Quadriceps Tendon Rupture, Repair and Rehab

Duncan, be careful on the ice. Thats how I tore my tendon in the first place. Glad to hear there is no infection.

Idaho - I think your progress is great. 10 minutes on the bike takes me 3 days to recover from the pain. Any of the other exercises and stretches I can handle that the PT throws my way. But the knee sure doesn't like the bike.

Re leg lifts. I could not do any at first. Leg just looked up and me, shook a little and laughed when I tried. At 9.5 weeks post surgery I am not at about 50 lifts per day. I do in sets of 10-15. Per PT, I tighten quad muscles, pull toes up, and lift leg about 6 inches off the bed, couch.... I don't have much holding power and can sustain for a few seconds. I think when I tried them first around 4 weeks I was happy with 1 or 2. Then progressed from there. Kepp at it, they will come.

Did lots of waking this week apart from usual stretches. Why the heck do airports have so many ramps? I guess if you are in a wheelchair it would help, but for those with this injury, it is not so good. I hate inclines. I had 6 flights in the last week and only now am I realizing how many ramps airports have. And then ramps out to the car rental area too. Geeze.

ROM s still around 125 for me. I don't think there is any change from last week. I now to my exercises whereever I am. At work do stretches. My assist laughs at me as I put conference call on speaker and then do stretches while on the call. In planes I request the aisles so I can stretch my leg down the aisles and to strength exercises. At 6'4" I need the leg room and can't get my leg under the seat anyway.

Has anyone tried a hot tub and did it help? I have a 7 person hot tub, but the pump went about the time I injured my leg. And I can't get down on my knees to fix it. I'm gonna try again today. I'm not sure if it will help the knee, but I'm sure it will help all my other aches and pains from walking funny for a couple of months.

Thanks everyone and a speedy and pain free recovery to all.

Phillybuster and Ankhsign: One other thing you can try is to have a protein / glutamine shake right after quad exercises. Glutamine (non-essential amino acid) is in my opinion the best supplement and works well to reduce the delayed-onset-muscle-soreness when lifting weights. I'm not sure if the post operative rehabilitation pain is the same thing but it can't hurt to try.

Duncan

Thanks Duncan. Hope that winter is gone for good there in Cowtown.

Major milestone today. Alternating legs, I walked up AND DOWN two flights of stairs today. Ok, so I used the handrail for balance on the way down. But I did it.

Do PT and Painkillers Mix?

Here's an open question for all you gents - Have any of you tried taking a painkiller before going to PT? My therapist recommended taking a Percocet about 30 minutes before I start my PT session with her. Have to admit that it sounds appealing, but I want to know what you guys think before I try it.

Phillybuster: My PT asked me to take a couple of Ibuprofen before PT each time - I did the first couple of times I saw her . . . . might have helped but I don't know. How do you measure the decrease in pain that MIGHT have occurred?

IG

PhillyBuster: I was taking one Aleve am and pm and Advil in between as needed, but I agree with IdahoGuy, how do you know the benefit? I can tell you this though, prior to surgery and I was traveling home with my QTR I was doing 16+ Advil a day and when I cut back, I saw the benefit of them. Also now I have tried different times stopping Aleve and after a couple/3 days go back on them...so it helps there. But sometimes I feel th need to "feel the pain" vs not feeling it and doing too much....havent figuared out a balance yet.
Duncan: 5-6 yrs ago when I had knee pain, I started on chondroitin-glucosamine, helped a lot! So i asked my OS about it on my last visit and hit a nerve! He is very anti! went thru the biochemical metabolism of it explaining how it could not work. I let it go, but scientifically he is right. I know it helped me before but I havent tried any since QTR.
Anksign: Congrats on alternating stair work! And that is why they have railings! Keep it up!

Snow here in MN yesterday...just inch or 2 here but foot-1.5 north.

Keep plugging guys!

Bulldog

Phillybusyter - I haven't tried painkillers before PT. Not sure about the painkiller before the pain. However I guess it makes sense as the sooner you attack the pain with painkillers the better it works. So I guess the theory sounds good.

bulldog - thanks for the encouragement. Snow, man winter is over. My Rhodos are almost done blooming here north of the border.

I managed 100 leg lifts in sets of 10 today so far. I find the more the muscles come back the less the pain. So I am working it hard today. Exercise - ice - exercise - ice..... I am going to try massage therapy next weekend. Has anyone tried this yet, and did it help? It may not help the leg, but I am going to go for a full-body massage. The rest of me needs it right now.

