! I can walk for probably about 20 minutes before tiring. No more peeing in bottles. There's barely any pain now when I'm still. They come up only when I twist or turn. I have been able to brush my teeth, but not shower (my Day 3 goal). :)
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@chasing_higher_dream
I have confirmed with Dr Betz that I used the 13mm nail. There was also an initial surgery gap of 5mm (so I'm already 0.5cm taller).
@RealLostSoul
I believe the mask was only for oxygen. I was pretty sure that I was knocked out by IV. The initial cramp is the main problem. I woke up fully dressed, so I was glad I got general anesthesia. The nausea during day 1 was intense though. Couldn't sit up or eat because of the nausea.
@RB
Thanks! I was just wondering when I can shower. Hopefully my legs will be strong enough tomorrow.
@Zatoichi
Great to see you join in on the action! I personally didn't have any issues travelling around Germany or getting to the clinic. A 40 Euro train ticket takes you from the airport to the local train station with a single connection. Booking your Airbnb between the station and the hospital helps!
@DonBones
Glad to hear! He's the only one around now with weight-bearing nails. I think it's a no-brainer until maybe next year when Stryde is back. I think you've made the right decision!
Day 2
The nausea from anesthesia is now gone, so I could finally eat! The hospital food quality was poor though. For breakfast, I got 2 stale bread. Lunch was slightly better with schnitzel, fries and salad. Dinner was just ham and bread... Most nurses, including my physiotherapist have limited understanding of English. So I have to use Google Translate or just not make certain requests. I took several pills which included supplements and blood thinners. The staff are all very nice but I would say the hospital stay has been a downer overall.
On a more optimistic note, I have been able to walk back and forth in the hallways with crutches! I can walk for probably about 20 minutes before tiring. No more peeing in bottles. There's barely any pain now when I'm still. They come up only when I twist or turn. I have been able to brush my teeth, but not shower (my Day 3 goal). :)
Good to hear your are making progress!! :)
It's weird that the hospital seems to be average. According to the bill they sent me up to 14 days in that hospital comes to €16000. That is €1142 per day. That kind of money would pay for one of the finest hotels on the Maldives..
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Good to hear your are making progress!! :)
It's weird that the hospital seems to be average. According to the bill they sent me up to 14 days in that hospital comes to €16000. That is €1142 per day. That kind of money would pay for one of the finest hotels on the Maldives..
Betz had to move hospitals because of covid but I don‘t know if that‘s the reason though.
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That is cheap compared to the US.
A state run medical system in an old hospital and high patient to doctor or nurse ratio still costs $500 a day.
Western medical care is expensive unfortunately
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I realise it's expensive, but I'd have hoped for that money it would be at least modern, offering good food and maybe some recreational facilities. Now I know why RB didn't like it :)
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@chasing_higher_dream
I have confirmed with Dr Betz that I used the 13mm nail. There was also an initial surgery gap of 5mm (so I'm already 0.5cm taller).
@RealLostSoul
I believe the mask was only for oxygen. I was pretty sure that I was knocked out by IV. The initial cramp is the main problem. I woke up fully dressed, so I was glad I got general anesthesia. The nausea during day 1 was intense though. Couldn't sit up or eat because of the nausea.
@RB
Thanks! I was just wondering when I can shower. Hopefully my legs will be strong enough tomorrow.
@Zatoichi
Great to see you join in on the action! I personally didn't have any issues travelling around Germany or getting to the clinic. A 40 Euro train ticket takes you from the airport to the local train station with a single connection. Booking your Airbnb between the station and the hospital helps!
@DonBones
Glad to hear! He's the only one around now with weight-bearing nails. I think it's a no-brainer until maybe next year when Stryde is back. I think you've made the right decision!
Day 2
The nausea from anesthesia is now gone, so I could finally eat! The hospital food quality was poor though. For breakfast, I got 2 stale bread. Lunch was slightly better with schnitzel, fries and salad. Dinner was just ham and bread... Most nurses, including my physiotherapist have limited understanding of English. So I have to use Google Translate or just not make certain requests. I took several pills which included supplements and blood thinners. The staff are all very nice but I would say the hospital stay has been a downer overall.
On a more optimistic note, I have been able to walk back and forth in the hallways with crutches! I can walk for probably about 20 minutes before tiring. No more peeing in bottles. There's barely any pain now when I'm still. They come up only when I twist or turn. I have been able to brush my teeth, but not shower (my Day 3 goal). :)
I think I showered on the 3rd day so you seem to be on a similar track. I used the seat in the shower the first time but every time after that I was able to shower standing in one spot. Let me know how you go with it!
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- You wingspan is on good side. You would look very proportionate in terms of arms length.
- I guess we would not be able to meet, since I would not be there at that duration.
- That's great. I presume 13mm is the largest nail size of Betzbone, hence you can weight-bear without any worries :)
Dr. Betz had said he would use 11mm Betzbone nail for me, hence I have to be more careful since less nail diameter = less weight bearing.
- By the way, I had my surgery planned for 3rd of May 2021 (this is same as your date of surgery :p), but my surgery was cancelled due to some issues and got postponed.
I will have this surgery somewhere around end of May.
- Sad to hear that the hospital and its amenities are not state of the art. Nonetheless, what matters most is the surgeon who is operating on our legs, IMO, Dr. Betz is one of the best out there due to his significant amount of experience in LL field.
I wish you a safe lengthening phase.
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RB
Daniela and Betz just told me that it has to be third day not including surgery. And the nurses have to re-wrap me. UGH
DonBones
Yeah so a previous Betz patient just rolled into my room, after having his nail removed. He was at a hospital 10 miles nearby, and said it was state of the art! Good food, good fascilities, hot nurses even >_>. I think Dr Betz had to change because of Covid, though he didn't lower his hospital costs. :)
chasing_higher_dream
Aww, maybe we will be able to do the removal together? 13mm is indeed the widest nail. Dr Betz said I had very wide bone marrow. I think it really comes down to high thick-boned one is, otherwise the nail would not fit the curvature of your femur. Yeah, The hospital has been a downer, but it's great that we caught Dr Betz, since he should be retiring soon. He's training Nada, another surgeon right now.
Day 4
Still no shower, since Dr Betz said not until day 3 after surgery (not counting the surgery date). After the anesthesia wore off during last night, I couldn't sleep. Had to take painkillers to sleep. But to my surprise a former patient who came in to get his nail removed was rolled into my room. We had a blast chatting about his lengthening journey, the confidence he built, and the overall improvement in life quality he experienced. I'm more optimistic than ever. :)
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Day 4
Just realized I've been given painkillers 3 times a day. It has caused some constipation, hence why I only shat a little today. Was able to duck walk slowly over small distances without crutches. Walking with crutches is much easier. Bought external food because the hospital food is terrible. Got another person who has gotten his nail removed coming in this Friday. Clicking starts on Monday, so I still have a few days to recover.
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You will need a lot of calories to support building new bone and soft tissue. When I underwent the surgery, I lost a lot of weight despite being at the KomfortKlinik where they fed me great food snd dessert every day. I hope you are getting lots of nutrition. I only stopped losing weight months later, after clicking stopped. It's very important.
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You will need a lot of calories to support building new bone and soft tissue. When I underwent the surgery, I lost a lot of weight despite being at the KomfortKlinik where they fed me great food snd dessert every day. I hope you are getting lots of nutrition. I only stopped losing weight months later, after clicking stopped. It's very important.
Can we choose between different hospitals? :)
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inchesmatter
Wow. I'd also like to keep my upper body muscles. Is that possible?
DonBones
Unfortunately not, as it's dependent on where the surgery took place. :/ Maybe in 2 months time it'll be different?
Day 5
By far the best day so far. I was given a moderate laxative, so I completely cleaned out my bowl, and my lower belly feels great. I could walk without crutches fairly robustly, though still like a super duck. My appetite is back, mood is also better. My gym physio is also starting today, so I'll definitely update you guys tomorrow on that. Aparently my company's insurance will cover the physio and x-rays when I get back to London, which is fantastic news too. The guys who got their nails removed told me to pack as much pain meds as I can before leaving, so I'll have to look into that.
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inchesmatter
Wow. I'd also like to keep my upper body muscles. Is that possible?
DonBones
Unfortunately not, as it's dependent on where the surgery took place. :/ Maybe in 2 months time it'll be different?
Day 5
By far the best day so far. I was given a moderate laxative, so I completely cleaned out my bowl, and my lower belly feels great. I could walk without crutches fairly robustly, though still like a super duck. My appetite is back, mood is also better. My gym physio is also starting today, so I'll definitely update you guys tomorrow on that. Aparently my company's insurance will cover the physio and x-rays when I get back to London, which is fantastic news too. The guys who got their nails removed told me to pack as much pain meds as I can before leaving, so I'll have to look into that.
Good to hear you are feeling better!
Did you tell your company that you are doing LL or just that you need physio and x rays?
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Told my company about the surgery. They actually don't want too much technical details, since they want to respect health privacy. What they do need is a letter from the surgeon outlining the date of surgery, hospital stay, and rehab time/needs. This is mostly for compliance purposes. The way it works is that a GP under my insurance network will assess my needs, which is partially communicated to him by Dr Betz. The GP then refers me to x-rays and physio that are then covered by the insurance.
Day 6
The physio on day 5 really hit the spot. I was partially recovering from my gait too. However day 6 was a retraction in many ways. I had a pretty poor breakfast which caused nausea, which led to somewhat of a depression. I started questioning why I was doing this and if all the pain was worth it, and struggle was worth it. My walking regressed as well. My clicking will start on Day 8, and from everything I've heard, it causes a lot of pain and distress for most people, unlike what Dr Betz' ads suggest. It will start with a few clicks, then up to 20. I just hope I'm one of the few lucky ones who don't experience tremendous pain during clicking.
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Don‘t worry it will be better soon, your hospital stay isn‘t too long anymore as well! And about the clicking, yea I heard it can be very different from patient to patient but if you are a rather slim guy it should be okay
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It's all about internal hip rotation. I wish I had known this before being forced to click. You may undergo a bad period, but it gets easier and by the end it is effortless. It takes a lot of experimentation. You will need to figure it out over the course of a few weeks. Whatever you do, do not assume you can click just because you have a day or two of easy clicking under your belt.
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It's all about internal hip rotation. I wish I had known this before being forced to click. You may undergo a bad period, but it gets easier and by the end it is effortless. It takes a lot of experimentation. You will need to figure it out over the course of a few weeks. Whatever you do, do not assume you can click just because you have a day or two of easy clicking under your belt.
What do you mean with internal hip rotation?
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Told my company about the surgery. They actually don't want too much technical details, since they want to respect health privacy. What they do need is a letter from the surgeon outlining the date of surgery, hospital stay, and rehab time/needs. This is mostly for compliance purposes. The way it works is that a GP under my insurance network will assess my needs, which is partially communicated to him by Dr Betz. The GP then refers me to x-rays and physio that are then covered by the insurance.
Day 6
The physio on day 5 really hit the spot. I was partially recovering from my gait too. However day 6 was a retraction in many ways. I had a pretty poor breakfast which caused nausea, which led to somewhat of a depression. I started questioning why I was doing this and if all the pain was worth it, and struggle was worth it. My walking regressed as well. My clicking will start on Day 8, and from everything I've heard, it causes a lot of pain and distress for most people, unlike what Dr Betz' ads suggest. It will start with a few clicks, then up to 20. I just hope I'm one of the few lucky ones who don't experience tremendous pain during clicking.
Hang in there man. There will be days when you think it wasn’t worth it and days when you feel great it’s such an up and down experience. Hell I’m still experiencing the up and down days. Try your best to remain positive and keep us updated with how clicking goes! For me clicking was only slightly painful for 3-4 weeks and now it is totally painless so it varies from person to person.
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inchesmatter
O_O What's the internal hip rotation?
RealLostSoul
:)
RB
Thanks!
Day 8
It's exactly one week from my initial surgery and I've done my first 6 clicks! The left leg was trivial. The right was extremely painful (expecially the first 1). As far as I could recall, it's the first time I've screamed out due to pain in my life. The 6th click was a lot easier than the 1st with only minor pain. I could feel there's something mechanical inside me as when I rotate my lower leg, I could feel a mechanical resistance, and a reduction in said resistance when it clicked. For those who have problems clicking, Stryde completely replaces this process with controllable magnets, which I think is correct way forward.
As for the depression, it was mainly due to me skipping painkillers. I thought I should have as little as possible (less than what the hospital prescribes me) since it was an opoid. However, this was a mistake as it caused chronic (not sharp) pain given the slightest movement. I didn't realize it could cause depression. I'll likely never skip my pain meds again.
I really hope I can update everyone with pleasant rather than dreadful experiences in the coming week. :)
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The right was extremely painful (expecially the first 1). As far as I could recall, it's the first time I've screamed out due to pain in my life..
As for the depression, it was mainly due to me skipping painkillers. I thought I should have as little as possible (less than what the hospital prescribes me) since it was an opoid. However, this was a mistake as it caused chronic (not sharp) pain given the slightest movement. I didn't realize it could cause depression. I'll likely never skip my pain meds again.
The reality of LL. Thank u for being honest. U will learn the right click technique trial and error soon.🙏🏻
Don't skip meds.. the media is bull and typical knowledge is limited. Drug have that negative stigma to it to the point a cancer terminal ill ppl may be reluctant to take it.. sad.. Yes there is a opioid crisis but that form of extreme addiction is more to do with people not having theire together in life + doctors giving it ignorantly for minor pains.. opioids for a leg break surgery is absolutely fine and in my opinion necessary and it won't do anything bad to u net-cost wise and boosting morale and reducing pain is a must for this journey many people say the mental aspect is the biggest part and so take care of ur self mental wise
U can do this.. 👍
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Told my company about the surgery. They actually don't want too much technical details, since they want to respect health privacy. What they do need is a letter from the surgeon outlining the date of surgery, hospital stay, and rehab time/needs. This is mostly for compliance purposes. The way it works is that a GP under my insurance network will assess my needs, which is partially communicated to him by Dr Betz. The GP then refers me to x-rays and physio that are then covered by the insurance.
Day 6
The physio on day 5 really hit the spot. I was partially recovering from my gait too. However day 6 was a retraction in many ways. I had a pretty poor breakfast which caused nausea, which led to somewhat of a depression. I started questioning why I was doing this and if all the pain was worth it, and struggle was worth it. My walking regressed as well. My clicking will start on Day 8, and from everything I've heard, it causes a lot of pain and distress for most people, unlike what Dr Betz' ads suggest. It will start with a few clicks, then up to 20. I just hope I'm one of the few lucky ones who don't experience tremendous pain during clicking.
