Quadriceps Tendon Rupture, Repair and Rehab

We Are Legion!

I've always suspected that our injury is more common than the medical community lets on, and the number of contributors here seems to be supporting that argument. Sir Charles Barkley and President Bill Clinton were both felled by our shared affliction not long before my first knee fell apart seven years ago, though I'm quite sure they weren't snowboarding in the backcountry. And this past January 29th, when I found myself in the Sugarbush ortho clinic to be told what I already knew (repeat performance, other knee, skiing this time), I had to wait while they saw another guy with the same problem. In 20 years, the clinic supposedly had seen four of these, and yet there we were - two of us there at the same time. Is this the beginning of an epidemic?

So begs the question - what can we old fellas do to prevent this? It's not like we were doing anything stupid - in several cases (both of mine) there wasn't even a fall involved. We were just doing our sporty things - powering a turn, absorbing a mogul, saving a slide on the stairs. And our bodies simply let us down.

In my case, as I mentioned in earlier posts, I had had pain in both knees my entire life. Prior to my first quad rupture, I had actually been seeing an ortho, had xrays and MRIs, and had been getting weekly PT (massage of the region from patella to hip flexor, essentially) for over a year. There was even a suspicious painful lump above my knee cap, which I suspect now was a partial tear. But the orthos dismissed the lump at the time (irritation), it was never mentioned to me at all that it actually could tear apart, catastrophically.

Most of us here are athletes, many very serious, maybe former competitors at an elite level. We may be old now, but still like to have fun. And though we may not have quite the power or reflexes that kept us at the top in our prime, we still have the skills to kick some serious ass when appropriate.

And most of us work out, strength and cardio - in the gym, in the pool, on the road, in the mountains. As a result, our muscles, joints, lungs, and hearts are in top shape.

So what can we do to keep our tendons from being the weak links that they apparently are? What's the use of having powerful muscles if they're held in place by what amounts to old rotten yarn? These questions are not rhetorical - I'm really curious to know if solutions exist.

As to my current situation, week six, post-surgery: life is pretty much back to normal. I walk without hitch for a mile every morning and night. Stairs are completely normal going up, a tad less so down. I can get in and out of my car and drive (5-speed) without the ridiculous contortions needed for same in weeks past (I do still wear my brace, hinged at 70, for that and only that - I never know what sketchy surface I may have to climb out onto). I do weightless leg extensions whenever I'm sitting, ad infinitum. For range-of-motion I slowly lift my thigh higher and higher, letting my lower leg droop until it goes no more. At about 100 degrees today. And then I do one-legged squats, 50 or so, down to about half my ROM. Hands on chair backs, just in case.

My doc was adamant the day my staples came out (Feb 13th) - straight brace, no knee flexion at all, no PT, crutches only, until my next visit (next Wed March 26th). There was no discussion with this guy, simply orders. He wouldn't even tell me if I would be able to tell if I did something to disrupt the healing (damaging his handiwork). I was just supposed to listen and obey, and that's that. "Let it heal." Wise words, maybe, if I were a prince and had handmaidens to tend to my every need. But I'm a dad (wild little girls, 1 and 4), and my wife works evenings. The rules as stated were simply not an option.

Absolutely none of what I've been doing has hurt in the slightest. Stiffness, sure, plenty of that, but I always stop short of the pain point. And I've had absolutely none of the weird panic-inducing knee-wobbles that lasted for months last time around. That time though, I spent six weeks with my leg locked straight, on crutches, as recommended. With zero muscle tone, it's no surprise my leg didn't know how to cope.

Sooo, now I'm wondering - should I hobble in to my appointment next Wed, with my brace on and locked straight, and pretend blind obedience? Just so I don't get the severe scolding I so obviously deserve? Or should I stroll in there, braceless like I've been for weeks now, and let him know that there may be another way to do this - an alternative recovery process that lets us heal, but still allows us to lead relatively normal lives?

Best of luck and healing to all - I'll let you know how it goes next Wed.

Visited the Orthopod for 6 1/2 Week followup . . .

. . . today. As I suspected (and as I suspected will occur to Sinrider), he did scold me for doing so much. He was happy that I am getting stronger and feeling ok, but he told me to hold back on weight-bearing ROM because the repair is very delicate and requires babying further. He gave me a hinged brace at 30* for 2 weeks, then 40* the week after and 70* the week after that (I intend to immediately go to 40* and then 70* and then 90* fairly quickly thereafter). He told me to stay on at least one crutch another 2 - 3 weeks. I can ride a stationary bike with no resistance in another week and a half (I'm going home to get on my own bike on a trainer tonight). He took a lot of time to show me the knee on x-ray and explain why the repair is delicate - I believe him, but I also know what I have been doing, and what I am capable of - and it is more than he is suggesting is permissible. Basically, what he is telling me is "Don't hurt yourself". I'll be careful, but I am going to push to be riding again very soon - have a goal of doing a "metric century" road race on June 14 - and I don't intend to miss it!

