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Quadriceps Tendon Rupture, Repair and Rehab - Page 54

post #1591 of 10801
 Had second day of PT today and ROM increased from 37 to 45 degrees. I guess my biggest concern was making sure my quad was still attached and would be able to slightly bend after surgery. During my surgery on Dec 21 I ended up waking up and turning into a UFC fighter punching 2 surgeon assistants and kicking one of them with my damaged leg. Doctor said after 4 weeks he would be able to tell if anything detached but so far so good. Next PT is next monday and will keep everyone informed. Thanks again for everyones added info.
Everyone be easy

post #1592 of 10801

Hey h2o_snow - I see you changed your icon.  Is that your boat?   Awesome pic!!!

post #1593 of 10801
I think your anesthesiologist should have to give you a discount!  Waking up during surgery?  Not good!

Congrats on the +8 degrees.

I have some fear that I damaged my repair... the left side of my kneecap is numb and more sore... I was having these violent night spasms while I was on demerol... what awake with a violent startle/shake, so much so my legs would fly up.  

So much so I went to the doc on the Monday following my surgery... he probed around a little but quickly dismissed it.  I'm like.. how do you know?  I asked him how hard of a twitch you would have to do to damage the repair and he said that it's possible just flexing your quad hard/sharp enough could do it... but wasn't sure.  Gee thanks, really put my mind at rest.

Guess we'll see once we get this knee bending... 1 more week now until my 3 week visit.

Originally Posted by QUADDESTROYER1 View Post

 Had second day of PT today and ROM increased from 37 to 45 degrees. I guess my biggest concern was making sure my quad was still attached and would be able to slightly bend after surgery. During my surgery on Dec 21 I ended up waking up and turning into a UFC fighter punching 2 surgeon assistants and kicking one of them with my damaged leg. Doctor said after 4 weeks he would be able to tell if anything detached but so far so good. Next PT is next monday and will keep everyone informed. Thanks again for everyones added info.
Everyone be easy

post #1594 of 10801
 5 Weeks Post-Op

BankandCrank - I can relate with those spasms and shakes bro. I was on vicodin the first 2 weeks and then told the doc I needed something a little better so he prescribed norcos which is amazing. But yes i would say around week 2 and 3 i would flex the quad or knee pretty regularly during sleep or dozing off. I even elbowed my girlfriend a few times while sleeping. So i was relocated to the couch for safety reasons for a few days. Might be the medication. I also have numbness on the left side of my knee and sometimes get like a tingling feeling. Dr. said it might be the scar tissue but that area tend to be more sensative because of the opening. Stay positive.I know easier said than done but i wont help worrying or stressing about it ive learned. 

I am currently doing PT on my own at home 3 to 4 time a day with slight knee bends, knee hangs, knee flexing exercising, glut flexing, and ice right after for 20 to 30 min. My knee seems to be slowly bending more and more which kinda eliminates my worry of any retearing. My next PT with therapist is monday. I will keep you all posted and keep the faith.

post #1595 of 10801
Originally Posted by Tigger44 View Post

Is anyone else experiencing the extreme tightness down the outside of their repaired leg at the kneecap. I am trying to find and do  exercises that isolates the outer (vastus lateralis) quad muscle to help that area along. As previously mentioned, I am of the opinion that I lost more tendon at this location, causing the tightness in this location. I will attempt to get a confirmation of this opinion from my OS. I can now, after many, many months of effort, achieve full ROM on the stationary bike but I still lose around 20 degrees when it cools down - or passive ROM I like to call it. The loss of around 20 degrees has been consistent since I began rehab. I am choosing to avoid the term "stiffness" as my knee joints are not stiff - it's the bending of my leg that remains difficult due to the "tightness". Has been from day one of rehab, thus the slow return of my ROM. Not sure why my medical team didn't just say this when I was freaking out over scar tissue many months ago! They honestly must not be sure but the OS did eliminate too much scar tissue as the cause of my slow return of ROM? 

Tiger these where the same symptoms I had leading up to my second surgery to clean out scar tissue adhesions just on a greater scale.

I would not put blind faith into your orthopedic surgeon (they are all not created equally) and don't think you are going to find the answers here on this forum or the internet. I would go get a 2nd and 3rd opinion if you are not getting answers from your current OS. I would shop around and find the best ones on your area and go get a couple more opinions. I came close to see getting another opinion before my second surgery despite the having one of the best working on my knee.  