You're brave, mate! Keep it up, and if that deprenssions strikes again, remember your strugles about being short!
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Damn, I hope the clicking eventually gets better for you as the days pass.
I have surgery with Dr. Betz in less than a month and honestly, I am too afraid of all this ordeal!
I hope things would get better for you here on. Also, I presume you have just 1 week of stay left at the hospital. What are your plans post that? Are you planning to move back to the UK all by yourself? If yes, do you think you would be able to carry your luggage and go to the airport and travel? I think this is very hectic for your body, considering you have a sharp pain on slight movements...
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Sucks about the painkillers and clicking issues. Hopefully both will be resolved (become less pervasive) as the process develops and you get more comfortable with things.
It's really valuable to have your honest and unfiltered account of the entire process so people know what they are really signing up for.
Keep going! You are on the road to a bigger target. The pain is a temporary nuisance that you need to deal with along the way!
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Serilium & Future Skycraper & Zatoichi
Thanks for the encouragement!
chasing_higher_dream
At my current pace of recovery, I believe I will be able to go back to London this Sunday without aid. A slight gait will still be there especially if my muscles are not relaxed, so I still need to come up with an excuse.
Day 9
Today the clicking for my right leg was equally painful, with scream-worthy pains in 2 of the 10 clicks. I am honestly worried it will hurt my knee at some point. It is worth to note that my left leg is recovering much better than my right. My right has persistant and accute pains, less flexibility, and sharp pains during clicking. Dr Betz is a brilliant surgeon, and I trust that most patients have no problem with Betzbone. But given the pain that a good portion of patients go through (like myself), I would recommend using Stryde for its magnetic lengthening if you're willing to wait for its return.
Further, I would also like to try grouping my naps together into one long sleep if possible. Sleeping during active hours is a waste since the painkillers are in effect. When the painkillers aren't in effect, I should be fast asleep.
I started stairs training for the past 2 days. Surprisingly walking up stairs is easier than down, as the movement to go down stairs is quicker and therefore more likely to shock your muscles. Again my right has much more difficulty doing it. I essentially feel like there're 2 patients in me. My left leg is recovering perfectly, without pain, gait, and clicking as advertised. My right is the exact opposite with all the complications.
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Day 9
Today the clicking for my right leg was equally painful, with scream-worthy pains in 2 of the 10 clicks. I am honestly worried it will hurt my knee at some point. It is worth to note that my left leg is recovering much better than my right. My right has persistant and accute pains, less flexibility, and sharp pains during clicking. Dr Betz is a brilliant surgeon, and I trust that most patients have no problem with Betzbone. But given the pain that a good portion of patients go through (like myself), I would recommend using Stryde for its magnetic lengthening if you're willing to wait for its return.
I started stairs training for the past 2 days. Surprisingly walking up stairs is easier than down, as the movement to go down stairs is quicker and therefore more likely to shock your muscles. Again my right has much more difficulty doing it. I essentially feel like there're 2 patients in me. My left leg is recovering perfectly, without pain, gait, and clicking as advertised. My right is the exact opposite with all the complications.
Try streaching more with the pt, maybe it could be more painful now, but it could get better in weeks. Hope it gets better! Don't forget to talk with the pt!
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Serilium & Future Skycraper & Zatoichi
Thanks for the encouragement!
chasing_higher_dream
At my current pace of recovery, I believe I will be able to go back to London this Sunday without aid. A slight gait will still be there especially if my muscles are not relaxed, so I still need to come up with an excuse.
Day 9
Today the clicking for my right leg was equally painful, with scream-worthy pains in 2 of the 10 clicks. I am honestly worried it will hurt my knee at some point. It is worth to note that my left leg is recovering much better than my right. My right has persistant and accute pains, less flexibility, and sharp pains during clicking. Dr Betz is a brilliant surgeon, and I trust that most patients have no problem with Betzbone. But given the pain that a good portion of patients go through (like myself), I would recommend using Stryde for its magnetic lengthening if you're willing to wait for its return.
Further, I would also like to try grouping my naps together into one long sleep if possible. Sleeping during active hours is a waste since the painkillers are in effect. When the painkillers aren't in effect, I should be fast asleep.
I started stairs training for the past 2 days. Surprisingly walking up stairs is easier than down, as the movement to go down stairs is quicker and therefore more likely to shock your muscles. Again my right has much more difficulty doing it. I essentially feel like there're 2 patients in me. My left leg is recovering perfectly, without pain, gait, and clicking as advertised. My right is the exact opposite with all the complications.
It would be good to know why one leg is fine and the other one isn't, did you ask Betz about it?
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Day 9
Today the clicking for my right leg was equally painful, with scream-worthy pains in 2 of the 10 clicks. I am honestly worried it will hurt my knee at some point.
When I was in Germany back in 2012 I simply could not click the standard way that Betz taught me. So I learned an alternative way from another patient and then it was very easy:
1) Sit down somewhere with your legs wide apart.
2)Put your right hand on the side of your right knee.
3) Push the knee down without moving your feet, twisting the leg inside until you hear the click.
4) Bring the knee back up without moving your feet.
5) Repeat how many times necessary (with the old Betzbone was 10 clicks. Now it's 20)
6) Repeat the whole procedure with the left hand and left knee.
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Daniela knows all the ways to click. You have to put your foot way out to the side, then slowly push your knee inward. If you don't have your foot out far enough to the side, it won't click. It takes a lot of trial and error but after a few weeks or a month it's doable. Eventually it's so easy you will be afraid to click accidentally. I think as the nail gets longer, it may make clicking easier, too. And be sure to totally relax the leg. Do not resist at all.
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Future Skycraper
Will do!
DonBones
Asked Betz, and he said there's no particular reason, the left might become more difficult at somepoint etc...
Serilium & inchesmatter
I just tried those methods until they clicked, and the pain level is very similar. Betz told me that the reason why clicking is harder for some legs is because of the tight fit of the nail within the bone marrow. He said it will get better as the rotors loosen. Don't know if that's neccessarily a good thing, but I'll take it if it means less pain.
Day 10
Did 15 clicks on the left leg in 5 min. Only 10 on the right so far because of the pain. I screamed for a minute straight on the first click. I really hope the clicking gets better as everyone says. For those who haven't done the surgery yet, I strongly recommend waiting for Stryde for its magnetic rather than mechanical clicking if possible.
Stairs training has seen much more success. I can now walk upstairs without handrails, and downstairs with some pain (when the knees bend). The muscles have definitely stiffened up further so I need to be more active with the stretching. I noticed that my legs are spread apart when walking, which causes the waddle. I've been conciously trying to close them, and that has improved my gait substaintially.
I also noticed the lack of ibuprofen and reduction in size of novalgin in my pill tray. They're trying to ween me off painkillers, which I'm happy with, but just not during clicking. :)
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Day 11
Did 20 clicks on the left and 19 on the right (to eventually correct a 5mm deficiency on the left leg). The good news is that the clicking pain has diminished, mainly attributing to better techniques and the return of Ibuprofen. I now twist my right knee in small increments, making sure that it doesn't twist a single degree beyond what is neccessary to click. :)
The not so good news is that my hip flexors have become extremely tight when I have close my legs. It's as if there's a pin being hammered into my right hip. There is also sometimes a bubbly sensation where it feels like my right hip will disjoint with my legs. My right leg is just hopeless at this point :'(
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Day 12
My right pelvis felt like it was rubbing against a screw and it was! The most recent x-ray showed that a screw is loose and I will have to redo surgery to secure it. The good news is it's only one incision and someone can do my clicking. The bad news is full anesthesia and another god damn surgery!!!
I commend Dr Betz for his professionalism, but this complication is purely an implant/surgeon error. Re-opened wounds are more likely to bleed, and leave a scar. Repeated anesthesia is terrible for the brain.
While I'm beginning to master clicking, it still takes a good chunk of my day. At this point, I strongly recommend a Stryde surgeon.
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Day 12
My right pelvis felt like it was rubbing against a screw and it was! The most recent x-ray showed that a screw is loose and I will have to redo surgery to secure it. The good news is it's only one incision and someone can do my clicking. The bad news is full anesthesia and another god damn surgery!!!
I commend Dr Betz for his professionalism, but this complication is purely an implant/surgeon error. Re-opened wounds are more likely to bleed, and leave a scar. Repeated anesthesia is terrible for the brain.
While I'm beginning to master clicking, it still takes a good chunk of my day. At this point, I strongly recommend a Stryde surgeon.
sorry to hear this man.
But is anesthesia really bad for the brain? "repeated" = 10s of times or even just twice?
And why dont you opt for a spinal block or something?
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Sad news man, but he cannot do a local anesthesia? I had a tumora in the middle of my left tibia 10 years ago and the surgeon just did a local anesthesia in my leg to go get it, how cannot it be possible to do it just for one screw replacement ?
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Day 12
My right pelvis felt like it was rubbing against a screw and it was! The most recent x-ray showed that a screw is loose and I will have to redo surgery to secure it. The good news is it's only one incision and someone can do my clicking. The bad news is full anesthesia and another god damn surgery!!!
I commend Dr Betz for his professionalism, but this complication is purely an implant/surgeon error. Re-opened wounds are more likely to bleed, and leave a scar. Repeated anesthesia is terrible for the brain.
While I'm beginning to master clicking, it still takes a good chunk of my day. At this point, I strongly recommend a Stryde surgeon.
Sorry to hear mate. At least the screw replacement surgery will be simple and non-invasive. Did you get a chance to see what the loose screw looked like on the X-ray? I assume it was the top larger screw that was loose?
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Day 12
My right pelvis felt like it was rubbing against a screw and it was! The most recent x-ray showed that a screw is loose and I will have to redo surgery to secure it. The good news is it's only one incision and someone can do my clicking. The bad news is full anesthesia and another god damn surgery!!!
I commend Dr Betz for his professionalism, but this complication is purely an implant/surgeon error. Re-opened wounds are more likely to bleed, and leave a scar. Repeated anesthesia is terrible for the brain.
While I'm beginning to master clicking, it still takes a good chunk of my day. At this point, I strongly recommend a Stryde surgeon.
Oh no that fking sucks.
Don't worry about brain problems, while there is indeed a maximum limit you should do within some time, brain damage will not occur, especially at your age. only on old patients long operations can leave (temporary) confusion and memory issues. It's dependent on how long the surgery takes too, a screw fix will most likely not take long at all.
I don't know if you have any other options like epidural has it's downsides too. It's not only very uncomfortable, but you also get a catheter, you may have bad headaches for some days and you are paralyzed for a few hours.
The biggest thing would be bigger infection risk if you have to operate on the same spot again but other than that it should be a quick and easy fix.
How much will this ordeal cost you?
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las vegas baby & Johnp86
Yeah so Dr Betz applies local anesthesia to the wound regardless of whether general is applied. It seems to be a surgical preference of his to always gas his patients as it's easier for him to move them. Still, general anesthesia has the potential for long-term memory impairment.
RB
He needs to cut a whole to either screw in or replace the screw. I think that's invasive haha. It was indeed the top screw on my right leg that became loose. They're checking operational x-rays to see if this was a surgical error. I honestly hope that's the case because if not, there's a good chance the screw will become loose again.
RealLostSoul
I think additional surgeries due to implant/surgery errors are free, as they should be. I'm paying in the form of further physiological damage.:'( Regardless, I had to rebook my plane ticket, and push a bunch of appointments which was a logistical hassle. Staying in this hospital for 2 more days isn't the most pleasant thing either. The only good thing I see out of this, is that the nail came loose while I was still in Germany. Flying in for another 30min surgery 6 weeks later would be upsetting given COVID.
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Ok got it, i asked Dr Betz when I met him why he was the only surgeon to put horizontal screws at the top of the nail and according to him it is better
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Interesting. He told me it‘s irrelevant which type of anesthesia I choose and it‘s up to personal preference. But maybe with purely local (not epidural) you could still move your legs which would be bad.
Don‘t worry about anesthesia cognitive impairment. At your age you would rather win the lottery than getting any of this.
Definitely is a crappy situation though, please update us when you know more, I am interested in how this will go. Wish you all the best!
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Day 12
My right pelvis felt like it was rubbing against a screw and it was! The most recent x-ray showed that a screw is loose and I will have to redo surgery to secure it. The good news is it's only one incision and someone can do my clicking. The bad news is full anesthesia and another god damn surgery!!!
I commend Dr Betz for his professionalism, but this complication is purely an implant/surgeon error. Re-opened wounds are more likely to bleed, and leave a scar. Repeated anesthesia is terrible for the brain.
While I'm beginning to master clicking, it still takes a good chunk of my day. At this point, I strongly recommend a Stryde surgeon.
Sorry to hear this. This is like a nightmare! I hope you recover from this setback and continue towards your lengthening goal.
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I am sorry to hear about your troubles and hope that Dr Betz will be able to help you out. Hang in there, I am sure it will improve and in the end you will be glad you did it :)
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Holy crap, that sounds like a nightmare. This is malpractice, I am so sorry man. I hope they resolve this ASAP
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Johnp86
Yeah. Dr Betz originally used oblique nails too. However, he said that he found horizontal nails to be much more stable.
RealLostSoul & chasing_higher_dream & DonBones & PerfectBody
Thank you guys for all the well wishes! Seems like the follow-up procedure did its job.
Day 14
It was not known whether the screw was initially not placed correctly, or that it loosened overtime. Nonetheless, during the follow-up procedure, Dr Betz managed to turn the screw further inside. He has also told me that the screw is fixed tight, so it shouldn't fall out. The procedure and anesthasia were both quite brief, so I didn't have the usual side effects. The wound is on local anesthesia, so it doesn't hurt. Finally, my right lateral thigh no longer hurt from the screw contact. :)
Apparently the reason for my right leg's slow recovery is due to the excess swelling still present from the initial operation, which is unusual. I was issued tight stockings to squeeze/drain out the lymph pus, so the leg can heal properly. The stocking is very tight...
The best thing is it's my last night in this hospital ;D. The pain, poor food and lack of socialization with other LL patients made these 2 weeks quite miserable. The only thing is I hope the surgery didn't harm my right leg's clicking, which has already been difficult and painful.
I really look forward to putting the surgery recovery chapter behind me and hope there will be no complications for any future Betz patients. He is definitely the most experienced surgeon in Europe, but his nails are indeed antiquated.
