36 patients undergoing bilateral tibial lengthening were included in this study to determine what effects botulinum toxin A (BtX-A) injections have on calf pain, swelling, and knee & ankle range of motion following limb lengthening. Patients had one leg randomized to a control group, which was injected with saline solution, and the other leg randomized to an intervention group, which was injected with 200 IU of BtX-A. A handheld dynamometer, a visual analog scale (VAS), and tape measure were used to measure outcomes. The results of this study indicated that there were no significant differences in calf pain, surrounding joint ROM, or calf circumference between the control group and the intervention group at any point in time, up to 39 months following the limb lengthening process.