On the limb-lengthening journey, a well-timed physiotherapy program protects joint range, maintains muscle length, keeps nerves comfortable and rebuilds gait and strength safely as bone heals.
Important: Weight-bearing and intensity depend on your system (internal nail or external fixator) and your surgeon’s protocol. The plan below is a general framework; your exact schedule is personalised by your team.
Aim: prevent stiffness and shortening, support circulation, and keep nerve glide friendly. Short, frequent mini-sessions are more effective than one long session.
Range of motion: Pain-free active/assisted hip–knee–ankle motion. Femur lengthening: protect full knee extension. Tibia lengthening: maintain ankle dorsiflexion to avoid calf contracture.
Muscle length: Gentle, sustained hamstring and gastro-soleus stretches; avoid aggressive forcing. Night splints/AFOs if prescribed.
Activation: Quadriceps and gluteus medius isometrics, controlled straight-leg raises, intrinsic foot work and ankle pumps for swelling control.
Patella & soft-tissue: Light patellar glides and fascial mobilisations to keep tissues supple.
Gait & balance: Partial weight-bearing per protocol with crutches/walker; weight-shift drills, two-leg balance and basic proprioception. Report dorsal-foot tingling or lateral-knee tightness early (possible peroneal nerve tension).
Aim: symmetric gait, strength/endurance, balance and coordination. Load increases stepwise after radiographic healing is confirmed.
Closed-chain: Mini-squats (0–45°), low step-ups/downs, hip-hinge patterns.
Strength & endurance: Bands/cables for hip abductors/external rotators, hamstring–quadriceps balance, calf heel raises (double → single), and eccentric progressions.
Cardio & mobility: Low-resistance cycling, pool walking/deep-water treadmill, elliptical; active mobility to maintain range.
Balance & gait: Single-leg balance progressions (eyes closed/head turns); metronome step rhythm; stance-to-push-off drills.
Functional return: Running, multidirectional work and hops only when ~85–90% strength symmetry, pain-tolerant ROM and control tests are achieved.
Do: intermittent cold, elevation, appropriate compression, and meticulous wound/pin-site hygiene.
Avoid: sudden load jumps, “no pain, no gain”, aggressive stretching and neglecting hip–core–balance training.
Want a personal plan? Share your device, protocol and goals; we’ll build a week-by-week exercise & loading schedule around you.
Sedat Duman, MD
With years of experience, Time To Be Taller serves its patients in its clinic located in Mall of Istanbul.
