There is a substantial risk of reinjury if its before 6 -8 weeks after the QTR surgery. This repair is somewaht fragile so you could easily re-rupture if you are doing too much before 6-8 weeks.
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Quadriceps Tendon Rupture, Repair and Rehab - Page 37post #1082 of 108014/27/09 at 12:10pm
Wanasail, thanks for that 90% and 95 % concept. That sounds encouraging. I wonder what that means, though. Does that mean no more tightness or pain at 6 months. That would be awesome. I mean, I'm at 9 weeks and I can now drive again and get around but still cannot walk without a cane and even with ROM at 130, its still so tight.post #1083 of 108014/27/09 at 4:08pm
Hi Floridaguy, I guess we're the ones with a little international flavor. I'm also about 9 weeks post-surgery and did my injury in the Virgin Islands. My story is back on page 34 (post 1003). I've read through a lot of this thread, it would be a huge job to read it all. It seems that the "old timers" report getting back to normal activities in 6-12 months, but that the tightness is noticeable even after a year. I'm on a sports rehab program similar to the protocol that Jakster posted on page 36. My goal is to make that 90% in 6 months - by Labor Day. I'm past the pain, but still feeling the tightness. It seems to get a little better each week. It sounds like you've recovered full ROM quickly, which is great!post #1084 of 108014/27/09 at 6:55pm
pt ended 4/23/09
Seems everyone is still making strides on getting better each day. Sorry for your luck newbies but it does get better, no matter how you feel right now. I have been officially released from therapy since last thursday. WHOOOO!!!!! My rom is 144 degrees compared to my un injured leg of 135 degrees. Everything is feeling really good. I have been back to working 50 - 60 hrs a week landscaping. I got rid of my neoprene brace for the last 2 weeks and its feeling more stable. strength is still the big thing right now but its getting stronger each day. The toughest thing to overcome is the mental torture of not wanting to reinjure the tendon. My last day of pt i was running 5 mph on treadmill for 5 minutes with no problems. wet conditions still make me nervouse. i survived my 1st fall on saturday while working when a rock rolled out from under my feet and down i went. overall i feel i'm probably 75%. good luck to all and keep a positive outlook.
stevepost #1085 of 108014/27/09 at 7:16pm
Hey guys and gals,
What a beautiful day! If you live in New England, there's nothing like an April day in the mid-70s with a nice breeze. There must be some link between nice and warm outside and good feelings in my left knee (I'll just trust that cold days can't have any effect ...). Lots of endorphins today. More on that later.
Floridaguy and Graceella, y'all sound like you're making great progress. I'm constantly intrigued by the variety of post-surgery PT options that we seem to get. Mine has been a much slower progress than either of yours in terms of ROM. At 10.5 weeks post-surgery, I'm still at only 90 degrees of ROM and wearing my brace. My OS subscribes to a 12 week in the brace program with slow, incremental progressions. I think it's to balance strength gains (such as they are) and ROM gains.
Back to the endorphins now. Tonight, my knee felt better than it has at any point since I found myself calling for an ambulance on the tennis court. It felt good all day at work (probably due to the unseasonable warmth). Then, when I started my evening PT workout, things felt really good. I rode my mountain bike on the trainer for about 10 minutes. All weekend, it felt like there was a bit of a hitch in the pedal stroke when I was going around. That cleared up after a couple of minutes tonight, and I felt pretty smooth in my pedal stroke. After 10 minutes, it felt good enough that I wanted to try my road bike. Oh my god, it felt so right to be on that bike again and spinning the pedals. When I got off the bike after another 12 minutes, my knee felt looser and freer than I can remember. I just hope that feeling lasts (or at least comes back again soon).
Best wishes, y'all. Garlandpost #1086 of 108014/27/09 at 8:55pm
Hey all, thanks for the support and encouragement, sorry you are all in the same boat as me but it does help to hear your stories and experiences.