I will take his advice and directions to heart -I'll obey their "spirit", but frankly, like the rest of you, I need some activity - I'm getting fat and cycling season is coming up fast here in the high desert, and I am not going to miss it. Moreover, cycling a lot this summer is going to help me next winter while skiing.

Well, here is to all of you - I know we will all have success at rehabbing this injury.

Idaho Guy

Interesting Sinrider! On my January Dr visit he told me he usually does 1-2 QTR a year, but he has done 5-6 since mine (11/12)! So perhaps an epidemic! or maybe just an aging population (although I refuse to give in to the aging thing!)

I too pushed it early (ROM primarily) and was told to back off, and if they said do 10 reps 2x a day, I did 20 3x a day. A person can only watch so much Gunsmoke and Hogan's Heroes!

Going to the pool soon and skip the circuit today. That is what the leg is telling me.

Bulldog

Man, I Love Gunsmoke.

Well, the pool is the BOMB! I probably hiked about 1000 yds with a soft brace to remind me of the injury but what a treat. I had my quad talking to me the next day for sure. I am trying to do the pool work a few times a week which is easier said than done. I have been back in the gym with a full flex brace doing upper body work as well. I am actually starting to feel a bit like myself with a minor injury. I have about 60 degrees flexion in the pool but I am taking it easy.

Sinrider, as always, interesting points on how do we prevent this moving forward. Eating bon bons and sitting in a chair for the next 30 years is an option I suppose. I would like to believe that this was a freak accident which it was but it was probably going to happen at some point in a variety of situations for me. I think that most in our age group are slowing down and this group of contributors does not fit that mold. My ortho keeps saying "slow it down" but it seems that is not an option for me. For me, I will continue to act like I am 20 at every opportunity and hope for the best. Who knows?

The best of days to you all. VS

I am wondering how many visits and duration between appointments with your Dr Othro? Next week I am looking forward to my 6 weeks post op visit. At two weeks I just saw his assistant which cleaned the incision and removed the stitches. Before I had the surgery he stated 3 months and I a back to normal. Now seems hard to believe.
I like Sinriders’ idea of understanding and prevention. I think mine was preventable, over the last years I had been tweaking by knee, quadriceps tendon area, and just limped around. My PT says probably had slight tears and developed scare tissues. If I would of checked it out and had some PT and added exercises, it would not have deteriorated and failed. I feel I have had worst falls. Also as we get older keeping the mass down helps our knees. Most of you seem to be in great shape, then I would agree with “it’s a freak thing”. One other thing on prevention I read or heard to strengthen tendons is through a constant loading like biking. It seems to be a more common injury then the medical people say. I work with about 15 guys in the 45 – 55 range and I am the third in 2 years. 2 slipping and 1 basketball.
Good Luck and Quick Recovery to all.

Prevention

On Sinrider's thoughts, my OS told me that my injury simply was not preventable, other than that I simply can't be as dynamic on skis anymore - he also tells me that I should expect to get almost 100% back to the same level of skier I was before. As to prevention, I already do everything right - I bicycle a tremendous amount until the weather gets too icy, then I head indoors to spin class. I do a program starting in early September that is ski specific: lots of weightlifting that is leg specific, a lot of core work, and literally thousands of lunges. I could lose 15 lbs to get back down to my age 22 weight - I am going to work on that this summer. Finally, I could do more core work year round. But, I think the real key for me is that I am going to have to become a little bit more of a short-turn, slice and dice skier, and less of a GS mode skier through steep, difficult terrain - I believe that is what got me into trouble.

Still haven't met anybody with the same injury other than you guys. My orthopod says they are out there, but mine is only the fourth he has ever done and he is in his 40s as well.

VS: Really glad you are enjoying the pool and feeling more like yourself. It makes a difference to you and your loved ones to have you getting some type of exercise.

EarlJ: My OS visits sound about the same as yours: Had one immediately post-op, another at 2 weeks, the next yesterday at 6 1/2 weeks, and the next is scheduled for 10 1/2 weeks. My OS is telling me that at 3 months I won't even be close to normal - we haven't even discussed completely getting rid of the brace yet - hopefully that will happen by then.

Headed up to Sun Valley tomorrow for several days with the family for some spring break skiing for them (we were planning on a full 9 days of skiing in Canada and Montana before the accident), and some condo-riding for me - with some visits to the Ketchum YMCA tossed in for pool walking.

Talk to you guys in a few days. Hang in there everybody!