Time to start my new struggle against duck ass and wide legs. :)
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Haha glad you bounced back man. I was really worried for you last night.
I’m happy to hear they operation was really small and trivial. I might have a similar issue on my left leg, it’s definitely lagging behind my right in terms of swelling and muscle recovery. Ah well let’s see who’s ty leg is tier 😬😅
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PerfectBody
Thanks for worrying buddy! Does your left leg x-ray look the same as right?
Day 17
2nd day back in London. The clicking is almost the same, but I have to start explaining to friends my gait.(I said it was a biking accident, and it seems everyone thus far bought it since I'm not that much taller yet.
I'm 1.5cm into lengthening, and I'm beginning to feel the wide-legs and obvious gait. I feel duck-ass is related to wide-legs, as standing up straight stretches the same side IT bands even more. I think I'm going to reduce to 15 clicks after 2.5cm~.
The x-rays show that my upper right leg has larger bone marrow, so the upper portion of my femur (above osteotomy) is slanted outwards, and not perfectly aligned with the lower portion as is the case with my left leg. Dr. Betz has said that the nail must adhere to the inner side of the bone marrow to prevent rattling of the nail. I can't help but to think this is what's causing my gait. I'll supply the diary with the actual x-ray when I find a CD-reader.
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Hey bro, it’s hard to say. What do you think? https://imgur.com/a/i0cgFH3
Ps keep working on your posture! Heels down before toes. It’s these small things we can’t let slide; we’re going to be fked up if we don’t constantly fight the temptation to let PT go to the wayside. Good luck man
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PerfectBody
Yeah, always trying to close them legs too =D.
Day 19
Life is settling down in London, though clicking on my right leg still takes a good chunk of my day (2-3 hours). The gait is quite apparent, and I've started physio to see which muscle group is causing it.
Walking for more than 60 minutes a day can be exhausting, so shopping can be tough. I've also noticed that I walk much slower than those around me.
I've also learned that taking painkillers through the night significantly improves my sleep. Instead of waking up after 3 hours, I can sleep for 6. Not ideal, but definitely a huge improvement. I still take painkillers 3 times a day, just in 8 hour intervals instead of 6. The pills do wear off after 6 hours, but I think the improved sleep is worth it.
I was also at an event where essentially everyone was at least 178cm with thick soles. Definitely a motivation booster. :)
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SirStretchAlot
What's your medication for the preventon of blood clots? Heparin, Aspirn or Xarelto?
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PerfectBody
Yeah, always trying to close them legs too =D.
Day 19
Life is settling down in London, though clicking on my right leg still takes a good chunk of my day (2-3 hours). The gait is quite apparent, and I've started physio to see which muscle group is causing it.
Walking for more than 60 minutes a day can be exhausting, so shopping can be tough. I've also noticed that I walk much slower than those around me.
I've also learned that taking painkillers through the night significantly improves my sleep. Instead of waking up after 3 hours, I can sleep for 6. Not ideal, but definitely a huge improvement. I still take painkillers 3 times a day, just in 8 hour intervals instead of 6. The pills do wear off after 6 hours, but I think the improved sleep is worth it.
I was also at an event where essentially everyone was at least 178cm with thick soles. Definitely a motivation booster. :)
Good to see you're improving!
I am from London too btw and will have the surgery with Betz in July :)
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Limbfan2020
Xarelto
DonBones
That's great. I would personally wait for Stryde but it definitely will not be available in July. :-\
Day 20
After some research, it is clear that I have Trendelenburg's Gait. While my left hip abductor muscles have no problem lifting my right leg up, my right hip abductors, when isolated simply cannot move my left leg in a meaningful range. This happens after hip/leg surgery and is often attributed to damage to superior gluteal nerve. I had no such issues pre-surgery, and the gait set on early after my first post-op mobilization, so it is clear that nerves were damaged during the surgery.
Nerve damage can heal, but never entirely. I will start physio on that muscle group in earnest. Immediate identification and exercise is key to recovering as much as possible.
From loose screws, to slanted x-rays, to painful clicking, and degenerated hip abductors, I am guessing at this point, there must be complications with my right leg during surgery that Dr Betz has not told me about.
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SirStretchAlot
Is the Betzbone inserted through the knee or the greater trochander?
I'm sorry to hear about all these problems. Hope you'll get well very soon!
I don't want to offend this doctor but could it be that he is too old for performing this surgery?
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Day 20
After some research, it is clear that I have Trendelenburg's Gait. [...]
From loose screws, to slanted x-rays, to painful clicking, and degenerated hip abductors, I am guessing at this point, there must be complications with my right leg during surgery that Dr Betz has not told me about.
Im' really sorry to hear you have complications. I am not sure what kind of research you did, but I'd wait until one or two doctors confirm your guess before jumping to conclusions :)
The best of luck for your recovery!
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Limbfan2020
Trochanter. I can't imagine any extendable nails being inserted through the knee. There would be little room to grind through the bone marrow necessary for insertion.
I heard from a fellow patient who had his nail removed, that Dr Betz is much less energetic now after his back surgery, almost a different person. He still seems lively to me, but forgetting to screw in a nail, is still quite a large oversight.
DonBones
My London orthopedic doctor and physio just confirmed severe Trendelenburg. My hip line is tilted up towards the left because my right hip is extremely weak. They could not ascertain whether it was nerve damage, but hypothesized my right leg likely suffered more trauma (tissue damage/bleeding) during the surgery compared to my left. The injuries and pain are likely blocking the nerve signals from reaching the hip muscle. Regardless, intense physiotherapy is the only way to recover any functionality.
Day21
Clicking is still extremely painful on my right leg. The twisting is also causing chronic knee pain. At this point, I am just taking Ibuprofen and toughing through the pain. I read another diary where the pain suddenly improved after 1.8cm. I'm near there now, so I hope it happens to me soon too. Please if you're using Dr Betz, reconsider Betzbone. There are patients who have more painful clicking than I do.
Wide legs are also very apparent now, and becoming difficult to surpress. Standing with my legs together is stressful on my it band (hip to knee). For most people, it comes after 2.5-3cm. It came much earlier for me even though I am quite active (stretching+gym+>30min of walking per day). The good news is that I have yet to see any signs of duckass.
I may not be the most successful of patients, but all that means is if I can do it, you guys can definitely excel. :)
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For the wide legs, I also developed them quite early on, just before 2cm. My legs were quite wide even while walking with crutches and I was told that it won't resolve until after clicking stops, however once I got out of quarantine in my home country and started walking a lot more, my wide legs have closed in significantly while walking with crutches, the point where they don't really look that wide anymore. They are still wide when walking unassisted unfortunately but I assume that's because I don't walk as much unassisted as I do with the crutches.
So my advice would be to walk as much as you can tolerate on the crutches each day and your wide legs should hopefully improve. Duck ass for me came after 3cm :'(
Good luck man!
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Did you contact Dr. Bentz on all the surgery issues?
Did he willing to resolve the issues with you?
It was really disturbing to hear ths mistakes he made.
....may be he is too old for the job.
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Hey man, I’m doing LON and I’m clicking as well. Holy it hurt dramatically the first day. Now the pain has subsided a very, very little bit. Whenever they rod shifts in my bone it’s super dramatic but not altogether painful lost of the times.
I heard it gets easier after another cm or so of lengthening. Then nerve pain kicks in 🤪
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RB
It's nice to know that I'm not the only one with early onset wide legs, haha. Yeah, I used to walk at least 20min daily pre-surgery, which at my post-surgery speed is equivalent to 40min of walking. I'll try to get to 60min!
Dang, I thought maybe duckass wouldn't come for me. :-\
leoth2
Yeah, I've emailed Yvonne and I should be getting a response back from Dr Betz soon. I think screws-related complications (loosening or breaking) is fairly common. They are more fragile than the nail.
PerfectBody
Oh wow, I can't describe how much I sympathize with fellow patients who suffer from clicking pain. Dr Betz and Daniela are nonchalant about clicking pains. I brought it up with them several times and they offered no solution. I even recall them re-assuring me pre-op that clicking should be painless or minimally painful. This is one part of the entire process which I felt lied to.
Day 23
I managed to do all the clicking in 1 hour today. The key is to fill the tub with very hot -- almost boiling water, and sink your entire leg into it. The first 5 clicks were almost painless. The next 5 were slightly painful. The next 5 were painful. The last 5 was as painful as if I were dry. This happens as the water in the tub cools. Make sure to also time your clicking within 1-2 hours of taking your pain meds. They are most effective then.
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RB
It's nice to know that I'm not the only one with early onset wide legs, haha. Yeah, I used to walk at least 20min daily pre-surgery, which at my post-surgery speed is equivalent to 40min of walking. I'll try to get to 60min!
Dang, I thought maybe duckass wouldn't come for me. :-\
leoth2
Yeah, I've emailed Yvonne and I should be getting a response back from Dr Betz soon. I think screws-related complications (loosening or breaking) is fairly common. They are more fragile than the nail.
PerfectBody
Oh wow, I can't describe how much I sympathize with fellow patients who suffer from clicking pain. Dr Betz and Daniela are nonchalant about clicking pains. I brought it up with them several times and they offered no solution. I even recall them re-assuring me pre-op that clicking should be painless or minimally painful. This is one part of the entire process which I felt lied to.
Day 23
I managed to do all the clicking in 1 hour today. The key is to fill the tub with very hot -- almost boiling water, and sink your entire leg into it. The first 5 clicks were almost painless. The next 5 were slightly painful. The next 5 were painful. The last 5 was as painful as if I were dry. This happens as the water in the tub cools. Make sure to also time your clicking within 1-2 hours of taking your pain meds. They are most effective then.
Seriously?
They told me during the initial phone call and the consultation that clicking may be extremely painful or not painful at all, with most people being somewhere in between. Should the pain become too much to bear, they would use local anaesthesia, they said.
Usually when I was distraught for one reason or another and argued with doctors, in the end I had a few regrets, too. If you want my advice, try and maintain a good accord with Yvonne and Betz. At the very least you want them to feel like they want to help you.
In any case, I think I can see between the lines that you are making progress, which is great. The best of luck for the next few days.
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"Usually when I was distraught for one reason or another and argued with doctors, in the end I had a few regrets, too. If you want my advice, try and maintain a good accord with Yvonne and Betz. At the very least you want them to feel like they want to help you."
Great advice, should be applied everywhere.
On another note, What made you choose Betz if I might ask? I am considering options and I think I will go with him (initial plan was stryde).
No need to answer if you don't feel comfortable by the way.
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Clicking update: there's not a ton of pain now, it just bothers the out of me. it's a super dramatic+uncomfortable sensation that shoots through your bones.
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DonBones
I definitely agree. I maintain a great rapport with them, but I can only give my honest opinions here. They never mentioned that clicking could be extremely painful. The advertisement said clicking was "painless." Guess they chose a good candidate.
sportiveshort
Chose Betz because Stryde was recalled (90% of the reason). The other 10% is Betzbone's ability to lengthen >8cm. I really have no problems with Dr Betz. Betzbone and its broken screws is what's causing complications for everyone. It's one thing to be a fantastic surgeon. It's another to be a mechanical engineer. There's a good reason why not a single doctor besides Betz have adopted BetzBone.
PerfectBody
Oh fantastic. After how many cm did the pain drop off for you?
Day 24
A major event happened yesterday. After walking for 3 hours (3x my normal distance), I felt exhilarating. All the usual tiny pains in my legs were gone and I felt great. However, the moment I got seated, I had one of the most painful experiences of my life. A solid lump formed on my lower, outer left thigh, a muscle knot. These tend to form after overusing a muscle group. The pain lasted for 4 hours, and I used every pain mitigation trick I had. I considered calling an ambulence. Luckily, the moment I sprayed a hot sprinkler directly against the lump, the pain thawed after 10 minutes.
Muscle knots form when there's insufficient oxygen and blood going through an area. This happens after muscles become super tensed to protect itself from further damage. It can happen for any number of reason. For me, it was overuse. I walked with only my left crutch supporting my right leg. My left leg was likely extremely fatigued. If my experience can help anyone, it's
1) Don't over-stress your body even if it's good to. This applies for walking >2 hours or clicking too much.
2) Use crutches! We don't want others to see us crippled, but crutches really reduce concentrated stress on certain muscle groups and reduce the likihood of the screws breaking.
3) Whenever you have pain, put something hot or spray hot water directly onto the surface. It has yet to fail for any lengthening-related pain for me.
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Just two-three days bro. I hate to say this but we just gotta plow through it. As of right now my left leg sometimes is dramatic but the pain is mostly not there! I definitely feel the tremors, but very little pain (most of the time).
My right leg started clicking yesterday. Holy sh*t just when I thought I got through it, it comes back -_- This is the second day after it started, it hurts a lot, but still less than the day before. Hoping it subsides tomorrow or saturday.
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Just two-three days bro. I hate to say this but we just gotta plow through it. As of right now my left leg sometimes is dramatic but the pain is mostly not there! I definitely feel the tremors, but very little pain (most of the time).
My right leg started clicking yesterday. Holy sh*t just when I thought I got through it, it comes back -_- This is the second day after it started, it hurts a lot, but still less than the day before. Hoping it subsides tomorrow or saturday.
May I ask which "clicking" you refer to? Your signature suggest you are with Baldu, which means it may not be the Betzbone clicking.
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PerfectBody
You got this! Wrap your knees with a heatpad when clicking. The pain comes from stiff muscles/tendons and warmth relaxes them a lot.
DonBones
The 20 degree clicking is fairly common for the mechanical elongation nails. It would make their clicking mechanism similar to Betzbone.
Day 25
The muscle knot recovered, and the lump has grown smaller. Ultrasound noted a collection near the screws, but nothing that warrants immediate attention. Crutches is key to alleviating acute stress on a specific muscle group.
The clicking has become routine. The pain is very similar, which makes it somewhat more bearable (no pain spikes). Keeping it hot can sometimes reduce the pain substaintially, which I will update this diary further with.
On the bright side, I have just asked another orthopedic doctor to look at my post-op x-rays. He said the visual misalignment is nothing to worry about. My bones will union just fine. I feel much more assured now that I got a 2nd opinion.
The doctor also said to keep optimistic, as one's mental state can influence nerve-related discomfort and pain. Clicking in the morning is also important as general movement at work will mask a lot of the minor nerve/muscle discomfort too.