What is your current non-warmed up working ROM and how is the quad size and strength?
post #1596 of 10801
Hi all,

I hope that everyone is progressing nicely. I haven't posted anything in ages, but still read as time and 2 kids permit. There are moments these days when I don't think too much about it anymore. It's nice to not have it in the forefront of my mind all the time. Just sometimes .

Tigger44, I'm definitely interested in hearing the outcome with the tightness on the outside of your knee. I was just talking about a similar issue on the inside of my repaired knee with my GP during my last visit. When I'm stretching after getting a warmed up a bit, I can feel that particular velcro-ish sensation along the inside of the quad/knee/calf area that suggest that I have scar tissue still there. It feels like it's pulling on the skin rather than in the muscles.

In2Falling, I can't remember all of your history (though I do remember reading it). Did your scar tissue have a significant impact on your activities? How was the recovery from the 2nd operation? Did it set you back in any way? Part of the conversation that I had with my GP involved the question of whether it would be worth exploring the option if it meant another significant period without activity.

Thanks, Garland
post #1597 of 10801
 6 weeks post-op

Begining second week of PT Workouts this week. 3rd session with PT today. ROM improved to 54 from previous 45 degrees. It takes work but sticking with it. I continue to feel numbness and stiffness on left side of knee cap. Therapist says its scar tissue build up and the damaged nerves from the surgical opening. It will possible take a few months to get somewhat normal feeling again.
Doing therapy on my own 3 times a day. Workout consists of quad thrusts, wall pushes, wall hangs, chair hangs, lateral straight leg raises, and glut exercises as well. Icing for 20 to 30 min after. Hope everyone is coming along. 
Patience is key. Everyone be easy.

post #1598 of 10801
HeyBankandCrank, thanks for the kick in the you know what, I've started to  bend 30% and walk a little around the house without the crutches, but what works and feels really good is I've got the OK to go in the hot tub, wow what a difference I can tell right away that the hot tub will be a great resource for therapy, my left outside of my knee also too has numb feeling and is swollen more than the right side, while in the hot tub the knee bending becomes really easy to do the work , I'll be sure to not over do it.I'll need to read more of these threads and up date the way some of you have done a great job of doing, which really helps me.
post #1599 of 10801
Tiger these where the same symptoms I had leading up to my second surgery to clean out scar tissue adhesions just on a greater scale.

I would not put blind faith into your orthopedic surgeon (they are all not created equally) and don't think you are going to find the answers here on this forum or the internet. I would go get a 2nd and 3rd opinion if you are not getting answers from your current OS. I would shop around and find the best ones on your area and go get a couple more opinions. I came close to see getting another opinion before my second surgery despite the having one of the best working on my knee.  

What is your current non-warmed up working ROM and how is the quad size and strength?

Thanks in2falling, good to hear from you. You too Garland, et al.  My non-warmed up passive ROM is 115*, off from my full ROM of 135*. I am pleased with the quad size and strength. Progress continues to be made & is a work in process. The swelling, numbness, hypersensitivity & tenderness also continues to improve. 

I met with my OS today and it was the most depressing meeting since my injury. He is of the opinion that where I'm at now with the tightness is likely what I'm going to be stuck with as it has been over a year and I have worked very hard at it. :( Not good. We agreed that a second opinion (or maybe 2 as you have suggested) is in order. I have also decided to proceed with getting the sharp bone that is sticking out of my kneecap cleaned up. Maybe this is part of the problem but I doubt it? At least one problem area will hopefully be resolved!

I recall you saying that if the problem is scar tissue that cleaning it up by the 6 month mark is important? I wonder if there is some leeway with that time frame? Regardless, my goal is to beat this tightness with or without help!    

Cheers to all - keep at the PT folks,
post #1600 of 10801
I just discovered this site, one year after my original injury.  I decided to post to hopefully spare some the agony I went through.  My sad story:

51, male.

FIRST Quadriceps tendon ruptured:  Dec. 27, 2008 (nothing interesting, I missed a step in my house and the tendon completely tore).
FIRST Surgery:  Dec. 30, 2008 (23 hour hospital stay).

In knee brace for six weeks, not allowed any rehab.
At six weeks, circa 2-14-09 began rehap.  90 degree ROM.  In two weeks, ROM was 140, same as good leg.  No leg strength, 10 pound max on leg extensions (good leg over 100 pounds)

On March 4, during PT, I was on a stairmaster with my therapist within arm's length.  She had me doing the stairmaster backwards (facing away from the stairmaster) and the stairmaster BROKE, COMPLETLY RERUPTURING MY quadricep tendon.  (It gets worse.)  I had a SECOND SURGERY on March 6, 2009 (23 hour hospital stay).  I am about to go into a lot of detail here, because this could be very important if anyone reading this ends up with symptoms like mine.