Idaho Guy

Regarding Sinrider's initial comment on prevention: I asked the PA assistant when he took out my sutures and he said do same exercises for rehab as on the other leg. But as has been pointed out, all of us were quite active prior, and in my case, I simply slipped down 4 stairs. And I would think a stronger quad would not help, as it is the quad firing that initiates the rupture. My OS really preaches bike riding as the best exercise, and I plan to upgrade my bike (a 1973 10 speed won't cut it!) and get active when winter leaves. Everything I have seen about QTR says "over 40, mostly males" which seems to fit this thread.

earlj- my first visitwas 2 weeks post to remove sutures and then 3 visits to OS every 4 weeks. OS told me I didn't have to come to 3rd visit if I felt ok but I had more questions for him. He first said 6 months to recovery and then added 6-12 months, but he noted that he never had a patient come back that far out. He did predict a "great outcome" for me but then they seem most concerned about us getting to a "regular lifestyle" which doesn't necessarily mean acting like a 25 year old outdooors!

I too think I may have had a small tear prior. Same deal, slipped on a stair, and had pain in tendon area for about 3 weeks. That was 1- 1.5 years before my rupture. I never had it checked out as I figuared was just a strain, so will never know for sure.

I have never met anyone with this injury, and of 4 PTs I had, only 1 had ever treated this in rehab. My OS said he usually does 1-2 QTR a year but has done 5-6 since mine! (basically Dec thru Jan).

When I exercised hard 4 days in a row I had more pain and swelling so held off a few days, and it seemed to get stiffer and more pain. So now I do regular exercises every other day and lighter in between and that seems to work for me. Lighter means no machine curls or extensions, less time on treadmill and more emphasis in the pool.

I leave for France on Monday and I am not looking forward to the long plane ride, but plan on bringing along my therapy band as I won't have access to other forms of work. Hope Sun Valley treats you well IG! I was there about 3 years ago and really enjoyed the spring skiing.

Keep plugging away Guys!

Bulldog

Continued progress to about 90 degrees without pain even with the OS giving me 30 degrees to work with in the flex brace. Attitude is vastly improved!

Earlj- My OS post op visits were about the same as the others, 2 immedieatly post op, 2 weeks (staple removal and new brace), 5 weeks and then one scheduled for about 9 weeks. My guy stated tht he does 3-4 per year. No explaination for why he does that many. I have followed the KC-45 acquisition process over time Earl, Bummerfor Boeing.

IG & Bulldog (we have an english female bulldog), have a great time on your respective trips. During this injury period, I have missed trips to Macedonia and Croatia for work. April we will travel to DC to check out Air& Space and Natural History museum.

Continued success all

6 weeks out

It's been great to read about everyones progress. Today marks 6 weeks since my OTR surgery. I'm in a brace now, limited to bending the knee 30 degrees and only during exercises 3 times a day. I'm not allowed to put any weight on it, though I can put it on the floor and roll the foot along as I walk on the crutches. Though my OS is on the conservative side compared to some others, both my physical therapists (they work as a team) have nothing but high praise for the Dr. I have been seeing him every 2 weeks and I understand that will be the schedule for the next 6 weeks to 8 weeks.

I will do as I'm told, though I feel I can do more (and, boy, am I ready). The fear of winding up back in that full leg cast keeps me in check.

A big thanks to everyone who posts on this thread for sharing and comparing info on this injury and rehab.

Brewman

7 weeks out

I've seen my orthodoc a total of three times now. Once in the pre-surgery consult, and once right before surgery. Post-surgery, he sent an intern to check on me - that guy hadn't even glanced at my chart and had no idea what the surgery was. He was wondering if I'd gotten out of bed to try walking.

My third visit with the OD was 8 days post-op. That was when he looked at the closed incision and decided I could get my staples out. But he told me to stay in the brace, locked straight and on crutches, until the next visit. He then left the room after brushing off my further questions about possible flexion, PT, exercises etc. "Don't do anything - let it heal".

My next visit is a half-hour from now. I'm prepared for a tongue-lashing.

Way to go VtS! 90 degrees is a huge improvement, and a very functional angle to work with. Is it free-moving the whole way, or does it get stiff part way into the range?

Keep smiling, gents! It only gets better.

8 Weeks out

Hope you guys are all doing well. It seems as if we are all beginning to recover quite well. My PT pointed out to me that 10 weeks ago when she first saw me after the injury, I could not even move my leg in any appreciable way - so, in perspective, I feel as if we have all come a long way since injury and surgery.

Sinrider: I am anxious to hear about your experience with the OS. VS: I am psyched you are moving the leg into a more normal ROM. Bulldog: have a great time in France -what part?