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Day 27
Including the 5mm initial gap from the surgery, I should have lengthened 20.76mm. However, a height measurement (always around the same time at night) only showed a 15.7mm increase. I made sure to force my legs together and stood up straight despite the wide-legs during the measurement. My reading around the forum suggests that a 1cm increase in femur length leads to less than 1cm in height increase because the femur is curved. Tibia lengthening on the other hand, is 1 to 1. Out of the 5mm difference, I would probably attribute 2mm to the curviture, 2mm to distorted stance, and 1mm to height variation (spine compression).
What do you guys think explains the significant difference between clicked-height and measured-height? Do we gain more height as our posture/stance recovers after consolidation? Would love your insight!
On the bright side, clicking pain has dropped after 2.2cm. I can now manage the pain without painkillers or hot water. Regardless, I might reduce my clicks to 15 because I become extremely tight and immobile the day after 20 clicks. it's amazing how Dr Betz can recommend 20 clicks everyday until 3cm. Some people must be stretching like gods.
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Day 27
Including the 5mm initial gap from the surgery, I should have lengthened 20.76mm. However, a height measurement (always around the same time at night) only showed a 15.7mm increase. I made sure to force my legs together and stood up straight despite the wide-legs during the measurement. My reading around the forum suggests that a 1cm increase in femur length leads to less than 1cm in height increase because the femur is curved. Tibia lengthening on the other hand, is 1 to 1. Out of the 5mm difference, I would probably attribute 2mm to the curviture, 2mm to distorted stance, and 1mm to height variation (spine compression).
What do you guys think explains the significant difference between clicked-height and measured-height? Do we gain more height as our posture/stance recovers after consolidation? Would love your insight!
On the bright side, clicking pain has dropped after 2.2cm. I can now manage the pain without painkillers or hot water. Regardless, I might reduce my clicks to 15 because I become extremely tight and immobile the day after 20 clicks. it's amazing how Dr Betz can recommend 20 clicks everyday until 3cm. Some people must be stretching like gods.
👍🏻👍🏻👍🏻
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Day 27
Including the 5mm initial gap from the surgery, I should have lengthened 20.76mm. However, a height measurement (always around the same time at night) only showed a 15.7mm increase. I made sure to force my legs together and stood up straight despite the wide-legs during the measurement. My reading around the forum suggests that a 1cm increase in femur length leads to less than 1cm in height increase because the femur is curved. Tibia lengthening on the other hand, is 1 to 1. Out of the 5mm difference, I would probably attribute 2mm to the curviture, 2mm to distorted stance, and 1mm to height variation (spine compression).
What do you guys think explains the significant difference between clicked-height and measured-height? Do we gain more height as our posture/stance recovers after consolidation? Would love your insight!
On the bright side, clicking pain has dropped after 2.2cm. I can now manage the pain without painkillers or hot water. Regardless, I might reduce my clicks to 15 because I become extremely tight and immobile the day after 20 clicks. it's amazing how Dr Betz can recommend 20 clicks everyday until 3cm. Some people must be stretching like gods.
A lot depends on your body.
It may be curvature as you say, in case you have very curved femurs.
Another possible reason is that femurs are oblique. Example: https://i.imgur.com/bjyQJ6V.jpg. If you have X-Rays of our femurs from which you can infer the needed angle, you can use the pythagorean theorem to figure out how much that explains the disparity in length. It's unlikely to be the full 5mm difference, but could be responsible for perhaps 1.5-2mm.
Yet another reason may be the stance as you say or even simple measurement errors.
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Day 27
Including the 5mm initial gap from the surgery, I should have lengthened 20.76mm. However, a height measurement (always around the same time at night) only showed a 15.7mm increase. I made sure to force my legs together and stood up straight despite the wide-legs during the measurement. My reading around the forum suggests that a 1cm increase in femur length leads to less than 1cm in height increase because the femur is curved. Tibia lengthening on the other hand, is 1 to 1. Out of the 5mm difference, I would probably attribute 2mm to the curviture, 2mm to distorted stance, and 1mm to height variation (spine compression).
What do you guys think explains the significant difference between clicked-height and measured-height? Do we gain more height as our posture/stance recovers after consolidation? Would love your insight!
On the bright side, clicking pain has dropped after 2.2cm. I can now manage the pain without painkillers or hot water. Regardless, I might reduce my clicks to 15 because I become extremely tight and immobile the day after 20 clicks. it's amazing how Dr Betz can recommend 20 clicks everyday until 3cm. Some people must be stretching like gods.
You can't stand 100% after lenghtening, and you lose mm due to things like duck ass or wide legs. An user I taltk to via whatsapp told me that, after doing 8 cm, he had gained only 6.8 when finished lengthening. Two weeks after, after recovering posture and all, he has gotten 7.6, so he has only lost like 4 mm due to femur shape
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I realise it's expensive, but I'd have hoped for that money it would be at least modern, offering good food and maybe some recreational facilities. Now I know why RB didn't like it :)
Based on other physicians that offer cheaper prices in Europe you might find in this situation that you get what you pay for. I can name one European LL specialist not to go to. It could cost more in terms of treatment, outcome and emotional stress. Betz sounds like a very good choice and wished I had tried him. I got lucky with the guy I chose but learned a valuable lesson. Read all the comments and remember this, few people have the impetus or desired to report negative reports. Consider the motivation of the comments or at least how they appear. I believe some unscrupulous docs maintain bogus bloggers to maintain "their good reputations" based on my experience.....I may report in detail at some point in the future.
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You will need a lot of calories to support building new bone and soft tissue. When I underwent the surgery, I lost a lot of weight despite being at the KomfortKlinik where they fed me great food snd dessert every day. I hope you are getting lots of nutrition. I only stopped losing weight months later, after clicking stopped. It's very important.
So do you have any caloric recommendations and supplements, ie, Calcium, protein ?
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Abbot
I noticed that I didn't gain any fat despite eating double my BMR per day (3.4k cal vs 1.7k cal). In my case, I do think I'm expending at least 1.5k more calories in my recovery. I've always eaten a high protein diet since I gymed. Calcium and vitamin supplements will be part of your post-op prescription.
V21 & DonBones
I think he's very lucky to have only lost 4mm after lengthening 8cm. Elsewhere I've read that people generally lose 1mm for every 1cm lengthened. If someone were to lengthen 10cm, he would only gain 9cm in height. In my case, I lost 5mm after only lengthening 2.2cm, which is quite disturbing.
Day 28
Today is the last day of my sickleave. I will probably have less time to write diaries in the future, but I think today is a pretty good transition point.
1) I've lengthened 23.62mm by clicks and initial gap. However, my measured increase has only been 17mm. This >5mm gap is quite consistent and concerning. I believe a screw might be bent somewhere and is reducing my height. This was what frequently happened to others who magically lost height during lengthening.
2) This is why I've since been using both crutches when I'm outside. I'd rather not take my chances with Betzbone not deforming over the lengthening period. Heck, I've seen x-rays of Stryde nails bending. I think walking without crutches is definitely an advertising stunt for all "full weight-bearing" nails. You should always walk long distances with crutches simply so you don't have to replace your nail in another surgery.
3) The clicking on my left leg has been trivial. Almost no pain and I can do all 20 clicks in 10 minutes. The right leg still has pain, but technique improvements has allowed me to reduce it to a brief second. I did it in a little over an hour. 1.5 hours in total today, which has been a record. I believe at this rate, I can get it down to 30 minutes in a month, which would be manageable with work.
4) I will be finally getting my first post-home-lengthening x-rays next week. I really hope there's callus and no nail/screws are deformed, especially since Germany has put more quarantine restrictions on travelling. Will be the biggest update since op. Stay tuned :)
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Day 31
A few small developments over the past few days.
1) Sleeping with Tizanidin (muscle relaxer), and Novaminsulfron (painkiller), gave me an 8-hour sleep. I did not take increased dose, but just elongated each pill-period to 8 hours instead of 6. I woke up briefly in the night, but was able to go back to sleep easily. It was simply the best sleep I got since the start of lengthening.
2) I've weaned myself completely off Tramadol. I found it to not provide any additional pain relief. Since it was an opoid, I was slightly depressed for 2 days.
3) Clicking with Ibuprofen (another painkiller) can be done with minimal pain. This is the best tip I can give for those who face pain clicking.
4) It is actually quite good to do this procedure over the summer, because we are more active and the muscles will be warmer. (lucky us)
5) I found being active (walking a lot) to be the single biggest contributor to the recovery. Walking while forcing each step to close your legs really helps. In terms of sleep, pain, and mood, I'm at my best following days of abundant walking. It is extremely exhausting, but I found it much more effective than stationary stretching.
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28.97mm
Thought it'd probably be better to denote the lengthening progress through length rather than date.
1) Slept on a latex foam topper last night. I was skeptical at first after reading about it on the forums, but it did indeed improve my sleep. I got a full 6 hours last night, and woke up with fewer sores.
2) Stopped taking Ibuprofen for clicking too, as the clicking pain has improved yet again. So the only painkiller I'm on is Novalgin. It doesn't do much, but it's supposed to relax muscles.
3) I've gone back to work part-time (4 hours a day). I intended to work full-time, but between sleep, stretch, and physio, conforming to a standard work schedule is extremely difficult.
4) No sign of duckass yet
5) My wide legs are hideous despite my best stretching efforts. :( Does anyone happen to have any tips to tackle this?
Thanks!
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31mm
1) Had a pretty bad day yesterday where my wide legs almost immobilized me. Extensive stretching and Tizanidin returned me to the day before. It is truly a losing battle, and I had to stretch whenever I had the chance to stand still (waiting for bus, in elevator, etc...).
2) I think Dr Betz should've done an IT ban release, which would have given me 2cm~ of lengthening before wide legs set in. Knowing Betz, he probably won't do one. So if you're looking to lengthen > 7-8cm, consider another doctor who does IT band releases unless you are already very flexible.
3) I have also stopped taking Novalgin (Novaminsulfon), as it was almost useless. The 2 drugs that will relieve you of pain is 1) Tizanidin (muscle relaxer) and Ibuprofen (general NSAID painkiller, though not good for bone reneneration). Tramadol was also useless as mentioned previously. I've done a grid-search of every drug combination thrice, to arrive at these conclusions.
4) Physio will have a lot of massages and specific gait training. While useful, it is ultimately up to you to stretch whenever, wherever.
5) Sleep without Tizanidin (2-3 hours). With Tizanidin (4-6 hours).
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Congrats on crossing the 3 cm mark, it's definitely a milestone!
Btw, I have too stopped taking Ibuprofen since now I am 10+ days post-surgery.
Right now, there are only 2 pain killers prescribed: Tramadol and Novalgin. I have been taking these and the pain has been relatively low.
I know the hardships you are going through right now, but just think about the end goal and keep moving forward!
I wish you good luck.
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Left: 41.14mm | Right: 37.24mm
Hey guys
1) I got my first 6-week post-op x-ray. The nails/screws are perfectly in place. Callus is growing strong. Walking with crutches really reduces the burden on the implants.
2) Clicking pain has been minor. However, my right leg still takes significantly more strength and time to click. I would say on average, 0.78mm each leg would take an hour in total.
3) Good news aside, my first worry is the angling of the femur head and shaft (in red lines) it is not straight compared to my left femur. This is due to the wide marrow on my right leg and has been like this since after the operation. Betz said it won't be a problem, but I am still concerned.
4) The 2nd worry (also visible in the x-ray) is that my wide-legs is beginning to immobolize me. I am essentially swinging side to side instead of walking forward. I am also stretching as much as humanly possible, to the extend that my hip and knees are starting to hurt. At this rate I probably won't be able to walk by 5cm. I am seriously considering an ITB release, which I think any good surgeon should have recommended for a patient with tight ITB in the beginning...
(https://i.imgur.com/ZP90k5J.jpg)
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Hello SirStretchALot.
Congrats on reaching the 4 cm mark. That’s almost 50% of the lengthening done!
Your callus growth looks fantastic. Regarding the alignment of bone, I have seen a couple of X-rays on this forum with similar case. So, I assume this is nothing new and hopefully will turn out all good as Dr. Betz says.
Regarding wide legs, are you doing stretches to explicitly target the IT bands? If yes, which stretches?
Also, I was curious about why did you lengthen your left and right leg at different rates?
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Hello SirStretchALot.
Congrats on reaching the 4 cm mark. That’s almost 50% of the lengthening done!
Your callus growth looks fantastic. Regarding the alignment of bone, I have seen a couple of X-rays on this forum with similar case. So, I assume this is nothing new and hopefully will turn out all good as Dr. Betz says.
Regarding wide legs, are you doing stretches to explicitly target the IT bands? If yes, which stretches?
Also, I was curious about why did you lengthen your left and right leg at different rates?
Haiya chasing,
Yeah I really hope the alignment turns out well, or it will structurally widen my legs :/
I widen/close my legs 50-100 times per set while laying my back on a flat surface. It's what Dr Betz personally demonstrated in the hospital as his most effective stretching exercise.
According to my pre-op x-ray my left femur was 5mm shorter than my right. However, the most recent x-ray showed that my left was 2mm longer which means I over-adjusted 2mm (likely due to initial surgical gap). It's important to take length references from multiple x-rays. Fixing length differences at the end based on one x-ray may not be the best practice.
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47.12/44.26mm
Hey guys, my leg abduction (wide legs) has reached 58cm when standing still. This is making my entire body swing when trying to walk. The gait is also making basic mobility exhausting.
My quads, hipflexors are completely flexible. I lost some hamstring but it is not affecting my daily routine. Stretching is working for everything but the IT band, which continues to ache during sleep and widen my legs.
To this end, I have consulted several European LL surgeons and have decided with Dr Giotikas since he had a surgical slot on July 1. To my surprise, he only charged 2250 euros for the consultation, operation, anesthasia, and 3 day hospital stay. This is extremely inexpensive. This is a simple procedure but I doubt he's making any money from this. There are still fantastic doctors in this world who don't want to profit from patient complications!
On the brightside, I am officially over the 50% mark. Sleep has improved after taking muscle relaxants before sleep. I can now sleep sound for a full 6 hours, and roll in my bed for another 2 hours.
Will update again after my ITB release. I personally recommend prospective patients who wish to lengthen >5cm in their femurs to only go with doctors who perform it. It is such a deal breaker, as there's no reason to fly to another country for a second surgery.
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Nice mate. Wishing you best of luck for the release. Keen to hear how you recover from it and how your wide legs are afterwards as I have mine booked for end of July.
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All the best for the release surgery. I wish everything works out well for you.