On March 11, I went off of Vicadin (sp?) because I didn't like the way it made me feel, and switched over to aspirin.  I was taking between 8 and 12 per day for the next two days.  Early in the morning on March 13, I begin to get quite a bit of pain in my upper leg and lower back.  The pain seemed to move up my body, but it was not as intense.  I decided to go to the ER if the pain was still there on the evening of March 13.  The pain ebbed and flowed during the morning and early afternoon, but all of a sudden at around 3 P.M.  I was having a very hard time breathing and had sharp pain in my right lung.  I decided not to call an ambulance because I thought I should get to the hospital immediately.  I got to the ER in about 10 minues, and found out that I had blood clots that had traveled from my leg to my lung and I was experiencing PULMONARY EMBOLISMS (PE), which I found out later, that about 33% of people with PE DIE before they get to the hospital (my vitals were horrible when I first got to the hospital: blood pressure almost 230, blood oxygen saturation in the high 80s%).  Fortunately, once you get to the hospital, the survival rate is quite good.  I spend one night in the ICU and then three more days in the hospital before I was sent home on blood thinners.  I have no way of knowing for sure, but aspirin is a fairly good blood thinner and I think  the fact that I had taken such large quantity of aspirin for two days, may have thinned my blood just enough to allow me to survive until I got to the hospital.

Nothing much to report since then.  I began rehab at 6 weeks (this time I started with 70 degree ROM).  The ROM rehab went OK, but I was and still am, very weak.  Five months after surgery I could only do 4 pound leg extensions.  As of today, 11 months after my second surgery, I can still only do 49 pounds on leg extensions, which is less than half of my good leg.  But I do seem to be improving, although my knee still buckles on occasion. 

As far as the PE, I was on blood thinners for six months, and for the rest of my life, my dr. wants me to give myself a shot of Lovenox every time I fly (flying is high risk for blood clots, so-called economy class syndrome) as a prophalactic (sp?) measure.

Anyway, that is my story.  I am posting it here, because PE is not uncommon for knee surgery, and, now I know (although I wish my dr. had told me this before my second surgery) that it is even more likely after a second surgery. 

My advice to anyone undergoing quadricep surgery is to start moving as soon as possible after the surgery and to wear compression socks for at least two weeks after your surgery.
Edited by twiceruptured - 2/1/10 at 9:56am
post #1601 of 10801
Originally Posted by Tigger44 View Post

I recall you saying that if the problem is scar tissue that cleaning it up by the 6 month mark is important? I wonder if there is some leeway with that time frame? Regardless, my goal is to beat this tightness with or without help!    

 What I read was that most orthopedic surgeons don't wait (go past) 4 to 6 months to treat arthrofibrosis (scar tissue) if the patient can't get full ROM on their own. My OS stated the risk of damaging the cartilage surface knee cap and the grove it rides in if we did not do the second surgery. If your issue is fibrosis it is not going to go away on it own and more than likey not going to over come it without help. If I where you I would go get a second and third opinion before getting any further procedures done.

Originally Posted by garland View Post

In2Falling, I can't remember all of your history (though I do remember reading it). Did your scar tissue have a significant impact on your activities? How was the recovery from the 2nd operation? Did it set you back in any way? Part of the conversation that I had with my GP involved the question of whether it would be worth exploring the option if it meant another significant period without activity.
My ROM was stuck at 100-105 five months out and I had to have the second LOA (lysis of adhesions)/MUA (manipulation under anesthesia) surgery. Surgery was done arthroscopically two small key holes in the bottom of the knee with him working his way up through the knee shaving/breaking up the fibosis (scar tissue adhesions), with most of it under the repair (suprapatellar pouch). He also worked the knee heal too butt while I was under MUA (manipulation under anesthesia) . I was rehabbing the same day few hours later with 125 ROM and took a few months to get full ROM heal too butt. I dont know if it is worth exploring? In my case was something that had to be done with my limit ROM.