Was in Sun Valley/Ketchum for four days this past weekend - the family alpine and nordic skiied while I spent time watching NCAA Basketball and hanging out in the Ketchum YMCA - really nice facility if you ever get there. Apparently the snow up high was great - midwinter conditions. Down low, you wanted to finish your nordic skiing by noon so you weren't skiing in sloppy snow.

Went to the PT this morning and GOT ON A BIKE!!! WOOOOHOOOOO! I'm going home tonight to spend some time on my trainer. She also gave me a bunch of new exercises (Active ROM), and told me the next time she sees me not to bother with the crutch. She believes I am progressing much faster than expected by the orthopod - but again, she counseled that I should exercise caution as nobody has seen too many of these. (I think we all collectively have as much information about how this injury occurs, and how it is treated and rehabilitated as anyone).

Keep posting guys - it is great to read of your progress; I have learned much from all of you. Thanks.

Idaho Guy

Sinrider, I have got to know if you went to the OS in full brace and crutches.

I have a f/u on 8 April and I am conflicted as to what I should do. I still work with the brace but it is getting used less and less around the office and during sedintary times. It is also getting to be less comfortable (my mind trying to justify taking it off). I will go to this appointment with brace but not crutches. OS will probably try to assure me that I will burn in hell but I am ready. I am not overdoing anything. 100 or so degrees flexion and i will tell you that it gets tight at the end of that range. I also note that there is some sharp local pain when I do leg extensions, nothing awful but enough to keep me honest. Still loving the aqua work.

All sound as though we have passed some imaginary milestone. 6 weeks ago, I could not see that I would be capable of doing some of the things that I am doing today. A tribute to positive thinking but there have been times for sure.

They are calling for 3-7 of new spring snow tonight in south central Vermont. Appreciate the conditions update from SunValley IG. Sounds great, glad you are back on the stationary wheels. That is huge. We have had some of the best spring conditions in years for the last month with no sign of a real melt off in sight. TOO COOL.

Well I be hornswoggled. My O-guy threw me for a loop at my 7th-week appointment Wed. No scolding in the slightest, and he didn't seem at all surprised by my progress (he may have found this forum?). He asked me how everything felt, how I was doing, etc. He had me show him how I could bend my leg and straighten it again. And that was pretty much it. Told me I can chuck the brace for good, start riding my bike, see him in six weeks. (VtS - No crutches, but I did wear my brace in to the appt, set at 70 degrees, since I already had it on for the drive anyway. But the doc wouldn't have known regardless, since the PA had me take it off before the doc came in. It just never came up.)

Unfortunately, I guess I'm not quite ready for the bike (trust me, I tried, as soon as I got home). My eyeball estimates that I've got about 110 degrees of flex. But it's just not quite enough to get over the top of my pedal stroke. But now that I've been given the go-ahead to start pushing to get back into shape (light-weight leg extensions, body-weight squats, and of course, RIDING), I'm hoping sometime in the next few days I'll be pedalling smoothly again. On a borrowed trainer at first, and then on the road.

And as soon as possible, I'll be getting back to what the doc agreed would be the best therapy of all - resuming my daily commute (36 miles round trip). For almost a year now I've been working toward building the ultimate high-speed commuter rig - a dedicated time-trial bike (Javelin Barolo), mounted with a rack and trunk. I've finally accumulated all the parts to build it up and I can't wait to start riding it. Soon I'll be ripping along Lee River Rd twice a day at 30+ mph. VT Soldier - I'll be sure to wave to your sister as I fly by.

IdGuy, very glad you made it back from Sun Valley without hurting yourself again. I'd hate to hear my brother had to rescue you (firefighter-EMT w/ Wood River F&R in Hailey).

Tear it up, all y'alls! The end is truly in sight.

I managed to do the same damage to my left quad tendon on Feb 18th (dang black ice) and feel your pain. Literally. I've had lots of injuries over the years and never experienced pain like this. Fortunately I was diagnosed right away in ER and surgery was performed the next day to reattach the tendon. I was actually placed in the straight leg brace the day I tore the tendon so it was no surprize to wake up to it after the day of surgery. Suffice it to say that the Tylenol #3s they gave me didn't help a lot with the severe pain.

I wore the straight leg brace for a week then they put the contour leg brace on with 15% flex. Each week it has been adjusted another 15 degrees. 5.5 weeks post surgery I have been off of crutches for about 2 weeks and able to flex about 60%. Although this changes daily and depends on which way the wind is blowing and if the knee gods are smiling on me that day. I can walk about 10 feet without the knee brace. With the brace and without crutches I can walk about 3 blocks now before it's time for a rest. Some days the pain is not bad, other days, not so good.

I see the surgeon again Tuesday at which point he told me he expects to tell me I can remove the leg brace. I suspect not yet unless he wants me falling flat on my face this time.