Whole 10 days post op and nothing really new here. Just trying to keep busy and keep a positive attitude. Really looking forward to my first post op doc visit tomorrow, going to drill my doc with a bunch of questions.

chihibulldog: I am a big believer in chondroitin-glucosamine, I have taken it off and on over the last five year and can say is does work. I am currently been on it for the last 6 months and take it twice a day morning and night. I found it takes about a month to two months of taking it before you notice its affects. I take it for my arthritic shoulder and other other good/bad knee and it makes a huge difference.

IG, chihibulldog and ankhsign - Thanks for your thoughts on painkillers before PT. I'll give it a try tomorrow.

in2falling - Keep up the good attitude! Seems a good attitude helps as much as anything else in getting over this injury.

Tiger Bait - How are you doing?

Hope you've all had a restful and recuperative weekend.

Cheers,

PB

Hey -

I've been watching the NFL draft all weekend, but I've still worked my legs alot. I was able to walk up and down 3 steps out of my front door with my walker for the first time yesterday. That was a big accomplishment. I've been having to go down a ramp in my wheelchair before that.

Philly Buster: Sorry about all the swelling. Like SinRider said, once he started being really active, it eventually went away, so maybe you'll have better luck as you get more active.

Anything on your leg lifts yet? Just keep doing what IG and Bulldog said, and it will happen.

One good movement for ROM is if you have stairs, put your foot one or two steps up and bend your knee forward. This seems to get a good stretch. It seems like everyone has a sticking point, but they keep pushing and get past it. Philly Buster, have you spent much time in the pool? After my first time in, it seemed to get me over one of my roadblocks.

Ankhsign: Good job on the stairs and a massage does sound pretty good!

One day at a time...

Tiger Bait

In2Falling: Yes, glucosamine helped my knees before, I should give it a try. I had results in about 3 weeks before.
TigerBait: Great! you are starting stairs! Keep it up!
PhillyBuster: I agree with Tiger Bait on the stair exercise. Recall my PT had me start using a book the thickness of a dictionary. Stand on it with your injured leg and simply dip your heel to the floor. Keep progressing the distance by adding books or moving to a stair. My PT said to be sure I did not move my injured knee forward of my toes. This is one exercise I continue at home, and used it a lot when I was in France. It helped there because everything I did, walking, standing, sitting on a bus, was for too long periods of time and this stair dip helped alleviate discomfort.
Anksign: when I went to PT I had my PT rub on a salve for the incision and to reduce drying/itching...it felt good. Go for it!

Bulldog

Day 11 post op.
Just got back from doc appt. must have been half the city in the clinic today never seen so many crutches in my life , so I knew he was going to be brief with me today. Ask him about how he anchored the sutures to the patella and said he drilled holes and anchored them that way, he did not use the suture anchors because they are expense $400 and leave metal in your knee. He said he does not like sending people to PT right way for these because PTists get to aggressive and he has seen them screw up his work in the past, he said I seemed motivated enough to do my own PT.

Gave me the green light for full weight bearing but wants me to use the crutches for protection and balance. Said I can do leg lifts and isometric quad flexes and wants me at 90 degrees in two weeks when I see him again. So going to see if I can get this bad boy off the ground this afternoon, which I don't think is going to be an issue. He also said that I REALLY need to manipulate and move the patella side to side to make sure that it tracks correctly and no scar tissue builds up.

25 Days After Surgery

in2falling: I am interested to hear your doctor's recommendations. 90 degrees is quite a bit more than I was prescribed (0-40). My doctor also did not mention anything about moving the patella around although my PT recommended it. Hopefully I will find out more from my OS when I next see him on May 5. I know what you mean about the crowds. At my cast clinic all the appointments are booked for 1 PM and there is usually at least 50 patients booked.

I visited my PT for visit #3 today. I mentioned that when I get close to 40 degrees ROM I feel pain in the upper leg, closer to the hip than the knee. She did a five minute leg massage, then had me do ROM exercises with a hot blanket over the thigh. I finished the session with electrically stimulated quad contractions and 10 minutes of ice.

Tiger Bait - Congratulations on your progress getting up and down those steps! Keep up the good work. I'm still struggling with the leg lifts. Not yet able to lift my heel off the bed when lying on my back and trying to raise it. My physical therapist seems happy with all my progress except for this. She gives me stronger and stronger electrical stimuli each time.

chihibulldog - Thanks for the recommended exercise.

in2falling -Seems you are recovering very quickly. I'm glad for you. I am nine weeks post-surgery, third week of PT, and am still just short of 90 degrees ROM.

Duncan - How are your leg lifts? Has the electrical stimulus helped you?

