I've been using the x4 labs extender for almost a year now and I never did any manual exercise, I also hang and never once did I do manual exercise. Most people will advise you to condition your penis first but if you have enough self control you can start using a device without doing any manual exercise just slowly get your penis used to it instead of going full blast with any device. By the way, I've gained .9 inch from just the extender alone, I've only recently started hanging just a 2 months ago and I also got some gains from it. Also, in my opinion the best extender is an extender with the x4 labs wide girth base and a vacuum mod that will make you last the longest since you can put your testicles through the base something that other normal base extenders can't do.