Here's hoping we all make a quick recovery.

ankhsign, sorry to hear about your day in mid feb. Sounds like your post surg progress is great and very different than mine. As my OS Dr NO says "all injuries are different". Sounds like you are doing well.

Srider, I am going to look for you on your contraption on Rt 15! I am overnight 2 days per week in Jericho. Commuter car is a silver VW Golf TDI. Sis is 1st house on Jericho side of Crossover Kennels, same side of the road. Stop in if my car is out there.

Bulldog: 2 pages of ?'s on first post op. visit

Blowout and surgery on 3/5 with first post op on 3/20. Popped the staples, explained the procedure (drill holes, mass of stitching, cinch it up tight), and answered many questions. One of my first, re-rupture rate...'very low'. Rehab properly, should be good. Having blown out my achilles, I asked about possible connection. Suggested decrease in collagen may have something to do with it, but 'don't live in fear of tendon degeneration' cuz mine looked great during the stitch up. Sent me on my way with instructions to massage, ice, bend to 40 degrees by 4 weeks out....and...stay in the brace! Been working on heel slides to achieve the 40 and I'm there with room to spare. Yeh, stiff as a board and the pain keeps me in check, but it gets better everyday. So, at 40 plus, 3 weeks out and head back to OS in a week.

Looking forward to the challenge.

Good luck to all!

Bitterrooter

I'm interested in what PT everyone has been doing and when it started. I am now almost 6 weeks post surgery, and other than stretches and walking I have not had any PT nor has it been prescribed by the surgeon. Although I do see him Tuesday for follow-up. I'm anxious to get going and get this knee back in shape. Although I did have a set back this weekend. Not sure what the heck I did, but knee is painful today. Perhaps stretched it too far? And suggestions will help as I want to discuss PT with Dr Tuesday. I have my annual overseas trip to plan for and want to make sure I am up for lots of walking on unever ground.

ankhsign,

I've started PT 4 1/2 weeks after surgery. I go to PT twice a week. They started with 30 degree knee bends, 2 sets of 10 reps, 3 times a day along with isometric exercises to get the quad muscle used to working again. Last Friday (at 6 1/2 weeks), the OS upped my ROM to 60 (though I'm lucky at this point to get to 45). I've been cleared to start putting some weight on it, but only while I'm using the crutches. The brace stays locked through the day. He's also letting the Physical Therapists call more of the shots as far as what I can do next.

The way the PT explain it to me, the controlled bending is a balancing act between letting the attachment heal while stretching the scar tissue (which is usually tougher than the original tissue) so it offers some flexibility.

I probably pushed a little harder today than normal. There's some pain in the knee and the ankle is swollen more than usual. But it was most excellent getting out in the sunshine today.

Hope all progresses well with you.

Brewman

Ankhsign,
I started PT two weeks after the operation. PT started with 45 degree flex, no flex by me; also at home we did 150 reps a day, after 4 weeks went to 70 degrees. Note: Had a brace that was locked at Zero but adjustable for flexing. At 6 week met with the surgeon and he pretty much turned my lose, as long as no weights will be used till week 10. I had already started walking without crutches around 4 to 5 week. At week 6 started standing without brace, very scary, thought leg was going to buckle. But in three days, I was walking around house without the brace. Tomorrow is week 7 and working on walking better and being in rougher terrain like the yard, always with brace on but unlocked. My PT told me the critical thing now is to get the swelling down. I should elevate and ice my leg more often. My knee and upper leg are ugly, 50% muscle mass gone in quadriceps. I can do a few leg lifts and bend to about 110 degrees. I am hoping to get on the stationary bike soon. I feel repetitive motion would loosen knee up. Stills feels like a rubber band attached.
Good luck in your recovery. The PT has given me a lot more info then the surgeon.

JE

9 1/2 Weeks Out

Ankh: Sorry to hear of your misfortune - like others, I'm sure you wouldn't wish this injury on anybody. But, sounds like you are quickly improving. It seems as if all of us are doing quite well after 6 weeks out. EarlJ: Look into an "Iceman" (check on the internet). I am still using mine every single night, and I believe keeping the knee on ice 6 - 7 hours a day has been one of the true keys to recovery.

PT: I started PT three days after surgery. Started with the PT passively bending my leg to 30* and doing isometrics, and gradually increased both ROM and activity levels since then. I am still in a brace - set at 40*, but I walk around the house without it most of the time (one level, no stairs). I have been walking in the pool since the scar was healed - I think this is the activity that has helped me the most. Started with 800 yards, and am still doing 1500 yards three times a week. I would recommend that every single person with this injury do the same - so would my PT. Am also on a bike 30 minutes or so a day - hoping to progress outside in another week or so. In the pool I do lots of weighted squats, calf raises, leg lifts, and stretches. Also do unweighted leg lifts and extensions at home out of the pool. Am now easily actively bending my leg to 125*, and I expect will soon be back to full ROM.