One thing I did do before and after the second surgery that seemed to help quite a bit, was my own Graston Technique message (http://www.grastontechnique.com/). I used a long thin screw driver grabbing both ends, lubed up the repair site with greasy lotion and would rub the hell out of the repair site.
post #1602 of 10801
Hello everyone! It has been a long while since I have posted. Still read the thread periodically, but have been busy making up for lost time. At least with me, when I was healthy enough to get back into the swing of things, I wanted to put this injury in my rearview mirror.
I am a bi-lateral QTR; injury 6/14 surgery 6/15.
Slipped on a gravel pathway. Pretty exciting story, I know .
44 Year old male, 6”1”, 230 lbs. 
So seven months into it, I have the following conclusions;
Conclusion 1; THIS SUCKS. 
Conclusion 2; Bi-lateral QTR REALLY SUCKS!!!
It has been a long haul, but I am still getting better. 
Left 6 weeks post surgery 35. Currently; 137
Right 6 weeks post surgery 33. Currently; 127
I slowed down on PT visits in Nov and Dec, going only once every two weeks, but I am back on the weekly or bi-weekly plan, still trying to grind out the last 3 degrees in the left, and hopefully another 13 degrees in the right.   Went 30 visits in 2009 and will likely go the 30 in 2010. I am targeting the end of PT at my one year anniversary of the injury in 18 weeks. Good insurance has certainly been a plus.   I still get one degree or so a week when I go to PT. I know most people are kind of done with ROM improvements this late after surgery, but I am not through yet. My PT and I am patient, and he keeps rubbing, doing a periodic Graston maneuver, bending and pushing. 
Strength, Balance & Flexibility
The problem with the bi-lateral injury is that I literally do not have a good base, or platform in the form of a good leg to work from. This has been totally from scratch. I have been working hard and steadily improving. Started out swimming, and then added a machine in the gym. Swam farther and more frequent, and added an elliptical machine to the mix. Kept increasing my yardage, and added the treadmill. Next week, believe it or not, I am going to hit the Stair climber!  Twiceruptured, I read your post and will be careful. 
I swim about 8,500 yards a week, and am doing about 180 minutes a week on one machine or another.   I am in the gym 4-5 days a week, and I am in the hot tub about 20 minutes daily.
The left is about 80% there and the right is about 65%. I occasionally try to do a bit of a jog, and it still hurts like hell and is unstable. If I could run, I could run through walls. I am pretty fit, but my quad muscle still needs work.
I also have a masseuse come to our home every 4 weeks, and she spends two hours rubbing, bending, pushing and twisting me. She has totally improved my overall flexibility and has really helped with recovery. She started at 6 weeks post surgery and is the best investment I made into my recovery.  
I have read some people who write “I don’t even think about it anymore”. Not a day goes by that I am not reminded of my injury. I am always trying to read what my knees and quads are saying, or being careful on a set of stairs, or wincing when I get out of a chair or a car. I work out nearly every day and am pretty active. I would say in terms of pain, I am at a constant 1, with about a dozen or so 2 or 3 level episodes daily. 
Still have some issues going down stairs and getting up after I have been sedentary for a while. But I never suffered issues with swelling, so I ice down once every three to four weeks for discomfort. No ibuprofen or any meds at all. I usually medicate myself with wine or rum. 
Not really a discomfort issue, but worth a mention because I have seen it posted several times. Still have a 1cm area on the inside of my knee that tingles or has no sensation. Takes a while (if ever) for all of the nerves and connections to return.  Scar on the left is almost gone!   Scar on the right is still a purple, crimson stripe.
Life goes on
Took the family (wife and three kids 8, 6 and 4 years old) to Disneyland first week in December (5 ½ months post surgery) and did really well. 4 days of walking and rides made me a bit sore. It was a fantastic trip because my legs didn’t stop me from doing anything!
We will all make it in one form or another with this injury, but recovery certainly isn’t passive! I keep getting better and plan to make a full recovery. 

Wishing everyone on this thread all the best in their recovery!

post #1603 of 10801

You have good eyesight.  The cat is a Hobie Miracle 20 on Payette Lake in McCall, ID.  Its been sold but we have another "big boat"  on line - a P19.  We'll  add a chute and hopefully have it on the beach this spring.  Mountain sailing is very sporadic.  We race/cruise with SISA - Southern Idaho Sailing Assc. w/regattas on 5 local lakes.  Usually trail a H16.  Can go weeks w/o wind but when its up we do see a full 25mph a few times a season.  Only out 2 days this fall - in my brace with a smile.

Have skied Bogus Basin lift served 3X now w/about 15 days on XC gear.  Area skiing is about half speed - I can only tele on flatter terrain with 10 turns max before I parallel.  Not very dynamic  and my knee hurts.  I believe its OK -  just not used to the constant stress.  Right now my knee is working better than my head - still very afraid of reinjury athough my orthopod says not to worry. 

Still swollen after 7 1/2 months post op and in slight, constant pain.  Is this the groups general experience for this recovery frame?


post #1604 of 10801
Hello all, I thought I would check in and touch base a little I hope everyone's recoveries are going great, I truly believe that this thread has been very therapeutic both mentally and physically for me, thank you very much Idaho Guy for starting this thread I can  see how much it helps everyone here thanks again.

