Observations and Questions on Extenders

In erect state? I very much dubt it. I also think wearing it 4 hours or six will not make much of a difference and wearing it more then 8 hours per day or so could even be counterproductive.

I cannot get anywhere like 12 hours in a day. I can do 4 hours plus an hour pumping. I agree about the jelqing. I do it between extender stretches and find it gets me ready for the next stretch earlier as well as the benefits Marinera describes.

>someone will gain about an inch in 4 months extending for 12 hours per day, or an inch in one year extending for 4 hours per day.

That’s broadly consistent with my experience.

Those numbers were roughly interpreted from the extender studies. They all use BPFSL, which I think is a good measure of tunica elongation.

I did the math to show what each study predicts for gains and then did a weighted average between all studies (based on the number of men in each study):

1) Scroppo et al., 2001: 4 hours/day for 4 months - .000854 inches/hour or 1170 hours/inch
2) Colpi et al., 2003: 6 hours/day for 4 months - .000986 inches/hour or 1014 hours/inch
3) Moncada-Iribarren et al., 2007: 10 hours/day for 4 months - .000817 inches/hour or 1224 hours/inch
4) Levine et al., 2008: 5 hours/day for 6 months - .000767 inches/hour or 1304 hours/inch
5) Gontero et al., 2009: 5 hours/day for 6 months - .000567 inches/hour or 1764 hours/inch
6) Nikoobakht et al., 2011: 9 hours/day for 3 months - .001309 inches/hour or 764 hours/inch

Note: if an average range was presented for any of the above values I used the median value.

Weighted average between all studies: 1176.92 hours per inch

Men in these studies above used an extender anywhere from 4-12 hours per day and the gains they reported were pretty uniform. That is, there is a roughly linear correlation between time spent extending per day and gains in length, even over 8 hours. Also, most of the studies that used those big times included an acclimation phase of several weeks where hours per day were gradually increased.

Anecdotally, men on the forums who are using standard spring extenders are reporting about 1000 hours per inch of BPEL on average.

Which all means nothing. For example, are you referring to this study of Levine?

“ABSTRACT
Introduction.  Loss of penile length after penile prosthesis implantation is one of the most common complaints. There is no recognized reliable technique to gain length once the device is placed.

Aims.  This noncontrolled pilot study was designed to evaluate the efficacy and safety of external penile traction therapy in men with a shortened penis used before inflatable prosthesis implantation.

Methods.  Ten men with drug refractory erectile dysfunction and a complaint of a shorter penis as a result of radical prostatectomy in four, prior prosthesis explantation in four, and Peyronie's disease in two were entered into this trial. External penile traction was applied for 2–4 hours daily for 2–4 months prior to prosthesis surgery.

Main Outcome Measures.  Baseline stretched penile length (SPL) was compared with post-traction SPL and postimplant inflated erect length. A non-validated questionnaire assessed patient satisfaction.

Results.  All men completed the protocol. Daily average device use was 2–4 hours and for up to 4 months. No man had measured or perceived length loss after inflatable penile prosthesis placement. Seventy percent had measured erect length gain compared with baseline pre-traction SPL up to 1.5 cm. There were no adverse events.

Conclusion.  External traction therapy appears to result in a preservation of penile length, as no man had measured or perceived length loss following prosthesis placement, but in fact, a small length gain was noted in 70% of the subjects with no adverse events. The protocol is tedious and requires compliance to be effective. External traction therapy prior to inflatable penile prosthesis placement appears to preserve and possibly result in increased post-prosthesis implant erect length. Levine LA and Rybak J. Traction therapy for men with shortened penis prior to penile prosthesis implantation: A pilot study. J Sex Med 2011;8:2112–2117.
http://onlineli brary.wiley.com … 2285.x/abstract
I don’t think you can compare healthy males with males who had radical prostatectomy or Peyronie disease; actually, I don’t think you can compare people with Peyronie and people with radical prostatectomy, How can you get an average number out of that? It will be meaningless.

I seem to remember also that in the work of Gontero gains and time wearing the device wasn’t proportionated: people who gained the most weren’t those using it for the most hours. Which again means shit, since the sample is too small.
If there is any coincidence of rate pf gains among different of those ‘studies’, it should be actually seen as highly suspicious.