Forecast calls for 49* here in Idaho today, sunny, but windy. Still feels like a few more weeks 'til spring really comes. Wife and kids were skiing this weekend in 5 - 7" of powder. Coming home both days with red faces and happy, excited looks. Good to see that others can enjoy the great season we are having here.

Take care all.

IG

Thanks Idahoman, Earlj and Brewman. This is helpful. I have been doing the knee bends since week 2 and am now up to 45%. So that sounds similar to the routine you're all had. I am now up to about 8 blocks walking with no crutches so long as I have the brace on. Brace is now set at 90% flex although there ain't no way I can flex that far. I overdid it today with 5 flights of stairs. That was a mistake that I am paying for. Earlj, I agree that it scares me at this point to walk without the brace although I am up to about 15 feet walking without it. But I agree, I am on scarey ground as it feels as though it will give on me at any second. I like the pool suggestion. Great point re scar tissue. I remember from the past that this can be a big problem. Thanks everybody for your help. Here's wishing you all a speedy and painfree recovery.

Spring has already hit here in Western Canada with all the Spring bulbs out. So I'm anxious to get out and enjoy it.

So here's what the surgeon says. He says tendon has healed very well and it is time to start pushing the recovery, really pushing it he says. So he said to get rid of the brace most of the time and walk without it unless it is really needed. At first he said I will feel like the knee will give out, but keep pushing it. He said the chance of tearing it again is very small and I would likely break the leg before the tendon tears again. So when I do leg bends, go as far as I can, and then pull another 10 degrees and hold it. Start PT 2X a week and his referral says to treat agressively. Ok, now I'm scared. Wish me luck!

I got a rock

OK Boys (assumed), do you remember the Charlie Brown Halloween Special from the 70s? All the kids were out for Halloween and when they came back to talk about the great gifts they got from trick or treating exploits and all that Charlie Brown could say(with a bag over his head) was "I got a rock". That is how I am feeling today. Everyone has these great responses to what their OS an PT are doing for them(congrats to all) and all I can say is "I got a rock". Dont get me wrong, I am jazzed by your success but a little pissed at my OS for his go slow attitude. I get to see "Dr No" next week and very much expect more of the same be careful attitude with no PT referral. I think that i am doing most of what you all are doing without physician clearance to do so. Loving the pool, working out without a brace (brace is laying on the floor most of the day now) doing leg press, leg extensions and a bout or 2 on the stationary bike with about 120 degrees flexion, shoveling snow, moving over rough moderate terrain etc. I cant help but think I would have been able to do MUCH more with a more aggressive Doc. I am moving forward without him. Ughhh. There is still that underlying feeling of instability in my knee which I think is the demon.

IG, You are the man in the pool, I think this therapy has been the most important part of my recovery. What ever happened to Robert P? I am looking forward to a normal summer for sure.

The best of days to you all.

7 weeks out

VG
I think you are in about the 7 to 8 week post op and seem to be making the same progress as myself, you without the support of your Dr. My surgeon seems to be little proactive and the results have been good. I worked in the yard today mowing grass (push mower) and splitting wood but certainly glad I had my brace on. I have it set at open for retract and locked for extend. Saved me a couple times already. I am thinking of buying a sports knee brace like QB wear in games. I feel any extension in my knee would set me back, already tweaked my other knee. Want that extra support. I feel with that safety protection can push the envelope more. The 6 week point is life changing point. Everyday I see improvement. But will be a long time before I forget this experience.
My Dr gave the same feed back as ankhsign.
Best of luck to all
JE

VG: Boeing is pissed about the tanker deal. Do we want foreign companies supplying our military hardware? Problem is this delays a much needed resource to the Air Force.

Vermont, you are making more progress that I have to date, so I think you're doing great. Hang in there. I suspect we're all anxious to get back to normal. I know I am. I just want this over with and back being active again. We all appear to be progressing well. So hang in there and you'll be hitting the slopes before you know it.

Besides, I gave my leg a good workout, climbed stairs with no brace, and I'm not talking one step and a time with one straight leg here. And today it hurts like h___ I know dr said it would hurt, but he under estimated the pain. I suspect the stretching I gave it will ultimately benefit my recovery. But dang it hurt.

20+ weeks Post

Guys! (again presumed!)

Back from France Tues pm (4/1). 3/31 was 20 weeks. I beleive I am the farthest post-surgery of this group, and maybe the oldest (57 in Feb). First, try to keep the positive attitude, it helps, it isn't easy (my PT was great at helping me with that), and progress tends to ebb and flow, but keep at the rehab even when you don't want to!