Garland, I sure do wish I was in New England, I am not one for the hot weather and in Philly today it was pretty warm. Although it would be a lot more tolerable if I didn't have this boot on my ankle, this thing is so hot!!!
It is interesting to hear the different approaches out there. I live just outside of Philadelphia and my OS and his practice is the practice that the EAGLES use for their players. They have a reputation for being pretty aggressive in their treatment approach. I have been doing these 60 degree leg bends since the day after my surgery. I have no idea how long I will be in this leg extension but based on what my OS has said it sounds like it will be a few more weeks at least. I am really looking forward to starting formal PT, just to do something to help things along.
Again, thanks to all for the advice and encouragement!post #1087 of 108014/28/09 at 11:00ampost #1088 of 108014/28/09 at 3:10pm
Hello All! I've got so much encouragement reading all the new posts, & remembering I'm not the only one with a pain like toothache & immobility!
Many thanks Jon for your 'milestones' info.: it gives me a focus in this seemingly never-ending recovery process. My treatment seems so different from many of you: I'm waiting 'till early June to see my consultant. Until then I'm gradually able to bend the knee a little more, but it's still very painful, especially at the end of the day, when both ankles have swelled up too. Sorry, I mustn't keep moaning but keep positive. Looking back, I have made progress in the 9+weeks since that fateful day in February! Yes, garland, the warmer weather helps me too & lifts the spirits!
Best Wishes to all
nabo19post #1089 of 108014/28/09 at 4:19pmpost #1090 of 108014/28/09 at 6:11pmpost #1091 of 108014/29/09 at 7:54am
REPORT ON THE WHOLE SWIMMING THING
55 year old cyclist; 6 weeks post-op
I made my first post two weeks ago in which I mused about getting in a pool, WITH the brace, to swim laps. Some concern was expressed. Since I had not asked for permission, and my OS has made me quite paranoid about "popping" the sutures and going through the whole ordeal again, I stalled for another week.
I'm pleased to report that, at least in the case of someone who was already a lap swimmer before the injury, this was a godsend. Using a commercially available float called a "pull-bouy" to support my legs, it was easy to swim with the immobilizer. In fact, I think it would be more of an issue to try to walk in a pool with the immobilizer on, because the drag it creates tries to bend your knee as you bring your leg forward. I'm now putting in a mile every other day.
I got ex post facto approval (hey, Florida guy--I'm a Florida lawyer too) from my OS yesterday. I didn't tell him that I'd already been doing it for a week. HOWEVER, since this activity has now been officially approved, I feel that I can recommend it. To an endorphine addict it's like a major fix after a long dry spell.
I was told to start putting some weight on my leg before I left the hospital, so long as I absolutely and positively did not move my knee for 6 weeks. I was off the crutches and on a cane in less than a week. I've noticed that some folks have been told not to put weight on at all. I have a question to you "no weight" folks. DId you have injuries to more parts of your knee than just the Quadraceps tendon? Are there distinctions in the kinds of injuries we have that account for the different regimens we are given? I think we need a doctor in this group.
Thank you all for helping; there is no other place like this on the web. It's great to have company and commiseration.post #1092 of 108014/29/09 at 8:16am
I too have seen that quite a few people were told no weight on their leg and no bending the knee. My OS said that I would be able to bear full weight on my leg the day after surgery and he has also had me doing the 60 degree leg bends three times per day since the day after surgery. It is interesting to see the different schools of thought regarding recovery.post #1093 of 108014/30/09 at 12:36pm
Injury -- 3/20/09 (6 weeks)
Surgery -- 3/24/09 (5.5 weeks)
Not much new here. Still straight in brace, but if it's not on real tight it does allow a little movement. Less scared about taking brace off for showers, etc. Feels a LOT less wobbly/fragile in general. PT once a week, but it's just leg lifts, ankle stuff, massage, etc.
Seeing OS next week. At that point, I believe I will start PT twice a week and begin to work on ROM and strength. I can't wait!