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49.51/46.65mm
Hey guys, I arrived in Athens yesterday and had my pre-ops done today. Several things to note
1) Due to a horizontal tendon running perpendicular to the IT Band, an ITB release will narrow the legs noticebly but not completely post surgery. Stretching and glute strengthening will need to continue to fully narrow the legs. Bearable gait is achievable a week after op with normal gait returning 1-3 months after lengthening ends.
2) Had I done the ITB release during nail insertion and stretched as I have since the beginning, I would not have experienced wide legs. Thanks Betz...
3) There will be no hospital stay. I will be discharged 5 hours after operation, though I'll have to stay in Athens for 3 days at my own expense.
4) Dr Betz seems to be ignoring my emails, as it has been 7 days since my last reply. (I did not mention ITB release with another surgeon)
Will update you guys tomorrow after my operation!
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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) A release is done by cutting a portion of the ITB from the intermuscular septum, seperating it from nearby tissues thus freeing it. Holes can be punctured into the band itself to make it even looser. The connection to nearby tissue as well as the holes will first scar, then remodel into its original fasia over time.
*This is partly why you want to lengthen as quickly as possible, especially in the beginning, since once the band and holes heal, you will be tight again.
*Most patients with ITB release complications tend to be runners or atheletes who put too much stress on their ITB before it fully heals
*Recovered bands usually appear and function near identically to uncut bands.
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 and the pain should disappear tomorrow. It has not affected Betbone clicking.
5) They could not fully 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 would have. It is definitely not an "optional" procedure for many. Not doing it is deviating from standard practice.
Here's a video of how it's done. The actual incision is smaller than in the video. https://www.youtube.com/watch?v=Xl8xBRKP6n4
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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
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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.
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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!
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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 ?
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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.
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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
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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.
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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.
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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.
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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?
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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.
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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).
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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.
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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?
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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.
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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.
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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.
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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?
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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?
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@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.
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Not long to go mate you are in the home stretch!
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@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 :)
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<Deleted comment>
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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 :)
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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. :)
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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+.
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@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.
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@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.
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@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!
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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!
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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.
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Thanks guys.
What do you guys think of 10cm? Now that i'm at 8cm, I think it's a real possibility. The only concern I have is that since I'm so wide already, I don't know if I'll ever be able to stretch enough to walk normally.
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Thanks guys.
What do you guys think of 10cm? Now that i'm at 8cm, I think it's a real possibility. The only concern I have is that since I'm so wide already, I don't know if I'll ever be able to stretch enough to walk normally.
The wide legs is not a problem in long term, since the legs can be closed in with sufficient PT over a period of time. But the extra gained height would be permanent 🙂 If your body allows it and if you are fine with the proportions, I don’t think there is any problem with going to 10 cm. The max limit is very individualistic and it varies for different people.
The only thing which I would be worried about is the mobility and function once you are back to normal. There is this guy on this forum called “BetzLandLiberator” and he seems to have also lengthened 10 cm and he claims that he is doing perfectly fine.
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The only concern I have is that since I'm so wide already, I don't know if I'll ever be able to stretch enough to walk normally.
Congrats on the 8! I think that your question though answers itself it you posed it literally as opposed to figuratively - ever walk normally again for just 2cm more?? Only you can truly judge, but if that’s a real concern, my 2 cents is no of course don’t go for 10; if on the other hand you’re just saying it’d be a lot more work and time to get there - again which you are the best judge of - your call. I seem to recall your original plan was 9; that seems to be very doable for you. It’s all gravy from here on though it would seem. 8 cm is a major success in and of itself. Good luck and congrats on the 8! Upward and onward 💪
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I agree. Wide legs / duck butt big deal. You go crazy at PT for a year and in the mean time just walk around like a cowboy challenging people to pistol duels...
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93.92/90.80mm
Hey guys, I just passed 9cm! Several things to note
1) I have started getting knee pain on my right leg. My ortheopedic doctor said that it was likely caused by my quads and ITB being overly tight, and thus pulling on my knee caps whenever I tried to move my knees. They told me it was a sign that my muscles are reaching their stretching limit.
2) I have also experienced significant muscle atrophy past 8cm. Walking has become very difficult, and I am having trouble walking without crutches. Lengthening after 8cm is quite exhausting.
3) Cliking at 0.78mm consistently has significantly softened my callus. This has made clicking trivial and painless. Clicking over 0.78mm causes nerve pain, so I think 0.78mm or 15 clicks is a sweet spot, where I can lengthen fast enough to escape hardening callus and not too fast to avoid neve pain. For those who have clicking pain, don't slow down clicking!
4) I have started getting compliments from girls for being "tall." Some have guessed that I'm 6' even though I'm 5'11. It seems that girls aren't that good at estimating heights. They just want you to be a head taller and give them an impressive around number so they can brag to their friends it seems...
Despite all the inconveniences, I am still on track to 10cm. I am looking forward to the end of lengthening so much. Only 2 weeks left!
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10 cm is crazy. :o
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Woah! Fantastic progress.
Good luck reaching your final goal and a successful recovery.
I'm currently only at roughly half your length and am sick of the entire process. I can only imagine the superhuman efforts and focus required for getting to 9-10 cm! Well done.
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Congrats on reaching 9 cm :)
Knee pain and other related problems will most probably go away once you stop lengthening.
You are the among very few who would be doing 10 cm, incredible. Requires a lot of patience, suffering from pain, and courage to go into uncharted territory.
What was your initial tibia to femur ratio when you were 170 cm?
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congratuliations. 9cm is already a huge success. i hope you will recover well!
so now you will be 1,80m tall? damn i would be happy with 1,76m already. haha but everyones different.
im saving up for dr betz now too haha i need this surgery so bad 8)
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@overandover
Yeah it is 8)
@Zatoichi
Thanks for the well wishes. I think it's mainly the amount of time stretching takes out of my day that is most fraustrating. Other than that, muscle relaxants and painkillers generally do their job :)
@chasing_higher_dream
Thanks. I didn't see many 10cm diaries, so I hope mine helps. I don't actually know my tibia-femur ratio pre-LL, but I can always just subtract 10cm from my final x-ray to see. I'll update you that.
@FiveSevenWannaDi
Yes 1.8m! Going from 1.7 to 1.8 is a huge change since it's below to above average. Though I can probably get another 6-7cm from tibias, I definitely want another surgery, lol.
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@overandover
Yeah it is 8)
@Zatoichi
Thanks for the well wishes. I think it's mainly the amount of time stretching takes out of my day that is most fraustrating. Other than that, muscle relaxants and painkillers generally do their job :)
@chasing_higher_dream
Thanks. I didn't see many 10cm diaries, so I hope mine helps. I don't actually know my tibia-femur ratio pre-LL, but I can always just subtract 10cm from my final x-ray to see. I'll update you that.
@FiveSevenWannaDi
Yes 1.8m! Going from 1.7 to 1.8 is a huge change since it's below to above average. Though I can probably get another 6-7cm from tibias, I definitely want another surgery, lol.
oh S, you've gotten a lot taller now. Congrat to join the 1m80+ tall group
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@ SirStretchAlot
Great diary! At which length have you noticed an exponential increase of pain/tightness/stiffness etc.
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@ SirStretchAlot
Great diary! At which length have you noticed an exponential increase of pain/tightness/stiffness etc.
Thanks. I would say that rather than the length, it's the pace of lengthening that causes nerve pain/tightness. This usually happens because one is lengthening faster than the nerves and muscles can stretch/grow.
Slowing down to 0.78 or 0.52mm usually almost always eliminates any discomfort. However, lengthening too slow would cause the callus to harden, which increases mechanical resistance to clicking/lengthening.
Lastly, a good night's sleep will eleminate any leg problems you will have for that day because more of our body's resources are proportionally dedicated to wound healing during sleep.
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SirStretchALot - Wow! Congrats on all the progress and thanks for the diary. Very inspiring. Must be crazy good to have all that new height and can only imagine how rewarding that must be. I’d be curious to hear about reactions from those who observe you after and knew you before. Good luck with finishing up with lengthening and everything moving forward! 👍
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SirStretchALot - Wow! Congrats on all the progress and thanks for the diary. Very inspiring. Must be crazy good to have all that new height and can only imagine how rewarding that must be. I’d be curious to hear about reactions from those who observe you after and knew you before. Good luck with finishing up with lengthening and everything moving forward! 👍
Reactions are funny and sometimes awkward. The look of confusion on people’s faces sometimes made me uncomfortable. It has to be one of the weirdest situations I’ve been in because it really does defy normal logic and people have perplexed looks.
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Haiya. My experience is slightly different than itseasy. Since I was on a weightbearing nail, I continued to socialize with friends and they witnessed my height gains gradually. No one has ever been confused by my height increase because there was never any shock.
I'd imagine this would only be a surprise to family members or bros who were previously your height but is now shorter. For girls and boys who you were already taller than before, there shouldn't be any adverse reaction.
Being able to say 180 or 182cm on a dating profile got me so many more likes. For every 10 people who viewed my profile previously, I'd get probably 6 who matched me. Now it's 8, a 33% improvement. If you want to quantify this, you would be 33% more attractive after LL, haha.
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Damn bro 9 cm!!!
So u did ITB and even with that still getting wide legs?
How's your gait?
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Damn bro 9 cm!!!
So u did ITB and even with that still getting wide legs?
How's your gait?
Thanks. Yeah, ITB release helps a lot, but stretching is still needed to prevent wide legs. However, I'm quite confident it'll narrow since everyone from surgeons to past patients told me it'll narrow with enough stretching.
My gait is quite bad because I've completely lost my glutes. This is normal for all LL patients.
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Hey I noticed your wingspan in 170cm and your new height is 180cm does it look like a big difference in the mirror? I think Henry Cavill has a 10cm difference in wingspan and honestly he doesn't look too bad just wondering what your thoughts are.
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Hey I noticed your wingspan in 170cm and your new height is 180cm does it look like a big difference in the mirror? I think Henry Cavill has a 10cm difference in wingspan and honestly he doesn't look too bad just wondering what your thoughts are.
So 10/170 is around 5.88%. The wingspan difference is barely noticeable unless one measures it. Though, my femur length probably increased by triple this relative to its old length, so I do notice that my femurs are quite long.
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101.46/98.34mm
Hey guys, I'm 3 days away from my right leg reaching 10cm! A few points of note:
1) The nerve pain from even 0.78mm is quite pronounced for the last 5mm. I wake up 3-4 times per night. Pills aren't really effective, so I'd have to tough it out.
2) Stretching has still been effective with hamstrings and IT bands. So now hip flexors or duckass will be my main focus.
3) X-rays show a slight upward bend in the upper screws of my right leg. I am sending it to Betz for analysis.
4) My femur to tibia ratio is around 1.49 which considering the median is 1.28 (2SD ± 0.08), my femurs are indeed considered quite long.
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That's amazing, 10cm is awesome! Congrats!
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Congrats. You are just almost there on the finish line. Just a few days to go :)
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wow 10 cm just in femurs!! That's impressive congrats hope you can rehab well... and regarding proportions yea for sure your femurs are going to look cosmetically longer than "normal" but who cares at least you'll be almost 4 inches taller lmao.
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This has been a super interesting read and huge congrats on reaching 10cm. I'm 3cm below your starting height and I'd kill to gain 10cm and end up at 177cm.
I think the overall opinion on Betz on this forum is somewhat mixed so it's interesting to see someone else in the UK who went with him and has had a good result. Onwards and upwards for consolidation and recovery.
I'm hoping to do this surgery in the next 2 years (25 now) if I can still run (a little), cycle and do squats and go hiking then I'll be happy. Look forward to hearing how you recover bro.
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104.42/100.00mm Mission Accomplished!
Hey guys, I've reached 10cm! My left was lengthened a bit more to match the length of my right. It has taken 139 days or 4.5 months since surgery day. Below is a summary of key points through out the lengthening process. I will update it with my recovery as I recall more.
Lengthening Schedule
I lengthened 1mm/day for the first 3cm, 0.78mm for the next 4cm, and 0.52mm for the last 3cm. The first 3cm was quite easy, as there was a lot of flexibility. However, starting at 3cm, I started getting very wide legs due to tight IT Bands. I got an ITB release with Giotikas and it has helped with my stretching a lot. Up to 7cm, my stretching kept up with my lengthening. My legs started to narrow during the last 3cm, as my stretching got more efficient and the lengthening slowed. I thought about stopping at 9cm, but my body felt fine so I went for 10cm. However, the last 0.5cm was exceptionally hard. I got daily nerve pain, and prolonged TFL soreness. My body and Betz basically told me 10cm is the max, even though the Betzbone nail technically allowed 12cm.
In summary, your stretching time is a function of your lengthening pace. 0.52mm ~ 1 hour, 0.78 ~ 1.5 hour, 1mm ~ 2 hours. Any less, and your gait will likely worsen.
Gait
I can close my legs completely, but the duck ass will look very severe, so I leave them slightly widened so I can stretch more effectively. With the ITB release, stretching the ITB became easier. Hamstrings and Quads are generally easy muscles to stretch. My anterior pelvic tilt (duck ass) is partly due to weak gluteous muscles, which I have none and need to work on. What I hear from past patients and surgeons is that the gait almost always recover fully, so I'm not too worried.
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Congrats! And, thanks for the insight on stretching time as a function of distraction rate. Very helpful to know. Good luck and again nice job!
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104.42/100.00mm Mission Accomplished!
Hey guys, I've reached 10cm! My left was lengthened a bit more to match the length of my right. It has taken 139 days or 4.5 months since surgery day. Below is a summary of key points through out the lengthening process. I will update it with my recovery as I recall more.
Lengthening Schedule
I lengthened 1mm/day for the first 3cm, 0.78mm for the next 4cm, and 0.52mm for the last 3cm. The first 3cm was quite easy, as there was a lot of flexibility. However, starting at 3cm, I started getting very wide legs due to tight IT Bands. I got an ITB release with Giotikas and it has helped with my stretching a lot. Up to 7cm, my stretching kept up with my lengthening. My legs started to narrow during the last 3cm, as my stretching got more efficient and the lengthening slowed. I thought about stopping at 9cm, but my body felt fine so I went for 10cm. However, the last 0.5cm was exceptionally hard. I got daily nerve pain, and prolonged TFL soreness. My body and Betz basically told me 10cm is the max, even though the Betzbone nail technically allowed 12cm.
In summary, your stretching time is a function of your lengthening pace. 0.52mm ~ 1 hour, 0.78 ~ 1.5 hour, 1mm ~ 2 hours. Any less, and your gait will likely worsen.