Prior to France trip my knee was sore, stiff, a little swollen. Anything in excess, such as 8 hours on a plane, 2 hours in a bus, walking up and down old France stairs and streets, or standing in one place long causes knee to be tired. I also experience some numbness moving up the thigh from the kneecap on occasion, but that has started to end recently. Actually, I did very little exercises (prescribed exercises) in France but had lotsa stairs/walking. My knee feels better today. Last nite I was aggressive in the pool "running" laps with 5# on my ankle. Before I left I talked with my last PT and expressed frustration that I cannot jog without a "hitch" (like Festus on Gunsmoke!). I asked should I back off or run thru it? He suggested trying to run thru it unless there is pain and if no progress talk to OS. He said you can run in the pool so maybe it is mental issue too.

Brewman: I was wt-bearing right out of surgery, possibly a mistake as at my first Dr visit 2wks post, the PA asked where are my crutches? But I survived, and like all, forced to some caution due to limitations of full-length brace. I followed all the directions of OS/PT.

Sinrider: On my first visit to OS (5.5wks post) all he did was ask me to extend my knee; he actually didnt touch my leg until my last visit (14 wks post) when he put his fingers on either side of patella and had me do extensions, bothlegs. He said there is some "grinding" on bad one which is expected at this stage and due to outside quad muscle stronger than inside muscle, they control the patella. Early on he also said, let it heal but follow the rehab protocol. His goal was 90 ROM because that allows "life activities", but I am well beyond that, 129 at last meaurement 3 weeks ago. Does your PT measure your ROM? 110 is good for your stage I would say. When i started the stationary bike in rehab, they didnt have me pedal full rotations, just kinda back and forth. It probably was 6 or 7 weeks before I did full rotations.

IdahoGuy: I was in Paris, then to Auxemme, Cluny/Taize, Arles, Aviginon and Marseilles. NCAAs in SunValley isnt the worst thing in the world! Hope you enjoyed! Iwas told by my PT that I was progressing quickly as well but to follow the protocol, dont push it, let it heal, progress will come. Again, OS said 6-12 months to "full" recovery, whatever that is. We had lotsa snow before Christmas (I was at 6 wks Ch.Eve) and shoveling with a full brace is not only difficult but hurt both legs. I didnt start icing my knee until my 2nd rehab PT, maybe 12 wks post....surprised noone mentioned it. It seems to help reduce swelling potential post exercise.

VS: As I moved beyond 40 ROM I also experienced "stiffness" (it is hard to describe the feeling in the knee to non-injury folks) and I would hit the wall at the end of my ROM....it improves each week, keep it up. I too experienced sharp pain on the interior of my patella, especially after my "step exercise" (stand on book like a dictionary and slowly lower good leg to floor). I backed off from about 5" dip back to 3.4" and went back on Aleve 2x/day and it subsided. OS said probably due to the outside quad stronger than inside and pulling patella outward so not a smooth sliding of the kneecap. Actually, that exercise, on stairs, was what I did most in France and it seemed to alleviate knee stiffness from extended sitting/walking/etc. Keep looking forward to full health, which is sometimes difficult to imagine or believe. But at 20 wks it is a little difficult to remember the details of Day One Percocet and trying how to figuare out how to use the bathroom in a full brace! Also, my OS advised me not to exceed body wt (no added wts) on leg press at 8 wks post so use caution with that exercise. I now do about 35#.

Bitterrooter: 2 pages of ?s! Great! One thing I have learned is we must mange/direct our own outcomes. As so many have said, all are different and most OS seem to be different in approaches. So ask questions, and if you dont like the answer, follow with "why?" Heel slides really helped me with ROM, although I hated them. My PT suggested using a cookie sheet under the heal to make the slide easier, and it was helpful.

EarlJ: my swelling seems to vary, right now I seem to have "permanent" swelling on the outside of my knee. If it doesnt change in a month I plan on a return to OS, even though he has released me to my own recovery. At 4+ weeks post a friend looked at my legs and remarked my injured one was almost half the mass of my good one! I could poke my injured quad with my finger and it would look like a wiggling bowl of jelly. While that has improved, it still is happening...need to continue to work on tone and mass.

Ankhsign: welcome to IDG's string! you are fortunate to have had surgery as soon as you did. I am sure you have read on the web that surgery within first 48 hrs is best outcome. i was 16 days post injury and OS told me I could expect a good outcome but he repaired a fellow who waited 4 weeks and said he would have lifetime issues. Tylenol 3??? Ouch! I had Percocet after surgery (a Mon pm) til the next saturday. When I first visited the PA 2 wks post he asked where i was doing my PT. PT? Noone told me to start, just had simple leg raises and quad flex. I started PT the next day. Simple isometric exercises plus E-stim of the quad at PT. Again, ask lots of questions and direct your rehab. I still do Aleve 2x/day. I have tried cutting back to 1 or 0 and find it helps my knee to take 2. I wanted to stop so I could judge the pain. 1 step at a time! I remember those days!

