Can I Work Right After Limb Lengthening Surgery?

Are you considering stature lengthening but wonder if you can work immediately post-surgery?

The truth is, patients can work after limb lengthening surgery, but it’s recommended that they postpone work for 4-12 weeks afterward because the first three months are jam-packed with daily physical therapy sessions and home workouts. Dedicating yourself to these recovery activities should be a full-time job post-surgery.

In addition, you need the mental strength to pull through challenges such as constant pain, sleep deprivation, and potential effects from narcotics. The journey ahead will be physically and psychologically demanding. To remain motivated, healthy, and focused on achieving the desired height, one should prioritize recovery above all else.

Why Working After Leg Lengthening Surgery is a Bad Idea?

Ultimately, the decision is up to the patient but working afterward means they’re less likely to reach their desired height, or worse, have severe complications due to the lack of physical therapy. 

The distraction phase follows almost a week after the operation and can last up to 11 to 12 weeks depending on which bone is lengthened[1]. During this time, the patient has to use the fixation devices to pull apart the bone by almost a ¼ of a millimeter four times a day [2]. This can be the most painful part of the process as the muscles, tendons, and bones are being pulled apart to grow faster than normal or fill in the gaps [3].

Going for hours of physical therapy every day is critical to loosen the surrounding muscles, and prevent complications [4] [5].

In addition, there are prescribed home workouts and stretching exercises to deal with muscle and joint stiffness. People who started working right after surgery admitted to not having time for physical therapy sessions or stretching, developing complications, and even found sitting at a desk difficult [6].

So, missing out on these activities can mean more time and pain to achieve the desired height. The longer the process takes, the more the pain can take a toll on the person’s motivation to continue lengthening to get to the optimal height. While some people may claim that they can work from home during this period [7], it is not worth the risk if there is even the slightest chance that work will prevent a patient from therapy, workouts, or stretching.

With most leg lengthening devices, patients cannot put full weight on their legs right after surgery as it can potentially damage the fixation device and cause injury [1]. Choosing to resume work soon after height surgery could increase the chance of accidentally putting full weight on the legs and undoing any progress achieved. Therefore, any non-desk or active jobs are strictly prohibited per the surgeon’s orders.

Despite the occupation, some surgeons will even refuse to operate on patients who plan to work within 4-12 weeks because they know the repercussions of neglecting physical therapy.

Negative Impact on the Quality of Work

You will come across many websites and doctors that claim this process is not significantly painful, but cutting the bone and lengthening it along with the muscles and tendons for months can lead to a constant, lingering dull pain. When 13 patients were asked to rate their pain during the process on a 0-10 scale (10 being the worst), on average, people rated 7/10 for external fixators and 3/10 for internal fixators [8]. This prolonged pain can wear one out psychologically and make focusing on work difficult [9].

After surgery, narcotics are prescribed for pain management and muscle relaxation. Some of these, such as Percocet (oxycodone) [1], can cause drowsiness and difficulty in concentrating [10]. Although not all pills have the same side effects, people on pain medication generally share forgetfulness regarding deadlines, a slower work pace [11], and low energy [12]. Even if a patient has minimal pain, it may be challenging to give 100% at work.

Getting good sleep is vital for performing well at work [13] and this can be a challenge post-surgery since most people can hardly sleep 2-3 hours per night. Firstly, it is tough to find a comfortable sleeping position with the screws (in the case of internal fixators) or the external frame. Sleeping on the back or in one fixed position for too long can cause soreness.

Second, even with painkillers, patients frequently wake up from pain or “tightness” during the night [14]. Some must use heat packs or a warm shower to get back to sleep.

Due to the factors above, it is better to take time off rather than deliver subpar work.

Physical Limitations to Work

Right after surgery, patients need supportive devices (crutches, walker, or wheelchair) to move since they should not put their full-body weight on their legs for a while (up to three weeks in case of STRYDE) [1]. It is also recommended to ask someone to take care of you or get paid help for the initial two to three weeks.

This means many day-to-day tasks like showering, cooking, or getting groceries can become difficult. In addition, driving after leg lengthening may not even be possible because of pain meds. So, it may very well be impossible to work any job that requires being on two feet.

Not to mention, most doctors require the patient to stay in town so they may attend regular physiotherapy and Xrays.