Gait
I can close my legs completely, but the duck ass will look very severe, so I leave them slightly widened so I can stretch more effectively. With the ITB release, stretching the ITB became easier. Hamstrings and Quads are generally easy muscles to stretch. My anterior pelvic tilt (duck ass) is partly due to weak gluteous muscles, which I have none and need to work on. What I hear from past patients and surgeons is that the gait almost always recover fully, so I'm not too worried.
Congrats on completing your lengthening journey. At last, the pain and suffering for so many months has come to an end.
Going from 170 cm to 180 cm is a huge leap and it is world-changing in many ways.
I wish you all the best in your consolidation and for holistic recovery :)
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Congrats on completing your lengthening journey. At last, the pain and suffering for so many months has come to an end.
Going from 170 cm to 180 cm is a huge leap and it is world-changing in many ways.
I wish you all the best in your consolidation and for holistic recovery :)
Thanks so much! How goes your recovery? I noticed my leg strength has returned remarkably.
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Thanks so much! How goes your recovery? I noticed my leg strength has returned remarkably.
My recovery is going on well. Just after 5-6 days post stopping lengthening, the tightness in my muscles has reduced by roughly 40-50%. Also, sleep is way better now.
In terms of leg strength, I did not see much of a difference yet. I will be starting strength training exercises for my leg from the start of October to build back the lost strength and almost non-existent leg muscles.
Also, I have started to gradually phase out pain killers, muscle relaxants and blood thinner tablets. Since then, I have noticed that I am having some knee pain in my left leg when I walk with full weight-bearing. I assume I did not realize about this pain till now, since pain killers were doing their job well.
The path to recovery is a slow and gradual process, so I am keeping my expectations low.
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My recovery is going on well. Just after 5-6 days post stopping lengthening, the tightness in my muscles has reduced by roughly 40-50%. Also, sleep is way better now.
In terms of leg strength, I did not see much of a difference yet. I will be starting strength training exercises for my leg from the start of October to build back the lost strength and almost non-existent leg muscles.
Also, I have started to gradually phase out pain killers, muscle relaxants and blood thinner tablets. Since then, I have noticed that I am having some knee pain in my left leg when I walk with full weight-bearing. I assume I did not realize about this pain till now, since pain killers were doing their job well.
The path to recovery is a slow and gradual process, so I am keeping my expectations low.
Fabulous about getting more sleep. I've noticed the same. I think if you tried to walk more, the strength will return by themselves. It's really the glutes that need strength training if you have a strange gait.
Oh by the way, do you have an anterior hip tilt (duck ass)? I have one when I narrow my legs and it is difficult to stretch. How would you stretch yours out?
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Fabulous about getting more sleep. I've noticed the same. I think if you tried to walk more, the strength will return by themselves. It's really the glutes that need strength training if you have a strange gait.
Oh by the way, do you have an anterior hip tilt (duck ass)? I have one when I narrow my legs and it is difficult to stretch. How would you stretch yours out?
Yes, I am trying to walk as much as I can, as it would also help in bone consolidation.
Luckily, I do not have any duck ass. Throughout the lengthening journey, for hip flexors, I did either of the below stretches:
1. Kneeling hip flexor stretch with help of Wall bars (image link (https://imgur.com/a/2ouqo30)) - This was my primary stretch for hip flexors.
2. Standing hip flexor stretch (image link (https://imgur.com/a/45N1StS)) - Crutches can also be used when you are leaning forward to be safer.
I presume because of these stretches I did not develop any duckass.
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@chasing_higher_dream
Thanks! I've been doing those stretches and they seem to be quite effective. Another one I did is simply lie on my chest with my legs closed. Compressing my butt downwards seem to cause a lot of pain/stretching on the legs, which I assume means it's working. :)
Post-lengthening Week 1
Hey guys, it's been a week since I ended lengthening. Overall I see minor improvements on discomfort/sleep, duckass/wide leg, and strength. However, the pace of recovery is slower than I expected. My duck ass is especially severe, but am working on it!
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congratulations for everything you have been achieving. You have been brave but in the end it seems that everything has been worth it. I see that your experience has gone through many difficulties in just 4 and a half months and I wonder if many of Dr. Betz's patients went through the same thing. I am almost 100% sure that within two years I will undergo a leg lengthening process but I am still hesitating between Dr Betz or Halil Buldu from Turkey. I live in the Netherlands so dr Betz could be a better option in terms of location. I really appreciate your information as it has given me a general idea of the lengthening process.
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Hey man, congrats on the 10 cm ! I'm scheduled for surgery this winter with Betz and I hope to be as successful as you :-)
I have one question for you (and also for other people who lengthened):
Pre-op, what are the most important muscles to strengthen ?
ie: what muscle did lose the most strength after the operation ? And what muscle you wish would have more strong right now ?
What weak muscles are preventing you from having a normal gait?
Thx
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@I want 8,07 cm
Betz and Buldu really can't be any more different. Betz uses Betzbone and doesn't do ITB release, while Buldu uses Precise and does ITB release. However, they are both known to provide little aftercare. I believe Giotikas is probably a stronger choice, as he does both Precise and Gnail, and isn't that much more expensive than Buldu. Since you're a European citizen, I'd also probably just stay in Europe (Betz/Giotikas), as your insurance will probably cover more and you have more legal recourse should things go wrong.
@Roger1300
Thanks. I wouldn't consider myself a success yet, haha. Maybe after when my walking completely recovers :)
1) Strengthening muscles pre-op is pointless as more muscles means less flexibility, and more muscles to stretch.
2) Glutes are the main muscles you lose through lengthening and what will affect your gait. However, you will lose them regardless, so I'd focus much more on stretching your hip flexors, quads, hamstrings and ITB pre-surgery.
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Recovery Week 2
Hey guys, the second week has been so much better!
1) Significant leg strength recovery. I can now stand for significant amount of time and walk 50% more before tiring.
2) Stretching progress has been slower. While the legs can narrow almost completely, the duckass has only improved a moderate amount.
Now that I've stretched my legs into a better shape, I will likely move to targeted glute strength training so I can stop swinging when I walk.
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Recovery Week 3
1) Steady progress. Legs narrowed. Discomfort reduced. Can stand-up from chairs without arm assistance, though still a struggle.
2) Duckass or anterior pelvis tilt is still apparent, especially when legs are closed. Trying various hip flexor stretches and glute strengthening exercises. I see some result, but it is very slow. In retrospect, I should have stretched harder during lengthening so it would not have progressed to this stage.
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Wow congrats on 10 cm man! Can you show us video of your walking gait?
Did 10 cm alter your squating motion?
How much percentage do you think you lost in sprinting speed?
Thanks!
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thanks for the update and congrats on the recovery. I'm pretty sure that the strength of your glutes (both medium and long) is as important as the flexibility of your hip flexors to prevent duck ass...
btw, people: my surgery with Dr. Betz is scheduled at the very beginning of December.
If anyone has a date with Betz before December and wants to switch with me, I'm open to it! DM me.
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Reading through this diary just gave me confirmation bias that Dr. Betz is either too old to be conducting this procedure or just flat out does not care about his patients at all. The man is like 70 or 71 for Christ sake. His earlier reports have been good but he’s been on the downhill slope for the past year. You claim to have gone through (3!!!!?) surgeries total???? Along with that what kind of doctor that cares about his patients allows them to lengthen 10cm with a 12cm max? You said after you left Germany he stopped responding to your messages? Marvelous. As of rn I have looked into manhoubian, giotikas, or even Paley as the main players that everyone has to go to right now, if any of these doctors have bad reports link me please I’d like to read them. But I’m sorry man you went through hell and back and I commend your perseverance through all the pain.
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@Antonio111111
I'll probably record something once I'm better, but right now my gait is still noticeably abnormal.
@Roger1300
So after a full doctor checkup, it was determined that my anterior pelvis tilt (duck ass) was due to tight TFL muscles, not hip flexors, as most people would presume. What this means is that you should definitely have your IT band released, or risk major deformities later on.
@KillerShark
I believe Betz is just too busy to worry about patient after care. My left leg feels slightly mechanically loose/shaky when I pivot on it. I'd say Giotikas or Payley would be great bets. I have not read much about Manhoubian.
Recovery Week 5
Hi guys, sorry I've skipped out for 2 weeks. Have just started work in another city, and had to settle a lot of admin. Regardless going forward, as changes become incremental, I think my updates will become less frequent, until my gait completely recovers.
1) The great news is that my leg strength has almost completely recovered. I can walk for up to 20 minutes quickly without much fatigue. I remember struggling with 10 minutes during the last few weeks of lengthening. Your strength will return quite quickly after lengthening stops.
2) Widelegs/duckass are still here, manifesting in the form of a very ugly anterior pelvis tilt. As I mentioned to Roger1300, this is due to very tight TFLs, that are difficult to target-stretch. This is compounded by the fact that I lengthened 10cm. My physiotherapist assured me that I will return back to normal eventually, but most likely by the end of the 7th month post-op (I'm on my 6th).
Hence I would like to ask everyone to not underestimate your recovery time. Expect at least 5-7 months of recovery time depending no your age and lengthening goal. Plan your life around it.
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So after a full doctor checkup, it was determined that my anterior pelvis tilt (duck ass) was due to tight TFL muscles, not hip flexors, as most people would presume. What this means is that you should definitely have your IT band released, or risk major deformities later on.
I disagree. The majority of Betz patients do not do IT band release and we are fine. I'm fine 9 years later after 9,5cm.
What most Doctors that do IT band release don't tell you is that your IT band won't ever be as strong again if you release it and this can give you knee problems later.
You had your surgery with Betz, then follow his advice which is to not do IT band release unless you're an extreme case.
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I disagree. The majority of Betz patients do not do IT band release and we are fine. I'm fine 9 years later after 9,5cm.
What most Doctors that do IT band release don't tell you is that your IT band won't ever be as strong again if you release it and this can give you knee problems later.
You had your surgery with Betz, then follow his advice which is to not do IT band release unless you're an extreme case.
I did my ITB release seperately with Giotikas. I've advocated for it so much that Betz is now making exceptions for patients who want it done.
Tight ITB is actually the usual cause for knee problems. In fact most atheletes with tight bands eventually get them released when physio fails.
Remember, the TFL is only 15cm long. Stretching it by 10cm or 66% of its original length will have severe reprocussions when it's injured.
Cutting the ITB saved me 2-3cm of TFL lengthening. You're essentially trading the safety of your fibrous tissues (ITB), for an actual soft tissues (TFL). I'd make that trade any day. Betz is the only one who doesn't perform ITB, and even that is changing.
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I did my ITB release seperately with Giotikas. I've advocated for it so much that Betz is now making exceptions for patients who want it done.
Tight ITB is actually the usual cause for knee problems. In fact most atheletes with tight bands eventually get them released when physio fails.
Remember, the TFL is only 15cm long. Stretching it by 10cm or 66% of its original length will have severe reprocussions when it's injured.
Cutting the ITB saved me 2-3cm of TFL lengthening. You're essentially trading the safety of your fibrous tissues (ITB), for an actual soft tissues (TFL). I'd make that trade any day. Betz is the only one who doesn't perform ITB, and even that is changing.
Yes, Tight ITB band can cause knee problems, but a harmed/weak IT band can cause problems too. There are tons of papers about that. Just google it.
You were just impatient and harmed your body for no reason, unlike dozens of other Betz patients who took their time and went back to normal without IT band release.
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I disagree. The majority of Betz patients do not do IT band release and we are fine. I'm fine 9 years later after 9,5cm.
What most Doctors that do IT band release don't tell you is that your IT band won't ever be as strong again if you release it and this can give you knee problems later.
You had your surgery with Betz, then follow his advice which is to not do IT band release unless you're an extreme case.
It’s insane how “being busy” is an excuse to not check up on your patient in which you mangled his legs with 2 surgeries. You could have been left with lifelong pain, I just think betz only cares about 1 thing and 1 thing only: money. He took your money and did not follow up, he’s old and should be retired but he’s preying off people like us with mental illness, along with allowing you to get 10CM!!!!!! 10 CM bro. Your legs are gonna most likely recover at 75% 3 years post op, no real doctor would allow that, no way in fk all paley, mahb or even giotikas would allow that medical malpractice to occur. I do not hate any doctor in any way, but just from this journal and other journals in the last year, it seems Betz just stopped giving 2 s and an Indian doctor doing LON would do a better job than he aims to do.
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Lol just because SOME patients lengthened a lot and didn't have ITB issues doesn't mean that in most cases it's not absolutely required! Why would you let patients potentially run around with duckass deformity and wide legs for months and months on end? what good does that do?do you know what kind of chain reaction running around like that is produced in your body? Instead of doing a very simple procedure upfront that prevents all of that bull youre basically playing Russian roulette with them and give them potential disabilities that keeps them from walking permanently if not addressed later on in another surgery. Betz is against releases and has No valid reason to show for that. "not wanting to harm healthy tissue" is pointless when that "healthy" tissue is producing major deformities during and after lengthing. Even a child would understand that concept. Reading through diaries on this forum clearly shows how many patients got this problem and how careless he reacted to most of them. But I guess all these patients are wrong and just "aren't doing enough PT" or even funnier "don't stretch out their ITB enough" right? But hey at the same time they are gladly allowed to lengthen 8,9,10,11cm right?
Ehh....
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Dear buddy,
I booked my surgery with Dr.Betz in Jan 2022. So with regards to the tight IT bands, intensive physio sessions and stretching won't solve out the problem when it comes to the IT band tightness?" Did Dr.Betz tell you other ways to get rid of it other than doing IT band release surgery? (I know that he refuses to do the extra surgery for IT band release).
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Dear buddy,
I booked my surgery with Dr.Betz in Jan 2022. So with regards to the tight IT bands, intensive physio sessions and stretching won't solve out the problem when it comes to the IT band tightness?" Did Dr.Betz tell you other ways to get rid of it other than doing IT band release surgery? (I know that he refuses to do the extra surgery for IT band release).
Well it depends on how much you will lengthen but in general the ITB is known to be Ver very stubborn to stretching hence why most well known docs do an ITB release profilactically, if you want to lengthen a certain amount.
Betz always tells his patients with ITB problems to do more PT or train harder which is straight up insane considering how many of his patients suffer with these issues and they can't do anything about it except go for a release surgery later on. He didn't tell me anything about potential ITB issues upfront and when I told him about the problem via WhatsApp he straight up ignored me.