Well I have my first appointment with my OS this Friday the fifth, for the first time since the operation on 12/29/09, the follow-up two weeks later was with the nurse practitioner on 01/08/10 she was to take out the stitches but they were none they were dissolvable.
So she advise me some weight bearing with crutches only and to wear the knee immobilize at all times including sleeping.  At home  I could bend the knee only 30% and to move the patella around as much as I could stand it. That's it. I sure do have a lot of questions for my OS thanks to learning most of them from here, at least from the threads here I have an idea of what's ahead and what to ask.

Our injuries occurred on the same day and the surgeries a day apart it'll be interesting to see how we progress in our time frames good luck and by the way I too can be grumpy without any sleep, I sure do  miss a good nights sleep.

6.5 hours a night six weeks from PO sounds good to me on averaging about four now from me, I sure do miss a good night's sleep.

Ouch!!! Talk about double your pleasure I mean pain, sorry to hear about not only your quad  you had to go and rip the retinacalum as well hang in there. Your sleeping habits sound exactly like mine, I sure do miss a good night's sleep. Hey spinning was that you who talked about how much you enjoy your cycling?  If so how long did it take you to get to your first ride from surgery, and how good  did it that feel.
I can't wait for my first ride on the bike I know it's a long ways away but I'm looking forward to it.

Sorry to hear of your misfortune after one year and three weeks of recuperating, try and stay as positive as you have been I'll be watching  for your updates.  I also would like to thank you for your earlier comments in regards to, no shortcuts along with a ton of effort are the only ways to overcome this debilitating injury I'll take  it to heart and do my best thanks.

Man I really do like your attitude keep it up its motivation and inspiration to my ears.

Great to see how well you doing two months in it gives me positive things to look forward to.

I think it's a good idea how you put everyone's charts together it really helps me because I'm always thinking when did they have the operation, so I can gage my progress and set some goals of my own, thanks.  I too have numbness on the outside of my left injured quad it is getting a little better but it is all swollen in that area.

Chazman   12/21/09           Not yet            30%               40-45%?            1. to walk around the house without crutches
                  SURGERY                                                                                  2.More aggressive W/ROM  in hot-tub
                  12/21/09                                                                                     3.Back to work on Monday
                  01/08/10 no stitches to take OUT dissolvable told to ROM Knee to 30% and to move patella around has tolerable.
                  PO VISIT WITH OS
                  02/05/09 hopefully my OS will allow me to start PT and get out of this full legged Brace.
post #1605 of 10801
 Wow, all of you folks are certainly an inspiration for me. Clearly there is big motivation and great support with all of you.
I am blown away by  the thought of having this injury X2 in either form.....I am in awe of your strength and resolve.
It sounds like most of us are taller, larger people who are active. I am 6'2" and have had tendinitis and arthritis in my knees for many years, used to be a crazy skiier but abandoned that about 8 years ago. 
Sleep has gotten a bit better...I think I am just used to this brace now, uncomfortable or not.
Second PT was yesterday...and boy was I sore last PM. Got to 45 degrees but had a lot of pulling across what seemed to me to be the patellar tendon and also pain posteriorly....I can feel a very tight band posteriorly. DOesn;t seem to be hamstring, seems to be from calf muscle(s). Interestingly, improves with massage so I think I will be doing that quite often.
I am not having any numbness like some of you.
My PT is very focused on patellar mobilitiy and urges twice daily gentle traction all sides of patella. Today I can actually see a tiny hair of movement and it is much less painful. Last week I could barely touch my knee after the first PT session. I haven't seen this mentioned much but it certainly makes sense given the injury and repair mechanism...I guess you can't expect either the patellar or quadriceps tendon to work very well if the patella is crazy stuck in place.
I am very interested in those of you who are doing swim/aqua exercises as I forsee that to be great for me. I have terrible arthritiits at the tender age of 42 and believe it could help me all the way around. 
post #1606 of 10801