Going Back to Work After Cosmetic Limb Lengthening

Even after the patient has been cleared of crutches or a walker, a cane is still recommended while climbing stairs or stepping on/off curbs [1]. It can also be nerve wracking for people to stare at the external fixators, ask personally invasive questions, or notice the walking cane. A viable solution to these can be working remotely after the 4-12 weeks.

Height-increasing surgery is physically and psychologically challenging, but dedicating six months of your life to it can lead to a permanent increase in height. Deciding to work after leg lengthening surgery adds additional stress and can potentially derail progress if the person fails to take care of their health. Any patient should make recovery and achieving their goal height a priority by taking adequate time off from work.

As always, follow the doctor’s orders and speak with a healthcare professional if any complications arise.

• Related Reading: Will I Be Able to Run After Limb Lengthening Surgery? 

References

[1] Paley, D. (n.d.). Cosmetic Stature Lengthening Frequently Asked Questions (FAQ’s). Paley Orthopedic & Spine Institute. https://paleyinstitute.org/wp-content/uploads/Cosmetic-Stature-Lengthening-FAQs15.pdf. <https://paleyinstitute.org/wp-content/uploads/Cosmetic-Stature-Lengthening-FAQs16-1.pdf >

[2] Rozbruch, R. (2020, April 22). Limb Lengthening: An overview by S. Robert Rozbruch: HSS. Hospital for Special Surgery. Retrieved October 3, 2021, from https://www.hss.edu/conditions_limb-lengthening-overview.asp.

[3] Hasler, C. C., & Krieg, A. H. (2012). Current concepts of leg lengthening. Journal of children’s orthopedics, 6(2), 89–104. https://doi.org/10.1007/s11832-012-0391-5

[4] Coglianese DB, Herzenberg JE, Goulet JA. (1993). Physical therapy management of patients undergoing limb lengthening by distraction osteogenesis. J Orthop Sports Phys Ther, 17(3):124-32. doi: 10.2519/jospt.1993.17.3.124. PMID: 8472076

[5] Bhave, A., Baker, E., & Campbell, M. (2016). Physical Therapy During Limb Lengthening and Deformity Correction: Principles and Techniques. Pediatric Lower Limb Deformities: Principles and Techniques of Management (pp. 181-197)

[6] GhostFish. (2019, June 2). I understand you must be very eager for CLL [Can I get back to work in 3 weeks after STRYDE surgery?]. limblengtheningforum. http://www.limblengtheningforum.com/index.php?topic=64036.0

[7] FormerKidd. (2020, October 8). I took a month off after my surgery and then did WFH for the remainder of the lengthening [Work from home while leg lengthening]. limblengtheningforum. http://www.limblengtheningforum.com/index.php?topic=65602.0

[8] Landge V, Shabtai L, Gesheff M, Specht SC, Herzenberg JE. (2015). Patient Satisfaction After Limb Lengthening With Internal and External Devices. J Surg Orthop Adv, 24(3):174-9. PMID: 26688988.

[9] StrydeNailChallenge. (2020, October 18). I would like to share my experience here [Work from home while leg lengthening]. limblengtheningforum. http://www.limblengtheningforum.com/index.php?topic=65602.0

[10] U.S. National Library of Medicine. (2021, February 15). Oxycodone: Medlineplus drug information. MedlinePlus. Retrieved October 3, 2021, from https://medlineplus.gov/druginfo/meds/a682132.html#side-effects.

[11] StrydeNailChallenge. (2020, October 18). I would like to share my experience here [Work from home while leg lengthening]. limblengtheningforum. http://www.limblengtheningforum.com/index.php?topic=65602.0

[12] Jolien. (2019, June 25). I saw people who did internal nail lengthening, one of them was stryde. [Can I get back to work in 3 weeks after STRYDE surgery?]. limblengtheningforum. http://www.limblengtheningforum.com/index.php?topic=64036.0

[13] Reynolds, K. (2016, July 25). How sleep deprivation affects work and performance? https://www.hult.edu/blog/how-sleep-deprivation-affects-work-and-performance/

[14] EndGame. (2016, December 4). The pain was a huge issue for my sleep [Why cannot patients sleep well during lengthening and recovery?]. limblengtheningforum. http://www.limblengtheningforum.com/index.php?topic=4014.0