I'm 4 months into consolidation, wasn't able to walk one step unassisted due to this issue until I had my release surgery on monday. Today I was walking outside WITHOUT crutches for the first time so since the surgery on Monday I made more progress than the past 7 months with the tight ITB hindering my walking gait. GO Figure. makes me angry when people on here downplay this as if it's not that important or it's just something you can "stretch out" like a muscle. IT'S NOT THE SAME AT All.
Who wants to lengthen for 3 months and do up to 1 year of daily intense PT on your itb just to be able to (maybe!) walk again?this is totally unnecessary suffering that could easily be prevented and betz has NO valid reason to not lengthen the ITB, a lot of his patients suffer from duckass/wide legs and he straight up ignores them or even worse blames them for the issue.
Hope that answers your question.
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I have an email from Dr. Betz's wife where I write in detail about the complaints on ITB release and she says, if you want it released, just ask for it and he will do it no problem. When I consulted with him, he said it's unnecessary but he will do it if you request it prior to the surgery. I believe this is new and he didn't do this before.
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I have an email from Dr. Betz's wife where I write in detail about the complaints on ITB release and she says, if you want it released, just ask for it and he will do it no problem. When I consulted with him, he said it's unnecessary but he will do it if you request it prior to the surgery. I believe this is new and he didn't do this before.
Ah okay interesting. but still... Him saying it's "unnecessary" is a flat out lie.I mean HE should guide his patients regarding that based on how much length they want to go for, not leave the choice up to unexperienced potential patients and let them decide, after all he is the expert and he needs to know when a release is necessary and when it's maybe optional. Damn,so backwards. I really liked betz at first but his behavior as a surgeon is straight up shady and dishonest in a way.
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Well it depends on how much you will lengthen but in general the ITB is known to be Ver very stubborn to stretching hence why most well known docs do an ITB release profilactically, if you want to lengthen a certain amount.
Betz always tells his patients with ITB problems to do more PT or train harder which is straight up insane considering how many of his patients suffer with these issues and they can't do anything about it except go for a release surgery later on. He didn't tell me anything about potential ITB issues upfront and when I told him about the problem via WhatsApp he straight up ignored me.
I'm 4 months into consolidation, wasn't able to walk one step unassisted due to this issue until I had my release surgery on monday. Today I was walking outside WITHOUT crutches for the first time so since the surgery on Monday I made more progress than the past 7 months with the tight ITB hindering my walking gait. GO Figure. makes me angry when people on here downplay this as if it's not that important or it's just something you can "stretch out" like a muscle. IT'S NOT THE SAME AT All.
Who wants to lengthen for 3 months and do up to 1 year of daily intense PT on your itb just to be able to (maybe!) walk again?this is totally unnecessary suffering that could easily be prevented and betz has NO valid reason to not lengthen the ITB, a lot of his patients suffer from duckass/wide legs and he straight up ignores them or even worse blames them for the issue.
Hope that answers your question.
I am more conservative than you of course but I had no wide legs. Like none whatsoever. Therefore I am glad Betz didn't cut any more of my soft tissue than needed, and so I agree with him that ITB release needs to be specifically requested by whoever wants / needs it, and definitely shouldn't be the default course of action. So yeah, there are different points of view :)
Good luck!
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I did 10cm and I didn't need IT band release. Most Betz patients don't need it. He's correct in not suggesting this for the majority of patients. It's always better to not have unnecessary extra surgeries.
Legendkiiller stop generalizing - your case is not the norm for most Betz patients, including the ones that did 9cm or 10cm. You needed IT band release, most of his patients don't.
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I did 10cm and I didn't need IT band release. Most Betz patients don't need it. He's correct in not suggesting this for the majority of patients. It's always better to not have unnecessary extra surgeries.
Legendkiiller stop generalizing - your case is not the norm for most Betz patients, including the ones that did 9cm or 10cm. You needed IT band release, most of his patients don't.
LOL that not true at all. It's not like I was one only case needing it, some don't but a lot of people do and that's why he's unprofessional in letting THEM decide now whether or not they want to have that done. He should tell them based on their goals and their individual flexibility! He didn't even tell me about that potential issue during the consultation or after at all! Not one word. When I told him about me having wide legs and itb issues even months after lengthing asking him for a release he simply ignored me and one time even told me to "stop texting me because he had other clients to answer". You think that is professional?? I paid him 52K and he couldn't even respond to texts and basically told me to not write him anymore.
I talked to other people and a buddy of mine who had surgery on the same date and he also ghosted them later on. You talk about me generalizing but that blind betz statement "it's not needed/unnecessary" is a slap in the face for every patient who needed it later on and we'll you should read a few diaries or talk to a few people outside and you'll find out that quite a lot of people had these issues and had it fixed later on. Get out of your bubble just because YOU didn't need it. You were lucky then.
Defend him all you want but even aside all of that his behavior as a surgeon and his noncare afterwards is something potential patients need to know about because it's really a shame and sadly quite "the norm.".
Btw: didn't you have surgery with him like 9 or 10 years ago? he might have been different then with keeping up with clients when he was a little younger but right now it's totally gone downhill. You can't tell people who paid you over 50k for surgery to shut up and ignore their issues. I really hope that's at least a point we both agree on dude!
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Hey guys, sorry for the lack of updates. Work has been consuming. I thought it's time for a big update considering it has been over 7 months.
1) I can now walk for about 20 minutes at a normal pace, twice a day without crutches.
2) My gait has improved significantly, in that I think it will be unnoticible within a month time.
3)
i) I still have duckass, or anterior pelvis tilt. Narrowing my legs makes the tilt more severe. My back is sore after long walks as it tries to curve backward, in an attempt to compensate for my hip tilting backwards.
ii) While BetzLandLiberator and DonBones have never had a problem with it, myself and LegendKiller suffer greatly from it. I think it is also somewhat correlated with knee pain while clicking.
iii) I have been doing many quad and hip flexor stretching exercises, but they have not been effective in combating my duckass. Emails to Betz/Danielle have been met with "just do the stretches on the package." At this point, I wonder if my pelvis will ever be put back into shape. Does anyone else have good recommendations for good stretches against anterior pelvis tilt / duckass?
Thanks!
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Do you think if you lengthened, say, 2cm less you would not have as severe duckass?
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to fight duck ass, I think stretching hip flexors is important but even more so is to have strong glutes. Both gluteus medium and Maximus. When you contract them, they are the muscles that get your pelvis from anteriorly tilted to normal position. If your glutes are very strong, your gait will be straight without anterior tilt.
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@thankscience
Lengthening less always helps. I think everyone will eventually stretch back in place, but the last 2cm, especially the last 0.5cm really complicated the healing process
@Roger1300
Yeah, I've seen many explainations online about it being short hip flexors and/or weak glutes. However, when I do contract my glutes, my TFL or the side of my pelvis, connected to my ITB is clearly blocking the hip-forward motion. The cause of the tilt is ITB for LLers, which is different for normal people who sit too much.
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Did you contact Giotikas to see what he recommends for this issue? Hope your recovery is going well now!
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Hey guys, sorry for the lack of updates. Work has been consuming. I thought it's time for a big update considering it has been over 7 months.
1) I can now walk for about 20 minutes at a normal pace, twice a day without crutches.
2) My gait has improved significantly, in that I think it will be unnoticible within a month time.
3)
i) I still have duckass, or anterior pelvis tilt. Narrowing my legs makes the tilt more severe. My back is sore after long walks as it tries to curve backward, in an attempt to compensate for my hip tilting backwards.
ii) While BetzLandLiberator and DonBones have never had a problem with it, myself and LegendKiller suffer greatly from it. I think it is also somewhat correlated with knee pain while clicking.
iii) I have been doing many quad and hip flexor stretching exercises, but they have not been effective in combating my duckass. Emails to Betz/Danielle have been met with "just do the stretches on the package." At this point, I wonder if my pelvis will ever be put back into shape. Does anyone else have good recommendations for good stretches against anterior pelvis tilt / duckass?
Thanks!
Hey man I just read this and since you mentioned my name I Wanted to share a few points on here. As you probably know I had pretty severe ITB and wide legs issues as well, even 5-6 months post finished lengthing. Betz simply ignored my issues and didn't help at all. I finally made my own choice and got my ITB released in November with another surgeon. It made a huge difference in my recovery and as of right now I'm back to walking normally without any wide legs or duckass. I want to make it crystal clear that without and ITB release now almost 1 year after LL surgery I would still be suffering with wide legs and duckass/Anterior pelvic tilt. My ITB simply failed to get accustomed to my lengthing process and I'm pretty sure that would NOT have changed significantly on its own. There's a reason why almost all surgeons do an release, especially with the lengthing amounts betz allows his patients to do. It blows my mind that he simply doesn't do it and then leaves his patients to their own devices. Maybe some of them are lucky and don't need it but at least he should offer it for patients like me and maybe you who do indeed need to get their ITB lengthened in order to not walk like an idiot for months and months on end. Not to mention all the joint and muscular issues that come from walking with wide legs and duckass for that long.
So IMO if you waited for months post lengthing and issues still prevail you should think about a release rather than wasting more time on stretches, of course stretching is super important but it won't cut it when it comes to these ITB issues. Watching myself being able to walk normally a few weeks post release was eye opening in how important It is for recovering your gait and making atequare progress like you should.
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He apparently already had an ITB release during the surgery, so I'm not sure if he can do it again now?
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I’m curious to know how squatting is with such a large increase to the femurs.
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I’m curious to know how squatting is with such a large increase to the femurs.
你不觉得他做的太多了吗？ 我只建议大腿6厘米最多
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How are you going now 1 year later?
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How are you Sir?
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Hi guys, appologies for the long hiatus. Work has consumed me for the past few months. Here's the 14 month update!
Pros
1) Height increase has significantly improved my dating pool and experience. Compared to my career and face, height had always been my weakness. Dating app matches have more than doubled, and the confidence of being taller than other guys frees your mind from the insecurity. This allows you to be more alpha in pursuit, which most women prefers.
2) No further degradation in nail or screw structure beyond the slight upward screw bend that happened 3 months in.
3) No apparent walking gait
4) Can jog and squat lightly
5) Right and left leg length descrepency closed from 0.6mm to 0.1mm
Cons
1) New bones are still darker on x-rays implying that they are not as dense as my natural bones. This means that I will not likely take out the nails in the immediate future. Note that this is a natural feature of weightbearing nails. They are harder than non weight-bearing nails like Precise, thus don't compress as much. This leads to less weightbearing for your bones post-lengthening, leading to slower bone densification. Regardless, the benefits of weightbearing nails still far outweighs the time difference in bone densification.
2) Since I lengthened 10cm and 10.4cm on my right and left legs respectively, recover has taken much longer than normal. My hips still feel sore if I sit for too long, and daily stretching is still required.
3) Lordosis/Duckass/Anterior Pelvis Tilt is still present under the mirror. This is due to tight hip flexors and tensor fasciae latae (attached to your iliotibial band). These muscles need to be stretched much more than your quads and hamstrings because they're much smaller.
Overall
I believe my operations has been a success. However, having needed 2 top-up surgeries for a loose screw and ITB release, made the first few months much more difficult. I am lucky to have worked with a firm that gave me medical leave, which made the entire endeavour much less burdensome financially. While I can carry on with normal life, I will likely have many more years if not a lifetime worth of stretching to do. Do note that while it is definitely possible to squat more, or do impact sports that involve your lower body, the increased length of your legs will mean that the chances of fracture will be greater. It is much easier to snap a long tree branch than a short one.
The silver lining is that post-operation, you will have learned much more about your lower body, and the need for stretching. Most people have lordosis, and this leads to back problems later on in life. I often had back pain when I walked long distances pre-op(>45min). Only after the surgery, did I know it was due to tight hip flexors and ITB. I believe with more stretching I can reach a state, where my back is less curved than pre-op, which will actually improve my posture beyond pre-op.
Good luck to your journey!
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Three years after my surgery, I have pretty annoying hip pain after sitting for awhile, such as driving my car and doing a simple errand. Getting out of the car, I look like a ninety-year-old man, stooped over. I'm not sure it will ever go away. I have to walk it off.
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Three years after my surgery, I have pretty annoying hip pain after sitting for awhile, such as driving my car and doing a simple errand. Getting out of the car, I look like a ninety-year-old man, stooped over. I'm not sure it will ever go away. I have to walk it off.
How much did you lengthen and what method did you use?
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Three inches. Betzbone. I didn't walk or move as much as recommended. I am a couch potato. I know of others who are not, though, and have the same problem (one guy).
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Any other long term issues? Did you get itb
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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) A release is done by cutting a portion of the ITB from the intermuscular septum, seperating it from nearby tissues thus freeing it. Holes can be punctured into the band itself to make it even looser. The connection to nearby tissue as well as the holes will first scar, then remodel into its original fasia over time.
*This is partly why you want to lengthen as quickly as possible, especially in the beginning, since once the band and holes heal, you will be tight again.
*Most patients with ITB release complications tend to be runners or atheletes who put too much stress on their ITB before it fully heals
*Recovered bands usually appear and function near identically to uncut bands.
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 and the pain should disappear tomorrow. It has not affected Betbone clicking.
5) They could not fully 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 would have. It is definitely not an "optional" procedure for many. Not doing it is deviating from standard practice.
Here's a video of how it's done. The actual incision is smaller than in the video. https://www.youtube.com/watch?v=Xl8xBRKP6n4
Dr Betz has now become the complete package, and we are so grateful he offers excellent lengthening and ITB release together.
Would you recommend we go for the soft ITB release, or the full one?
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Dr Betz has now become the complete package, and we are so grateful he offers excellent lengthening and ITB release together.
Would you recommend we go for the soft ITB release, or the full one?
you seem to be obsessed with "soft" ITB release. why you care that much about not having ITB release like all US doctors offer?
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How are you now ?
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Hey guys do you think 4,5 cm wir betzbone would be a Good Choice and fast recovery ? ( 4,5cm in femurs)
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Do you think it's worth the 60k just to do 4-5cm?
Hey guys do you think 4,5 cm wir betzbone would be a Good Choice and fast recovery ? ( 4,5cm in femurs)
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Yes i think it is Worth. Better recovery and better proportions of femur and tibia. I think this amount would fix my height neurosis
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What's your current height?
Yes i think it is Worth. Better recovery and better proportions of femur and tibia. I think this amount would fix my height neurosis
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Do you think it's worth the 60k just to do 4-5cm?