This thread has certainly been informative.  There seems to be a dearth of information/ differing opionions on the rehab of this injury.  48 yrs old..My injury was on 11/11/2009 while playing bball with my two sons...was executing a "jump stop" when left qud tendon ripped cleanly from patella.  Most of you had intense pain, but fortunately, I must have had a clean tear off the bone because the only pain that I had was the muscle spasm in the quad.  Surgury was 11/16, outpatient full weight bearing with knee locked in brace 4 hrs after operation.  Very little pain even post op, ibuprofen worked best.  At 6 weeks Doc told me to "wean myself from brace"  so I discarded it at 6 weeks.  ROM was about 45 deg at the start of PT, now at 11 weeks about 135 deg.  Full ROM would be around 150 deg.  The best exercise for ROM was the stationary bike.  At first rocking back and forth and then with full arc while progressively lowering the seat to force greater flexion.  I started doing intervals on the treadmill last week, jogging foe 1 min then walking etc.  Today, I ran two intervals at 8.5 mph.  The knee is still swollen, and I find that a compression bandage works well and of course ice after exercise!  I had (have) chronic tendonitis of both knees since high school, and I think that it was a prime causal factor to my injury.  Interestingly, the knee post op now has less pain going up and down stairs than before!! 

post #1607 of 10801
 bballwall: I want to be like you when I grow up and out of this! :)
Third PT this morning, would love to gain 5-10 degrees.
It is amazing to me how one moment the knee feels great and 3 hours later sore, swollen and annoyed.
Good Luck all, look forward to checking in soon to make sure you are all behaving yourselves.
post #1608 of 10801
Hello everyone, what a beautiful day it is here in New England today it's only 27°but there's not a cloud in the sky, I just got back from the hot tub while doing my exercises it felt good and decided to work on my tan, that's right my tan, take a look at the photo below where I have my lounge chair and my Mr. Heater, I suppose you could call it my red neck tanning booth, I'm trying to get ready for my trip to Mexico into 2½ weeks.  I've Gotta do something right, unlike charnsophie hello! it looks like you've been to three PT sessions already, I still haven't started my PT but I have to visit at the orthopedic surgeons office tomorrow, I sure hope he takes the handcuffs off or should I say the leg brace and allows me to start my PT.
Welcome to the thread
it doesn't seem like a thread we all aspire to join but it does have a dearth of information, how cool how you enjoyed yourself I wish I could say I was playing basketball I just happen to fall down, it sounds like you doing real well it'll be interesting to see your first time back on the basketball court good luck.

Wish me luck, it's off to the OS tomorrow I'll be sure and let you know how it turns out.
post #1609 of 10801
 Chazman, where in the world in NE are you...I'm out on Nantucket enjoying the incredible sunshine as well.

Good luck at OS tomorrow...I'm quite sure you will be hitting PT very soon.
My PT was far more gentle on me today, not pushing the flexion as much and working more on patellar mobility and my patellar tendon which feels like the tightest rubber band in the universe when I flex >45 degrees...
Next PT for me tomorrow, doing three times weekly.
Anyone else have issues with patellar tendon? Definitely responds to massage, etc but wow. 
Keep the faith everyone...spring is coming.
post #1610 of 10801
Hi bballwal - My injury was close to yours, on 11/15/09 (at karate).  I started PT Jan 8th with 50 or so ROM and now at 120. Can go full arc on the bike since last week. Going downstairs normally is still not possible and I have not started jogging yet. At PT, they hooked me up to this treadmill used by NASA to reacclimate the astronauts to gravity. You step into this harness that is pumped with air and takes weight off. Pretty cool and worth the co-pay... The most painful at PT is the Graston work where they dig into my knee and scar with metal instruments to break down scar tissue. Not fun. Swimming is ok but I was reminded how far away from normal I am when someone ask me to play the 4th at tennis. Sorry, but not yet. Taking my first cross country plane ride in a couple of weeks. Paid $40 for extra leg room on Jet Blue. Seems like money well spent. The knee is still a bit swollen and tender and it feels like that the last few degrees of ROM and walking normally will take a while.
Thanks to all for the always useful updates.
post #1611 of 10801
Well, finally some progress.

Saw doc on Tuesday, x-ray was good for kneecap position and I could bend the knee to 45 degrees without too much strain so he releaed me to PT.  He also is allowing me 45 deg. of passive bend when I need it (but still locked out for walking) so I can get in my car and drive to work.... I've been getting some not so subtle hints from my boss that I needed to get back in the office.  So, on Wednesday I did my normal 90 minute commute... each way... plus a full day at work.  Fun.

First 40 minutes or so was a little tough as the knee was definitely tight... but it eventually loosened up and was only a minor nuisance.  I did stress the knee a little too much though as  I really didn't have a good solution for 1/2 the day for keeping my leg elevated while at my desk.  solved, but now need to lugh around a litle portable chair when I go to meetings, etc.