Working out at gym (upper body, of course) as I can. Even trained a couple of my regular clients from before! (Of course, I could not demo every exercise....). I think everyone at the gym is amused that the big muscleman trainer is now hobbling around looking somewhat helpless! :)
Still not driving...I might be able to swing it, but I have manual transmission, and I am officially not bending my knee much (injury is on clutch, left, side), so have decided to wait until I have done some official rehab ROM work. Luckily, I live right by a Metro station, and many buses stop there too. And I have been getting groceries delivered.
Those of you who come out the other side....how long were you inj the brace total?? It sounds like, for safety's sake, I'll be wearing the damn thing for many more weeks.
Jimpost #1094 of 108014/30/09 at 1:06pm
FloridaGuy--the "band" i referred to is the tightness many of us have experienced around the knee near the repair. Feels like a tight rubber band.
Graceella--- as many say, the mental aspect can be as difficult as the physical, but keep a positive attitude and it will come!
Bulldogpost #1095 of 108014/30/09 at 3:31pm
PT started 04/06/2009
Saw my OS today. Hadn't seen him in almost a full month. He wanted a full month of PT under my belt (3X per week) before I went back to see him. He was pleased with my progress and said that I'm way ahead of where I should be for a guy my age (60) at only about 9 weeks post-op.. He was also very pleased that I have my full ROM back. Said the swelling would be there for a while. (There ireally kis a fair amount of sweeeling still at the knee). There's still lots of fluid in there but he said that its not an alarming amount of swelling and to remove the fluid would be counterproductive as there'd be so much irritation from the needle, that it would not be worth it. Did emphasize that I have to always be very careful for the rest of my life to be careful that I don't fall again. Not sure that was such intelligent advice...I mean, who falls on purpose? LOL. But his point was the the tendon will always be vulnerable [especially for the next YEAR [YIKES] and if I should fall again, re-rupture is very likely. Sent me for another four weeks of PT and then said to see him again in a month...Said I would not be 100% [ whatever that is] for a year. I'm very encouraged, I guess although a year more of some form of this disability does suck. My only complaint at this point is that I do still feel the tightness...the "band", I guess...when I walk. But I'm walking without the cane or crutches and am getting much better at steps. No steps at home but there are at the office and I can tell I'm getting better with stairs. ROM is no longer an issue or a goal, but my therapist keeps emphasizing that now its really time to concentrate on the quad stength. For those of you still in the brace...hang in there...it really does suck and sometimes seems endless, but it really does improve..post #1096 of 108014/30/09 at 3:35pmpost #1097 of 108014/30/09 at 4:51pm
9 weeks post-op
Hi Gymdude. I'm also longing to give my wife back her SUV and get back my 5-speed Mazda(VROOM VROOM) . I've been doing "clutch sets" for the past week. I get in the car and put my left foot in a normal position next to the clutch, lift it up and depress the clutch, hold about 10 seconds and return to the normal postion. I'm doing 10 reps whenever I'm near the garage. I 'll know that I'm ready when I can do it smoothly without hesitating due to pain, stiffness, etc. I think I'm close!! The poor PT just rolls her eyes and humors me.
I was in the brace set for no flex for about 6 weeks, then the PT set it for 40 degree extension. At 8 weeks I was able to go without the brace at home, but wear it other places with the flex range opened to 60 degrees. This week (9 weeks) I'm out of it completely except she encouraged me to use it if I go somewhere that is crowded, lots of stuff to trip on, etc. I've been weight bearing rrom the beginning and climbing steps (good leg up, bad leg down) from about post-op day 5. Interesting, she's transitioning me into taking stairs normally (alternating legs) in stages. This week I'm working on a 4-5 inch step.