Cheers to all,

PB

Tiger Bait - congrats on the progress. Keep it going. I really struggled with leg lifts at first, but now 10 weeks post surgery I was up to 200 yesterday. I did them in sets of 10-20 throughout the day. They really work to bring back those tired muscles. I've found that the more muscle I gain back, the les pain as well. So start small and keep building from there.

In2falling - keep up the positive attitude. It was hard at first for me and maybe it is for you. I set goals for myself and work hard toward those goals. I find it helpful to set and achieve them. I am 10 weeks post surgery tomorrow. My goal is 140 ROM by 12 weeks. At 6 weeks I had a ROM of 70 degrees. PT measured me today and I pushed hard and reached 134 degrees. So almost there. Next week I will be at 140 and also build back more muscle mass. But when I was where you are, I wasn't sure I'd ever get here. So hang in there. If I can do it, you can do it. And I too had the holes drilled to anchor the tendon. Surgical report says they drilled 3 holes.

Phillybuster - 9 weeks and 90 degrees is great. Keep up the great progress.

Duncan: Ya 90 degrees seems like a lot to me also since I am having a hard time right now getting 50, but I have two weeks to reach 90. Think I am going to pick up some microwave heat packs tomorrow and use them before doing my PROM, the message thing sounds like a good idea also.

PhillyBuster:I would not call it healing quickly my knee still looks like a softball down from a grapefruit it was 5 days ago. I was able to do some leg lifts today after about 5 minutes of trying, think another week or so of not do anything would have made it much harder.
One thing that I think helped with the first leg lift today was to do a few of them on my good leg to convince my brain on how easy they are and then told my self to now do them on the other leg.

Hey -

Today I went to PT and I made my goal of 90 degrees ROM before my OS appointment tomorrow. I had a 91 and a 96! I know I still have a long way to go, but I'm happy I dodged the threatened MUA!

Phillybuster: Thanks again for the challenge. It helped me, and I know you're working hard, too. For your leg lifts, I have what is called a "loop", and you can lay on your back and lift your foot with it easily all day until your muscles can do it themselves. I'll be happy to send it to you if you want it. It really helped me and got me started. Let me know...

In2falling: It's great that you got the green light for weight-bearing and your OS wants you at 90 degrees in 2 weeks, but also remember that it takes time for the tendons to heal. You might not want to push it to the limit to start, but, once again, who really knows?

Tiger Bait

Torn Both Quad Tendons

On Feb The 20th Fell Off My Porch To The Driveway Tore Both Quad Tendons. Wore Braces For 6 Weeks, Started Pt At 5 Weeks ,in My 10th Week Now ,been Brace Free For 3 Weeks Now Cant Climb Stairs Yet With Out Getting On All Fours To Do So. Mussels Are Comming Back Slow But Sure,my Question Is To All Who Have Had This Injury Does The ,the Best Way To Dicribe It Is If I Keep My Knees Tight Then My Back Just Kills Me,but The Quivers Like They Just Want To Give Out, But I Catch Them.has Any Body Delt With This And How Long Did It Take To Get These To Go Away.thanks

russ50: Hey - Very sorry about your injury. I know what you are going through. BQTR on Feb. 16; 6 1/2 weeks immobilized in braces; brace-free for 2 weeks. Like you, my legs are weak and I have to use a walker everywhere I go. My thigh muscles quivered the first 8 weeks, but that has stopped now. My back never hurt. I truly have made more progress this week than ever before.

This is a great forum and everybody is getting better with time, determination and help from each other. So....ask questions.

Tiger Bait

13 Weeks out from surgery

. . . tomorrow. Went to PT today. Was able to get to 133 active ROM, and 140 passive ROM - that puts me within a few degrees of the other leg. Lifting weights -still very painful to do leg extensions and that leg is really weak. Still have problems going down stairs, although I can climb up no problem, and can even do two at a time. Still walk with a hitch in my gait that the PT is concerned about - she tells me to walk bent-kneed as much as possible until it goes away. The knee is still stiff and sore, and I have a bulge where I didn't used to have anything - as has been previously described. I've been climbing pretty steep, long hills on my mountain bike in low gears - My PT says to start mountain biking on the trails very slowly - I am psyched about that!

Russ50: I'm sorry for your injury, but Tigerbait is right: keep working at it, keep asking questions, keep writing about your experiences, and it WILL get better!

I just wanted to thank all of you for helping me out with my injury: Tiger Bait, SinRider, Duncan, Ankhsign, ChiChi, Vermont Soldier, In2Falling, PhillyBuster, Bitterrooter, and others. You guys have all helped by chiming in, being supportive, offering advice and experience - this is exactly what I needed at the time. THANK YOU ALL!

