The Vac-Extender is probably the most comfortable traction device on the market. Some people complain of not being able to feel a “stretch” when wearing it, however. If you do opt for the X4 labs extender and find the noose or strab intolerably painful to wear, you can modify it with the Vac-Extender head/sleeves for 90 bucks. I say go with what looks comfortable. I use a JES modified Vac-Extender, it’s very comfortable.