Had my PT evaluation today... fortunately my therapist has worked on 5 QTRs previously and has another case going on right now.  Did the usual poking and proding and testing... bent me to 45 degrees with hardly any stress.  My OS wants 45 degrees passive only, with gains of 15 deg/week for 4 weeks before I can start active ROM.  Looks like I'll be going 3x/week - 2 regular visits plus one aqua therapy visit.  That's a lot of time away from work.. some I'm trying to schedule appointments at the beginning of the day or evening... going to be fun to drive 90 minutes and then hop out of car for 45 min of PT.  There will be electro stim as well.. for building back muscle and the therapist said it can also help combat swelling.  I think I'm going to invest in one of those ice contraptions someone mentioned earlier.. .that wraps the entire knee and it suctoins in cold water or something like that.. what is that again?

On the plus side, my near term goal will be to ditch the brace, which my OS is going to eval me for at next check-up in 6 weeks.  I'll be braceless for St. Paddy's Day!  March Madness!  Medium term goal is to be back on my MTB by June... that will be a great tool to get back leg strength.  Long term is skiing with my 5 year old next winter... he's missing lessons this year because of this injury.

I've been doing pretty well getting around with the leg... I can now drive with regularity and that will be a huge boost.  I really don't use my crutches anymore - I haven't used them since the second week.  I think the early weight bearing is beneficial. 

I'm sleeping okay too... guess I can just sleep through about anything.  showering has sucked, but tomorrow I'm trying my first stand up shower w/out the brace. 

So, tomorrow at 8 AM begins my PT journey.  Time to buckle up and get going with the recovery.

Bank and Crank
post #1612 of 10801
Injury: 11/16/2009
end of week 11

Hello again!!  After exercise today I am reminded of two things:  Always use the compression sleeve and apply ice for 10 minutes or so.  Also, (and let me know if you think Im cheating) Ive been taking Naproxen once a day, which certainly has taken some of the edge off.  AlmostBlackBelt, as soon as you get to about 125 deg and gain a little confidence you should be coming down the steps with no hands I'm sure.  My bedroom is upstairs and the first thing I have to do is go down the steps to start the coffee, and those first few steps I am hanging on to the rail for sure, but by the second trip its pretty normal...  Alot of you seem to have really advanced PT facilites (pools etc) and Im kinda jealous...As far as the "Graston work"  the PT's mentioned friction massage briefly, but must have concluded that it wasn't necessary in my case... I've cut mine down to once a week because they have really been a little conservative and not very knowledgable with this injury.  However, Im a Gym rat and I just get on line and talk to people like us and various web sites for the "correct" protocol and do my own rehab. 

Talk to ya soon!
post #1613 of 10801
 Had my first real shower today - took the brace off and showered standing up instead of on a seat.

Oh yeah, it was good.

Had my first PT session today too... it went well.  Got some new exercises - calf stretch, calf extensions w/theraband, and some hip abductor/adductor stuff.  Had a session of electro stim... a little weird but it definitely helped fatigue what little quad muscle there is.

Oh, and an added bonus.. there's a PT student assisting my therapist..... and she's a smoking hot 21 year old!  Let me just say I will have to man-up even more than before... can't look weak in front of her.  
post #1614 of 10801
Great news on the PTA!

How is it that I don't get a 25 year old hottie male PTA?
Ah well, such is life.
post #1615 of 10801
 Anyone doing patellar mobes at home on regular basis?
I have heard conflicting things...like no superior/inferior for first 6 weeks.
I am doing lateral/medial at home, tough going, but less painful now.
My biggest issue is the tightness that I feel with passive flexion >45 degrees in the patellar tendon.
Any comments on this helpful. It makes sense but I am worried about it impeding my progress
post #1616 of 10801
 Charsophie...  I guess we all can't be lucky, huh?   ;)

What is a "patellar mobe"?
post #1617 of 10801
Hi Everyone:
This forum is great. Lots of great education!. Headed to see my OS on Tuesday and will be almost 6 weeks post op. Hoping for the Rx for PT and hope to begin shortly thereafter.
Been having short periods of sharp pain in the knee area. Only lasts for for 2 to 3 seconds and feels like a pin or needle being inserted into the knee. Happended right on top of the knee cap the other day when I tried to do a leg lift. Wondering if anyone else has experienced this or not.
Thanks everyone !
post #1618 of 10801

How far along are you?  My ortho gave me little guidance other than around 3-4 weeks to do heel slides and some quad sets.  I did move (try to move) my patella around manually a little but I didn't know what I was doing!  Also, I have some pain and tightness in the patellar tendon as well, and its kinda lumpy there, so maybe I should be be trying to do the Graston thing.  I think some of the tightness you're feeling may be due to the swelling.  Once I was out of the brace the knee got really puffy and my PT gave me a compression bandage, which seems to squeeze the knee enough to keep the swelling and stiffness down.