A final piece of what I have gleamed from all of this: Despite what the OS's might say, it seems to me that those who have recovered quickest, best and most completely from this injury are those who started PT right away and were relatively aggressive with rehab. My OS and PT both agree with this analysis - perhaps the docs who are not on board with this protocol are older and not used to working with PTs?

Regardless: Good luck to all. Hang in there.

IG

Thanks To All, Went To The Doctor Today Rom 138 Both Legs Still Weak In Them But Getting Better.got A Script For Another 6 Weeks Of Pt.i Like Pt Because IM With People That Care And No What I Am Going Through.there Was A Time That I Thought I Would Never Walk Again,and Ask God Why Me I Have Allways Been Hard Working What Did I Do To Deserve This,then It Came To Me One Night That God Had Nothing To Do With This, And If I Was Going To Get Better I Had To Work As Hard As I Can.and In 10 Short Weeks I Am Walking With The Aid Of A Quad Cane,but Im Walking And I KNOW I Will Recover I Know This. And It May Sound Dumb But In Some Kinky Way Its Made Me A Better Person,because I Dont Look At People With Canes, Or In Wheelchairs In The Same Way I Used To.and I Believe That God Needed Me To Go Through This To Open My Eyes.thanks To All

Russ50: like everyone else, sorry to hear you needed to join IG's thread! and a BQTR! Like TigerBait! The rest of us cannot imagine a double! I am 24.5 wks post, and I still have the stiffness, especially if I sit, stand or anything for long periods of time, getting up in the am it is very noticeable. It is better after exercise. And I too felt, will I ever walk right again? How will I do my outside chores etc? And you note that that Sinrider (right SR?) did one knee and then later the second, and he felt the first was "normal" around a year. So it takes time, but it does come back. My OS said it will 6-12 mo but put the caveat "although noone has ever come back at that length of time", which I also take as good news! If there were big issues, we would go back. So it is great you got your PT extended, my PT person helped me so very much with my mental attitude as well as rehabing. Keep it up! Attitude and dedication to rehab are the keys!

IDG: We thank you! I was doing great even going down stairs until I did my "warrior weekend" in the woods. It has been sore and less stable going down since, but I can "run" up them! So I probably overdid it...I need to get that bike Man! And interesting you have that new bulge too! Sinrider had it also you recall. I had the hitch I was concerned about, although it got to the point where I think others couldnt notice but I felt it....and when I first tried jogging on the TM, couldnt...my second PT told me to "run thru it, you can run in the water, and if it hurts too much, go back to OS". I did run thru it and could jog pretty well until after my woods weekend. But that was what? 20 weeks post? My rehab instructions were "lite running" at week 16, which I could not do, which drove me down cuz I felt I had done all and more I was asked. But again, like you say to R50, it WILL come!

Best to All!

Bulldog

Charks, Russ50, another BQTR. Cannot even imagine it.

Just a quick update - I'm now 12 weeks post-op, and I'm doing pretty much everything I would be doing this time of year anyway. I can squat in the garden, and climb up and down ladders and even the roof. And I'm having no problem keeping up with my mtn-bike buddies once again (trust me, they're no slouches - it's the A-team). No doubt all that early road-work paid off. My knee is sore after a long hard effort, but quite honestly, that was always the case. So we'll have to see if this knee pans out like the first and the post-activity pain disappears.

My ROM is past the point where I could guess an actual angle in degrees. But if I sit on the couch with my knee up, I can scooch my foot back to about three inches from my butt.

My walk is completely normal - I feel absolutely no awkwardness or hitchiness at all any more. IdG - keep at it - after walking funny for so long, it takes quite a while to unlearn the new habits. For me, so much of that was simply concentrating on trying to do exactly the same thing with both legs with each step. And yes, working on keeping the legs bent is a big part of it - the fixed one wants to rebound dead-straight with every step and you gotta keep it from doing that. Good luck with the process, and definitely get out on the trails asap - it's so good for your head.

And don't worry about the strange new lump(s) on your knee. It's just the way it's going to be. Call it a badge of initiation to the club you started, now with numbers in the dozens.

I'll probably be visiting rarely from this point on, but you definitely got a ball rolling, and there's no sign of it stopping soon. I attribute my current level of activity in great part to this forum. Reading about the PT regimes that other people's OS's were allowing at such an early stage in the recovery process gave me the confidence to attempt, and pull off, everything I did in my own recovery. And it obviously paid off.

So I salute you IdahoGuy, and everyone else who's contributed, for helping me make a recovery that is now essentially complete. Hats (and helmets) off to all of you! And great luck in all your respective recoveries!

