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Do extenders work in a similar fashion as manual stretches? Or are they two very different methods of gaining length?
Yes and yes.
Both work by putting outward pressure on the ligaments and tissue, creating a need for additional growth.
However, stretches are short timed, high tension, and done in a focused manner. Extenders are long timed, less tension, and applied in a gradual fashion.
Why is it commonly agreed that extenders give permanent gains?