Question for the veterans. How did you know when you were ready to ride your bicycle outside? At this point I'm up to a level on the trainer where I could do an easy, flat 5 mile ride. However, I'd be real concerned if I had to quickly clip-out with my left foot and support myself at a stop on my left leg. As noted above - if I screw up and fall its big time bad news. Also -- any suggestions on exercises that build the bulk back on the medial (inner) quad?
Its great to read so many posts celebrating progress!post #1098 of 108014/30/09 at 5:32pm
Its been 1 year and a week since surgery and things are still improving slowly. Remaining tightness is slowly subsiding which I am helping along with my long thin shiny screw driver doing my own Graston Technique massage (http://www.grastontechnique.com/) a couple of time a week again.
Still having a hell of a time getting my quads back, my leg is still a good 1 1/2 inches smaller and about 85% strength of the other leg, course I think the good leg has gotten quite a bit stronger this last year . Tried working legs twice a week but was too much on the knee and getting pains in the patella tendon area, so I have backed off to once a week and focusing on single leg work with the exception of doing squats. Been pedaling my butt off with high resistance on the bike 4 times a week and getting a 2 hour mountain bike ride in on the weekend. At the rate I am improving I think its going to take this summer to get the quads equal to the other leg.
I gained some extra ROM this last month. This mornings leg workout doing some warm up stretching on the quads I was able to get my heal past my butt about an inch, previously I was only able to get it to reach my butt with some force.
Wanasail: Peterson step-ups are suppose the be good inner quads and VMO (http://www.jumpusa.com/peterson_step_ups_for_jumpers_knees.html). You could maybe pick up a cheap pair of platform pedals for your bike until you get comfortable riding again, that way you dont have to worry about those clips.post #1099 of 108014/30/09 at 5:42pm
11 weeks post-op tomorrow
12 weeks post-injury Sat.
Gymdude, I am still in the brace at 11 weeks. It's open to 90 degrees, and I don't really wear it around the house after they said I could work on moving around without it :) My OS says 12 weeks is his standard practice. I get it off Tuesday. If I weren't worried about eventually needing it again, I'd barbecue it like I did my Inorganic Chem lab book in college. There've been moments when I felt like I needed it, but geez I want to get rid of it now. I definitely feel the rubber bandy tightness more without the brace than I do when I'm wearing it. It makes me a bit more reticent to bend my knee as fully as I would in the brace where I can see the ROM displayed.
Wanasail, I have the same question you do about when you know you're ready to go on the road. I'm starting to feel antsy for a flat ride after only a few days on my trainer with the road bike. I'm mostly sane, so I will be as patient as I can make myself be -- say May 15. By then, I'm hoping to be able to handle more resistance for longer periods. For those who've done it, what was your guide to when to try it on the road?
Lastly, anyone on the list who's had the repair for more than a couple of years? I'd be interested to hear about the longterm effects of the surgery. That's tops on my list of queries for the OS on Tuesday afternoon. Followed by when I can expect to play tennis again.
Keep up the good work, y'all.post #1100 of 108014/30/09 at 8:15pm
Floridaguy, My OS said to me that he wanted me to walk as much as possible while I am in the brace, but added that I need to make sure I don't fall. I thought the same thing you said, I didn't plan to fall the first time. It is pretty scary to think about going through this again. Did you OS give you any suggestions about how to reduce the chances of rupture again, other than just not falling of course!post #1101 of 108014/30/09 at 9:44pm
Graceella, I too fractured my opposite ankle in the fall that caused my rupture (left knee, right ankle). For the six weeks my knee was in the full brace, my biggest challlenge was getting in and out of chairs. I would sit in this big chair in my living room and to get in/out of it, I had to rotate around on the bad ankle, swinging the bad leg up on to the hassock. It would really torque the ankle pretty significantly to a point where I didn't get into the chair very much, spending most of my time in bed. I felt like I had some bad choices, either slow the ankle recovery significantly or spend way too much time just in bed. I opted for the latter, and in hindsight that was probably good as the ankle recovered quickly and fully.