Yesterday marks two weeks post OP and time seems to be flying along. Still stuck at 50 degrees PROM but 50 is feeling loose and easy to reach now. Going to shoot for 60 to 65 by this weekend without pushing it too hard, have two weeks to get to 90. Been working it PROM fairly hard here at work every chance I get. First few leg lifts are quite painful when I do them but once I do a few the pain seems to numb down.

Tiger,Russ: I really feel for you guys having to go through two of these.

IDG, Sinride: Thanks for sharing your experiences through out your rehab. I have my calendar circled for middle/end of June to be on my MT bike and going to buy a nice road bike around that time.

29 Days After Surgery

I had PT session #4 today. PROM is still stuck at a paltry 31 degrees. I have been fairly conservative in not pushing the ROM since my doctor only prescribed 0-40 degrees. I have not tried any leg lifts yet since those have not been prescribed either. Maybe my OS will let me do these after I see him again this Monday.

In2falling: I am interested to hear that your ROM is improving steadily. When you do ROM exercises do you have to push through the pain barrier or do you find that the ROM naturally increases without too much pain? Are you still wearing a brace at all? My doctor allowed me to take it off while I am inside the home but I still wear it everywhere else including at work.

Duncan

Duncan: Oh ya I still have the brace on and feel very weary without it getting into the shower even with two crutches. I have been hobbling around mostly with one crutch with the brace locked at work and at home and putting around 50 to 75 % weight on it this week.
I really do not have much pain at all doing PROM just a lot of tightness, feels like I have a very tight knee wrap on and have to push through the tightness with a little discomfort. So I have been just working it under the desk at work all day long. I set my brace to the degree I want put my foot (heel) on a box and work the PROM with my hands every chance I get.

Tiger bait - congrats on hitting your target. Very very well done. Keep it up. Glad to hear of your progress.

In2falling - hang in there. My progress stalled a few times and then I would get spurts of progress

Duncan - my Dr, OS and PT all told me that I had to push through the pain. And some days the stretches hurt like @@@@ But I hae to confess that it did work. They kept telling me that I would go though hell with the first month or so bt I had to push through the pain to stretch out the scar tissue and stretch the tendon. They were right on both counts. So I'd suggest following the OSs and PTs advice to be safe, but if they say to push it, it worked for me. But man it sure hurt some days.

I also like in2falling's suggestion. I do the same and work at stretches all day. Under the desk, sometimes take 5 minutes to stand and stretch, even small sessions of a few reps all add up.

A few people have talked about leg lifts. When I first could do them, 1-2 was all I could do. Now I do over 200 a day. But had to work up to it. They sure help bring the muscles back to life.

Thanks for your support and encouragement everyone. Hope you all recover soon.

Hello,i Need To Ask A Question Of All Of You.has Any Of You Had Your Legs Just Give Out Than You Have To Catch Yourself,now I No I Tore Both Of My Quads,but This Just Scares The H#$% Out Of Me.i Was At Pt Yestreday Doing Squats" Mini Squats" Went To Stand Stright Up And Both Of Them Just Gave Out .now I Will Admit That I Was A Little Tired,but I Am Just Getting Tired Of These. You Just Dont Know When The Next One Will Happen And You Better Be Holding On To Something, Or You Will Fall.now It Seems I Can Tighten Them Up When This Happens To Catch Myself. I Just Wondered If This Is Some Thing Normal Or Not Thanks To All

Hi Russ. Yes I too have had the leg just give out. Sometimes after stretching, once going up stairs, and a few times while walking. I too am nervous of it giving out and mainly of reinjuring the tendon. However it does happen less as I gain my muscles back. When I spoke with OS about this and my fear of reinjury, he said that with the way he reattached the tendon to the bone, there is very little chance of it tearing again. He said "your leg will break before you retear the tendon". Although this gives me some comfort, I am still careful as I don't want to suffer through this again. Good luck and keep working on building back the muscles. I know this helps me.

hello guys, boy I'm glad I found this site. I was wondering if someone could give me some advice. I have quad tendon rupture both knees. I'm 48 and the injury happened 3Feb. I have read the longer you wait for surgery, the harder it is to recover. I'm having surgery 15May. do you think I will be able to recover or will it be a waste of time. right now I'm not able to walk up or down on the stairs and my leg buckles sometimes, can list both legs at first doctor wanted me to rehab and not do surgery, but he changed his mine and told me it would be better to have surgery. I have been out sick since injury from my job. but I ned to be able to climb steps and walk around for about 3 to 4 hours at work. I'm not really wanting to be super active, just want to be able to walk again and do things I always took for granted. well thanks for any info and advice.

Steve