Anecdotally, I have seen people reporting great gains wearing it less than 1 hour per day and people gaining nothing even afte hundreds of hours, several hours per day. There was, years ago, a supposed ‘gains’ calculator, you enter the number of hours, it gives how much you will gain. It didn’t work that well.

Oh forgot: collagenous tissue under constant stretch plateau in lengthening with a constant traction once over the 8 hours per day.

Listen, I agree that those studies are ALL ugly in many ways. The Gontero one is the worst because the dude used pictures to assess length. But those are all we have. And I know the anecdotal examples are all over the map, but I am merely speaking about averages. Your personal experience may have varied significantly, but once again I am only speaking of averages here.

I think by definition a gains calculator will not work as no man is exactly average, but some figures can give us an idea of what to expect - at least some average range.

The Levine study I included was published in 2008 and did not involve any treatment other than extenders. It was this one . I did not include the one you posted because it was performed on men that received a very invasive surgery which generally causes penile retraction.

Where does this come from? They apply long-term traction (measured in days, weeks, and months) all the time with turnbuckles, dynamic splinting, serial casting and static progressive stretching and these methods all produce longer tendons and ligaments in vivo.

Doesn’t change much right? People with Peyronie’ disease. And 4 subjects? You said it well: all these studies are flawed. So, can I legitimately have the doubt that, on average, those who wear this device 12 h/day will gain 1” EL in 4 months? I guess I can. Neither I have seen demonstrated anywhere that you have to wear it at least 4 hours. Or that there is a correlation hours-gains that stands for every value of either variables. I could go on, but I think you got what I mean.

elastic and plastic deformation

Not seeing any data or methods reporting measurements of permanent change in vivo in that article.

I suppose you have to check the references.

I spoke with a sports rehab physical therapist today. I phrased the topic at hand in terms of an athlete’s ability to exhibit extreme range of motion in his limbs as in a pitcher’s external rotation. He said the connective tissue and associated tendons, ligaments do remodel to the stretched state to allow the rotation they are able to achieve compared to the public at large. So there you have an additional clinical perspective. I’ll probably bump into an orthopedic surgeon soon so I’ll see how I can construct an a similar analogy for further inference.

“The ligament deforms considerably at first. Elongation tends to plateau after 6 to 8 hours, although vely
gradual deformation can continue for months if the load is continued. The creep phenomenon is characteristic of viscoelastic materials and occurs at load well below those of the linear region of a stress strain curve. Creep deformation is not permanent, and the tendon will slowly resume its original length after the load is remove this response is called a “damped elastic response.”

This is what he is talking about Ectopasm.

What is being talked about here is viscoelastic elongation. When a tissue is placed under stretch viscoelastic elongation will occur over time manifested as either creep or stress relaxation depending on whether applied force or strain/displacement is constant, respectively. It is completely time dependent and follows a curve. The most efficient point of viscoelastic elongation happens around 300 seconds in most connective tissues, then slows down considerably as time goes on. As this quote notes, after a time, continued viscoelastic elongation will slow down to the point of imperceptibility, though it technically continues forever.

But the important point here is this: “Creep deformation is not permanent, and the tendon will slowly resume its original length.”

Using long duration, low load stretching, it is NOT creep that actually causes gains, nor is it true plastic deformation to any great extent. Rather, permanent changes in connective tissue length are caused by fibroblasts actually making more extracellular matrix and proliferating themselves. This is in accordance with Wolff’s Law and Davis’ Law and many studies have shown how mechanotransduction prompts fibroblasts in soft tissue to make more tissue. Generally speaking, the more the tissue is deformed the greater the synthesis of ECM by fibroblasts (this does get reversed after a point, but that point isn’t reached until the yield region of the stress-strain curve). So viscoelastic elongation will add to the mechanotransduction being “felt” by the tissue’s fibroblasts, but it is not directly responsible for permanent gains in and of itself.

Actually what this is saying is that after 6-8 hours, the OPTIMUM environment is achieved for permanent tissue growth, because at that point strain/displacement will be maximized.

That is absolutely correct. “Specific adaptations to imposed demands.”

What actually says is that after 6-8 hours daily tendons plateau in elongation. It is clear enough. Wishfull thoughts are not facts. You tend to make confusion between the two. A lot.