Nabo19, I'm still pretty aggressive with ice for the swelling. When I walk a lot, my ankle swells a little and my knee swells significantly. A good hour with the ice (15 on, 5 off) seems to help me recover more quickly.
I have found that the rubber bandy feeling is very responsive to heat. When I take a hot shower, it goes away almost immediately but returns within minutes after getting out of the shower. Has anyone tried wearing something like a neoprene sleeve to retain body heat and if so, does that make a difference? I'm thinking of trying it because I find that even the retained heat under the sheets keeps me band-free but 10 minutes out of bed in the morning and it starts again.post #1102 of 108015/1/09 at 8:50am
This is interesting. I find that hot tub sessions feel very good, but the relief of the rubber band feeling only lasts for a short time after I get out and cool down. I didn't think much about it, but it seems to fit.post #1103 of 108015/1/09 at 8:59am
Jon143, you have just described my life. I actually rented a wheelchair so I did not have to sit in bed all the time because I could not for the life of me get up from a chair or couch in my house. The wheelchair helped in that area. The biggest concern for me was going up and down stairs because their was no way to not put any weight on the ankle. I am hoping that it has not slowed the recovery of the ankle but I won't find that out until I see my OS on Monday and have an xray. How long did you have your ankle in a boot/cast?post #1104 of 108015/1/09 at 10:30am
Hello. New to this Forum. I have the same injury..a Quad tendon tear. It happened just last week while on Vacation in Nicaragua. Not a place to get injured by the way. It was a harmless little slip and fall, but the pain was intense.
I had an MRI and Doctor visit one week after injury. They are telling me that I have a 75% tear on my left leg of the Quad tendon and that I am looking at surgery as the best and really only option for full recovery. I am a 43 yr old male who is fairly active...Golf, travel and go on a Tahoe ski trip at least once a year.
Looking for advise from those who have had the surgery. How long did it take until you could go back to work? Stupid question but how do you go to the bathroom if you can't bend knee for several weeks?
This is going to be the worst thing ever, isn't it?
Thanks.post #1105 of 108015/1/09 at 11:54am
18 weeks Post op.
Welcome Newbies. Sorry your here, but it's a great place considering our circomstances.
I have officially "graduated" from PT on April 21st and had last OS visit on April 22nd. Both said they did not need to see me anymore. Good as new! mmm.... not quite. Still working on strengthing the quad. I tested out at about 65% strength in my left leg. Was given set of exercises to do at home.
One thing that was troubeling me. Many of the exercises that I had been doing under care of my PT involved deep knee bends and caused quite a bit of pain in the knee. Not at the injury site, but internal to the knee. On my final OS visit, they asked if I wanted to talk to the athletic trainer they have on staff. He gave me a different set of exercises that keeps the knee back behind the foot and does not involve deep squats. what a difference! I really fell like I'm isolating the quad and getting a good workout on it. Also involves a lot of streching. I was told that the quad strength would eventually come back, but it would be slow. I'll post the exercises if anyone is interested. This athletic trainer also stated that the exercises of my injured leg would need to continue for a lifetime. Not just until it gets back to "normal". He stated that severe injuries such as this can regress back from normal if continued streching and exercising is not kept up. I had not heard that before.
Several recent questions above:
1. I too felt a "band" across the top of my knee for quite a while. As my ROM increased, the "band" disappeared. Now that I have full ROM, I don't feel the band at all anymore. I think part of this was streching the quad. I spent quite a bit of time streching the quad. Real streching of the muscle and tendon did not start until after I got my full ROM back. Before then I was really just streching the knee.
2. Someone asked about weight bearing after surgery. I was weight bearing the day after surger. OS said I could weight bear as much as I wanted as long as I had the immobilizer on. I used crutches for long walks, but mostly hobbled in semi Frankenstien fashion. Per OS direction, I kept immobilizer on for 8 weeks, then discarded compeletly.