I agree with you on that totally. Yes the less cm the quicker your recovery but I must say to me personally the very least amount that would have been worth it was 7cm. Bc that’s about when I truly felt that I gained length. Even visually when looking down at my legs etc.
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Dayheight 165-165,5 cm
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Dayheight 165-165,5 cm
same height as you, just do 8 man, 3 more cms, what if later you regret not doing it, being 170 is okay but 173 is a very normal height in the usa just lower average rather than short like 165 is. unless you are in like an asian country or India then ignore what im saying
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Did Goitikas do the full ITB release or did he do a soft release?
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I’m also a former patient of Dr. Betz and damn do I relate so much to these issues addressed in this diary. I also struggled severely from wide legs and duck ass, and was told to basically stretch + his very slow replies to my emails regarding any concern.
I lengthened 9 cm, and even 3 years post op, I am struggling with tight hips and the worst part “snapping hip” when I walk. And this never went away, although my wide legs and duck as has improved it was slightly present when narrowing my leg and standing straight. No amount of stretching or PT has adequately helped - and it only helps to a certain point.
I had to get my it band release by Dr. Becker last week and it immediately fixed my snapping hip.
So yeah, anyone doing a great amount of cm, should be offered an it-band release at least.
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I lengthened 9 cm, and even 3 years post op, I am struggling with tight hips and the worst part “snapping hip” when I walk. And this never went away
What exactly do you mean by snapping hip?
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What exactly do you mean by snapping hip?
You would know if you have it. Basically your IT band is tight and snaps around your curved hips due to the tension. Makes walking unnatural. Its the last thing that gets solved because you really need things to get loose for it to go away and its tough to stretch that last bit.
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@Siegfried basically what lessthanavg8300 is describing. A very weird sensation and freaks out other people for sure lol. My gf was terrified when she felt the "pop"
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This is so mind blowing. I can't emphasize this enough guys, medical research has shown that the ITB band is fairly resistant to stretching. Stretching is so important yes, but so much evidence and an incredible ammount of testimony here has been precisely in favour of the ITB release.
I am so happy your problem was resolved.
I am due to have my surgery, and i genuinely will beg for a full ITB release. I don't want to pay this much money only to stop early because for me, if i get those complication it might stop me from getting past the length i want.
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Hey let us know if you'll return for an update?
I also found this, which corroborates what you've said about the ITB release you had with Goitikas
Read this: https://uesca.com/it-band-syndrome-myths-and-facts/
"Let’s first address stretching. The ITB is a very tough structure. In fact, in a 2010 study by Falvey et al., a strain gauge was used to test various stretches on the ITB and the result was that the ITB was unaffected.
Therefore, it is highly unlikely that stretching will have any effect on the ‘tightness’ of the ITB."
I highly recommend reading this: https://www.painscience.com/articles/iliotibial-band-syndrome-stretch.php
"Even if you do everything right, even if you perform the ideal stretch and manage to pull firmly on your IT band for a couple minutes — which is longer than most people ever bother — how much would you actually change the length of your IT band? How far would it move?
Roughly 2 millimeters — an overall change in length of less than half a percent.
You still won’t actually change its length, any more than you can make a leather belt longer by pulling on it. This is the most important thing IT band stretchers need to understand."
And also this: https://thedoctorsofpt.com/it-band-pain-myth-v-reality/#:~:text=Myth%202%3A%20The%20ITB%20can,to%20actually%20induce%20a%20stretch.
"Myth 2: The ITB can and should be stretched
Since the ITB is made up of fascia, which is different from a muscle, it’s nearly impossible to stretch it. It would take way more force than we’re capable of producing on our own, to actually induce a stretch. This is a good thing – since the roles of the ITB are to stabilize the side of the knee and provide energy storage and release during running, we don’t really want it to be stretchy anyway. "
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If you have recent imaging data please put it at this thread. Redact any information that could be used to dox you.
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Hi guys, it has been 2 years since my surgery. Here's an update.
1) As discussed in the thread, ITB release is critical. I have had both of my legs released, but my right hip is still tight. It occasionally has a popping sensation mentioned below as well. It was coincidently also the one I had pain clicking. It is just a tighter leg.
2) I do not have a visible gait.
3) My hip and hamstrings muscles have fully recovered. However, the quads are thin and difficult to train since I have begun to have knee problems.
4) The most important story is the chronic knee pain. My left knee had always been the easier leg to click, stretch and recover. However, this may also be the reason why it is now chronically in pain. I suspect the femur-tibia traction is off. I do not know if it is due to the lengthening surgery, ITB release, or my poor squatting posture. Note that people with elongated femurs will always put more stress on their knees when squatting the same depth, given a longer angular distance / leverage point.
Already contacted Betz, Giotikas, and generic physiotherapists to no avail. Might enlist more professional knee therapists. Would appreciate any of your insights as well!
Thanks
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Thanks for the update. Have you taken the nail out yet?
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3 years (RHS 8cm Precice femur) , one year (LHS Precice Femur 8cm) post surgery, both knees click and pop more so than pre-surgery, now both knees are stiff all the time and the LHS TFL gives me pain almost constantly esp. noticeable if knees are bent for a few minutes of sitting then trying to stand up, usually have to grab something to pull me up or push off with hands - yes like an old man.
Squatting pre surgery was easy, and i could squat 100 lbs no problem, and could deep Asian squat (like squatting in a rice paddy field) for 15 minutes easy with no pain , but now max squats with no weights at all is like 15 reps before knees/thigh give out, esp left knee gives me pain, I cannot really deep squat now at all, note I usually do 100 full pushups, groin stretches (Yoga poses) and 4*10 body squats per day, I ride my bike daily to work and gym 3 times a week I am 66kg at 5 10.5 and not unfit, during squats i now have to lean back and keep my hands locked behind my neck to stop myself toppling over forwards.
I walk ~ 2 klms at least daily and my tibs (frontalis muscles) get very pumped to the point I have to slow my walking and let the pump dissipate before I can pick up the pace again, this maybe due to my new T/F ratio of 0.72, my running is comical and slow, I hate this tbh as I was fast before surgery, I have considered lengthening Tibs to help the T/F ratio as this may solve the walking running issues?.
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@thankscience
I still have the nails inside as I'm still doing hard stretching. Looking to remove them in the next 12 months, perhaps with another ITB release on my right.
@throwaway123456
Ah, it must be due to our T/F ratio then. My right leg is actually OK, but my left has completely given in. I'm around 68kg and active as well. I guess not all parts of us recover post a major surgery, sigh.
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Your journey was one of the journeys that inspired me to go on this myself
and i have surgery in 3 months time.
Betz has now retired, and Becker has taken over.
He is offering a 'soft' ITB release, where they poke holes to create a mesh type elasticity/stretch, as opposed the the kind of ITB release that is more aggressive that you had with Goitikas that gives you a proper, rather than soft release.
It is absolutely amazing to have you post on here. Legitimately, what is life like ten centimeters taller? How does it feel?
And with regards to your iTB release with Goitikas - did you get this done while still lengthening, and do you know what sort of iTB release it was? I.E. Z cut?
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and i have surgery in 3 months time.
I thought your surgery was in July? Why 3 months?
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Your journey was one of the journeys that inspired me to go on this myself
and i have surgery in 3 months time.
Betz has now retired, and Becker has taken over.
He is offering a 'soft' ITB release, where they poke holes to create a mesh type elasticity/stretch, as opposed the the kind of ITB release that is more aggressive that you had with Goitikas that gives you a proper, rather than soft release.
It is absolutely amazing to have you post on here. Legitimately, what is life like ten centimeters taller? How does it feel?
And with regards to your iTB release with Goitikas - did you get this done while still lengthening, and do you know what sort of iTB release it was? I.E. Z cut?
Very glad my diary was useful. And it may be better that Betz retired, he was quite old and already prone to error.
Besides the knee pain, lengthening 10cm has completely cured my height neurosis. Dating has become significantly easier, which was my main motivation.
Pieracing the ITB with holes is what they perform on athletes with runner's knee. It provides "relief" rather than "release".
Giotikas explained that poking holes was inadequate for purposes of limb lengthening. He performed a diagnal cut near on the ITB near the knee, where it's thickest.
The reason why Betz did not like ITB release is because it is what keeps your legs laterally stable. It is unclear to me if the full ITB release caused my knee problems as the ITB provides lateral protection to the knee.
The main drawback to mechanical nails is the clicking which damages your knee over time, not that there's an alternative right now.
I would still recommend a full release nonetheless, as it was still inadequate for my right leg which is still tight all along the ITB, from hip to knee.
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I have never read that the clicking damages the knee over time. Why would this be the case?
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@throwaway123456
Ah, it must be due to our T/F ratio then. My right leg is actually OK, but my left has completely given in. I'm around 68kg and active as well. I guess not all parts of us recover post a major surgery, sigh.
My starting T/F ratio was around 0.72, so I don't think that ratio in and of itself is problematic.
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No disrespect intended :) , but 0.72 T?F ratio is rare in the natural population, the measurement is hard to make via palpitation, was this verified with long leg standing XRay or CT ?
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No disrespect intended :) , but 0.72 T?F ratio is rare in the natural population, the measurement is hard to make via palpitation, was this verified with long leg standing XRay or CT ?
Do you know what is the distribution of T/F ratio?
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from this study "Normative Values for Femoral Length, Tibial Length, and
the Femorotibial Ratio in Adults Using Standing
Full-Length Radiography"
Radiographed adults " . Lower limb length, femoral length, tibial length,
and the femorotibial ratio were measured in 1077 limbs"
They found F/T ratio mean was 1/1.28 = 0.78 (T/F), from the graph in the study ~ 1% had a F/T ratio of 1.39 (0.72 T/F))
"The overall ratio of femoral length to tibial length was 1.28:1 (2SD ± 0.08) with a
normal distribution. The calculated ratio for patients with shorter-than-average tibiae
(length < 39 cm) was 1.29 (2SD ± 0.07), which was the same for men and women. This
differed significantly from the ratio of 1.27 (2SD ± 0.08)"
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Thanks for sharing! I looked up that paper, looks like they only had 753 patients. I wonder whether it's enough or not.
Anyhow, my doctor (Rozbruch) measured the ratio using a full leg x-ray during my consultation, so I think it's pretty accurate. I believe the actual ratio was 0.74, but I think my point still stands.
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Thank you so so much.I absolutely love your post.
I had a call with Goitikas and he said the same, this 'soft' ITB release will do next to nothing for people who are basically lengthening their legs - we are not runners, we are literally breaking bone and lengthening our limbs by many inches.
Becker is an amazing surgeon, as was Betz, but Becker seems to think we should not damage a perfectly healthy tendon, that it will cause severe imbalance and seriously impede recovery and that many, 8, 9, 10 cm lengthen femurs with no ITB release.
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Very glad my diary was useful. And it may be better that Betz retired, he was quite old and already prone to error.
Besides the knee pain, lengthening 10cm has completely cured my height neurosis. Dating has become significantly easier, which was my main motivation.
Pieracing the ITB with holes is what they perform on athletes with runner's knee. It provides "relief" rather than "release".
Giotikas explained that poking holes was inadequate for purposes of limb lengthening. He performed a diagnal cut near on the ITB near the knee, where it's thickest.
The reason why Betz did not like ITB release is because it is what keeps your legs laterally stable. It is unclear to me if the full ITB release caused my knee problems as the ITB provides lateral protection to the knee.
The main drawback to mechanical nails is the clicking which damages your knee over time, not that there's an alternative right now.
I would still recommend a full release nonetheless, as it was still inadequate for my right leg which is still tight all along the ITB, from hip to knee.
How difficult was it to fly to Greece after having been to Germany , to get the essential ITB release?
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Hi all, I just saw a sports physiotherapist and my knee pain is almost entirely fixed now.
1) Turns out that my quads were too tight, which made it pull on my knee cap. This impacted knee traction, which ultimately caused the pain when bending. Discomfort while sitting was a dead giveaway. Joints rarely causes pain when they're not being used or inflammed. Muscle tightness was obvious in hindsight. Do stretch your quads until your heel touches your glutes in a lunge.
2) I was informed that given my elongated femur, my center of gravity has shifted forward significantly during squats. This means that my knee will be stressed much more than a regular person when squatting. He recommended that I should never squat beyond my body weight (68kg~). Normal people can usually squat until 1.5x their body weight (100kg in my case) if they had normal t/f ratio.
@sixfootandhalf
1) It was not difficult flying to Greece as I was mobile 3 days after the surgery.
2) I think ITB release has a chance of reducing knee stability but the tissue will heal completely. From past diaries I've never seen anyone get to 10cm without doing an ITB release. Your TFL is only 15cm long. It's simply impossible to stretch a muscle by 65%.
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Hi all, I just saw a sports physiotherapist and my knee pain is almost entirely fixed now.
1) Turns out that my quads were too tight, which made it pull on my knee cap. This impacted knee traction, which ultimately caused the pain when bending. Discomfort while sitting was a dead giveaway. Joints rarely causes pain when they're not being used or inflammed. Muscle tightness was obvious in hindsight. Do stretch your quads until your heel touches your glutes in a lunge.
2) I was informed that given my elongated femur, my center of gravity has shifted forward significantly during squats. This means that my knee will be stressed much more than a regular person when squatting. He recommended that I should never squat beyond my body weight (68kg~). Normal people can usually squat until 1.5x their body weight (100kg in my case) if they had normal t/f ratio.
@sixfootandhalf
1) It was not difficult flying to Greece as I was mobile 3 days after the surgery.
2) I think ITB release has a chance of reducing knee stability but the tissue will heal completely. From past diaries I've never seen anyone get to 10cm without doing an ITB release. Your TFL is only 15cm long. It's simply impossible to stretch a muscle by 65%.
Hope you are well!
How will this bode for you going forward with regards to squatting?
Becker i believe, does not feel an proper ITB relese is needed and has mentioned maany do 8, 9, 10 cm without a release and slow down the rate to 0.5mm a day.
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Hi may i ask how many cm are you going for and also did the doctor suggested the femurs or was it yourself btw is itb release necessary for people who are going for even 5cm on tibias
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Do u think all the pain and knee problems are due to the 8cm meaning if u did 5,5 u wouldn’t have any complications and also do u have to pay extra for the itb release, I’m thinking of getting 5,5 on my tibias and i really can’t afford a penny more than the initial price and also I’m opting for 5,5 to have no complications, did u meet anyone who did betzbone on tibias for the same amount as mine and if yes did they have any complications ¿