I am aware of my knee 24/7. I wouldnt say I have pain but again, the feeling of fullness, stiffness, a little hitch i am aware of but noone would notice it walking. Anyone feel "fullness"?

Keep your attitudes positive Gents! We will get there!

Bulldog

Life is great!

Good day gents!

I just got back from a 16 mile road ride, and it was one of the best rides of my life. Why? Because I was outside, riding my bike. On a beautiful sunny day. And I felt like a real rider again, not just an old fart plodding along doing rehab. I actually powered up several moderately steep hills, comfortably. No pain at all. Yeeeehaaaw!

It wasn't the first time I'd ventured outside on my bike. This past Sunday after picking up a borrowed stationary trainer, I set it up in the sun on my deck and gradually worked the pedals back and forth until I finally made it (owww) over the top. And once I'd made it past that point, it just got easier and easier. I'm not saying it didn't hurt, but the rotations gradually got smoother. And eventually it didn't hurt at all. I kept it up for about a half-hour, and then quit only because my kids woke up from their naps.

And when I got off the bike, for the first time since my injury on January 29th, my leg had absolute freedom of movement, with none of that progressive elastic resistance we're all so familiar with. I felt like dancing (and did).

I wish I could tell you the free feeling persisted, but the stiffness returned after about an hour. But for that brief period, I really felt like I'd turned the corner.

Tuesday, I decided to go out for a roll around the neighborhood while I was running some walk-away instrument tests at work. It was close to 60 degrees for the first time since last fall, so I had no excuse not to go. Getting the bike rolling was tougher than I had hoped though - it took a great deal of effort (and pain) to get over the top again. I felt like I hadn't gained anything since my trainer ride on Sunday. The most gradual of hills found me poking up in my lowest gear, and I had absolutely no spunk at all. The weather didn't help, despite the temperature - it was howling windy (gusts to 40), and spitting rain. It was a very dramatic day to be outside, and it was nice to be actually riding a bike, but overall it was a rather depressing trip - kind of a letdown.

So what was different today? Hard to say. Sun always helps. But also, last night while I was sitting watching a special on the Amazon with my daughter, I discovered that my ROM had suddenly jumped from a very stiff 110 to an easy 135. That's only 45 degrees away from a full-on kneel. And I've got to attribute that to my cycling activities of the previous days.

I'm so happy right now I could cry. I'm an athlete again.

Hi-
I came across your forum while researching quadricep tendon ruptures online. I am so happy to have found out about you all, and you are already helping me. I know what you are going through.
Seven weeks ago, February 16th, I was on a ladder at home. As it began to fall, I jumped off and landed flat footed, rupturing BOTH quadracip tendons. Fortunately, I was diagnosed quickly and accurately, and had bilateral surgery within 24 hours of the accident.
The first 2 weeks I was immobilized in regular braces. The past 5 weeks I have been in removable velcro braces with passive therapy at home.
When I went to the doctor Wednesday, he said I could finally stand straight legged in my braces and try to bear weight and walk. So with the help of my in-home physical therapist, I walked about 60 feet around the den with a walker yesterday. It was not far or fast, but it was great to me!
He also okayed me to begin more aggressive therapy. It seems most of you have doctors that are more aggressive than mine. I have worked up to 48 degrees in one leg and 52 degrees in the other yesterday. He wants me to be at 90 degrees when I go back to see him on the 16th. He also gave me my first 4 exercises, and I'm ready to start making more progress now. But, I am warned to take it very slowly.
It was great reading about all of you, because this injury does not sound too common, and I have so many questions. It helps to know others who have already and still are experiencing what I am going through.
I hope you will allow me to join you all and share our experiences. I'd like to hear from you.

Hi Tiger bait. Ouch, both tendons. Sorry to hear about your accident, and like I wish everyone, Ihope you have a speedy and painless recovery. I can tell you that I sure enjoy being able to walk again without the splnts and look forward to pt starting Monday. My leg raises are doing ok, walking is quite good, stairs are ok.

Hang in there Tiger Bait. There is light at the end of the tunnel.

Bulldog, thanks for the info too. This is helpful.

Gents (assumed once again), Join me in giving TigerBait a perfect 10 from the international judging team. Dude, All I can say is that a bilateral qtr NEVER crossed my mind as something that could happen to anyone. This injury recovery has been the toughest experience of my life but I can not imagine this thing X2, that is nuts. I get down sometimes with my (self percieved) lack of progress but I can not imagine having both knees involved. Best of luck to you from the group.

I am off to the OS tuesday. PT referral would be great.

IG, Thank you for starting this string.

The best of days to all.