3. For Cvorbs - as for going to the bathroom without bending the knee. I purchased one of those handicap rings that raises the stool seat height up about 6 inches. Worked like a charm. Easy to install. Best thing is no one else in the family wanted to sit on the raised toilet, so I had a bathroom all to myself!
Good luck all. I look forward to reading your continued recoveries!
Scott.post #1106 of 108015/1/09 at 1:45pm
re: the brace: Sounds like I am on the same schedule most of you were. I think they are gong to set it to allow some ROM next week (week 6), then I assume I'll have to wear it a few more weeks, but maybe less and less.
I know it will be many many months before I can do my heavy leg workouts again, but I hope that I can carry the weights to the bench, get in position, etc. like I used to , to do my heavy upper-body stuff. Right now I'm just using cables and Smith machine barbell (more safe).
By the way, I was evenin seriously considering doing another bodybuilding contest this Fall! Maybe next year...but in any case, you don't place very well at those things if one thigh is twice the size as the other!!
wanasail: I don't know why I didn't think of "clutch sets". I am gong to try that before too long, before actually getting on the road!
garland: HAHAH I love the barbecue idea!
cvorbs: I could get on and off a toilet OK, and use it fine with one leg straight out, BUT in my bathroom the tub is about 1.5 feet in front of the toilet....so I have ot sit sideways on it!! And oh,it took me 3 weeks to get back to the office....taking the subway (with short walks on either end).post #1107 of 108015/1/09 at 1:49pm
Hey - now we're starting to get into the important questions ;-)
Work - I had my operation on Tuesday, worked at home (I'm an office guy) with a laptop and wireless internet on Thursday and Friday and drove into work on Monday. I started out working 1/2 days at the office and 1/2 days at home and transitioned to full days at work over the first two weeks.
Toilet - Nothing special. I was able to use a crutch to raise and lower myself with the left leg extended straight out with the brace for sitting. I had to wear smooth soled shoes so the heel would slide as I moved up and down. For standing, I was able to free up a hand by leaning against a wall that happened to be situated in just the right place.post #1108 of 108015/2/09 at 7:20am
The practical questions were the scariest part of the first two weeks (1 post-injury, 1 post-surgery).
Bathroom stuff -- I also adopted the side-saddle approach due to tub/wall positioning. I did upper body workouts everytime I had to get on/off :). I also invested in one of the shower stools in the 1st week when I wasn't supposed to be weight-bearing. That got much better post-surgery when the OS said I could put as much weight as I could tolerate on the leg with the brace. Still, with a tight bathroom, it helped a bit.
Driving -- One of the few times I'm glad I listened to my wife was buying our new car last year. I wanted a stick 'cause I've had one since I was 16. She can't drive a stick and didn't want to learn with 2 kids in the car. I was able to drive at about 2 weeks post-surgery with my leg still fully extended. Getting in and out was tough. I shudder to think of the results of an accident, but it feel so amazingly good to drive after 3 weeks w/o driving that I got past it. Definitely, this had an impact on my sense of freedom and independence.
For all of you who are doing this while living alone, my hat's off to you. I couldn't imagine it for the first couple of weeks.
Work -- I wanted to do 1/2 days after about a week. Something about daytime TV. Anyway, our short term disability policy wouldn't allow that even though I have an office job. So, I went back 2.5 weeks post-surgery when my OS would allow it.post #1109 of 108015/2/09 at 8:41ampost #1110 of 108015/2/09 at 9:23pm
Is this the worst thing ever?? It definitly sucks and you definitly have to make accomodations in your life. Like figuring out how to get in your car and sit on the toilet but you will figure out what works for you and you will get through it. I am only four weeks post surgery and while I have my moments that I am really down about this experience, there are many things that are way worse than this. If this is the worst medical experience I ever have than I am damn lucky! So keep your chin up and remember that you will get through this and in time you will look back and it will be a distant memory. I firmly believe it is all about a positive attitude.
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