The early weight bearing I think was of great benefit to me.  If you can find your way to an Arc Trainer, which is similar to an elliptical, but has a longer smoother motion and can be set such that you  only need to bend the knee maybe 5 deg (You get this amount by loosening your brace slightly).  I started in week 2 on the Arctrainer.  My Ortho said it was OK (after the fact) as long as my leg stayed locked in the brace.  Once I had discarded the brace at week 6, I was able to gradually increase the incline which really helped expand my ROM early on before I could get full arc on the bike.  Remember you should only be exercising the pain free ROM unless your PT tells you it OK to do otherwise! 

Enjoy the Game!!
post #1619 of 10801
Hi all,

Wow! Lotso new folks! Welcome, I'm so sorry that you'e here. Still, I think this is the best clearing house for experience with a relatively rare injury.

I've been waiting for a while to post this. Okay, so I've been holding off on an extended post to the forum until I reached another milestone. Today, I am one year post-injury. Twelve months ago at this time, I was on my way to the hospital in an ambulance. Today, I'm sitting in my living room watching Inglorious Basterds and typing before I do 30-45 minutes on my bicycle in the basement. Life is good!

At twelve months, I'm still recovering. My activity level is back to and beyond what it was pre-injury (it's pretty much back to what it was before my boys were born -- 4 years and 18 mos now). The difference is that I've had a purpose over the past twelve months. The activity has been specific and focused on getting back to what I used to do. In general, it's been successful. I'm faster with greater endurance than I was before I ruptured my left quad tendon. Of course, there are other variables in play. I'm also ~25 pounds lighter than I was pre-injury and 65 lbs lighter than I was when I started to lose weight and get back into shape again. I figure I lost a step with surgery and gained two with weight loss :).

Like Wanasail, bballwal, and a few others, the tear was a clean one right as the tendon met the patella. Rehab was normal for this injury, with a lot of it being an excuse to spend excessive amounts of time on my bicycle to recover aerobic fitness. I enjoyed it and enjoyed the PT work. Somehow, I think that mattered rather a lot in the course of the past year. It made sticking to the program for the first 6 months a LOT easier.

My initial goal was to get back on the tennis court and play at the same level as before. I was looking forward to updating y'all on that component. I have been playing tennis again since early August and playing competitively since October on my club's travelling team on Saturdays. It took me a while to feel like I had shaken off 6 months of rust -- okay, so it's only been for the past 2-3 weeks that I've started to feel comfortable with my game again. I feel like I'm moving well and that I'm finally able to get enough lift from my legs to serve at full strength again. The biggest difference is that it now takes me forever to get warmed up and moving well. It's not until the end of the first set that I really start to feel "loose." The other difference is that singles is more comfortable than doubles now -- more rhythm, longer runs and less sharp bursts. Unfortunately, I think I'm still a better doubles player :). I don't think I'm fully back to the level that I was before, but I do think that I can get there as I play more and regain comfort/confidence (yeah, I think the level thing is probably mental at this point).

Today has been the most sore that I've been post-tennis all year. I'll choose to think of that as a good thing despite the tenderness. It means that I played hard yesterday and didn't think about my knee while I was playing. It also means that I should have iced it last night instead of walking around the mall with my family. I think that's the biggest difference. Standing for long periods (or walking/strolling like when shopping) results in the knee swelling a bit and feeling "tight". I even feel this after 75 minutes or so on the tennis court (esp. playing doubles where there is some standing without moving and tension in the quad muscles.

As far as the vital stats go: my ROM is now around 130 when loose (135 in the good leg), my estimate is that my strength in the left leg hovers around 85% of the right leg. I still work the quads on a 2-3 times weekly basis when I'm at the Y. My biggest concern is that I can't seem to rebuild the vastus medialis as well as the outer quad muscles. Any advice on this one?

There are moments when I can feel like the left knee is normal. That's not always or really even often the case. It's like those moments of spring-time temps in the midst of the New England winter, though. I focus on those to keep me focused on getting to the actual spring. Of course, I could take the more cynical route and argue that I'm just losing my memory of what it's like to have a normal knee :). 

I think the nice thing about this injury is that it does rehab pretty well for most folks. As my OS suggested, I will trade many things for a functional (if imperfectly so) knee. It's been a year of hard work. I've enjoyed much more of it than not.

Best wishes to all.

post #1620 of 10801
 Garland, thanks for the post.

As I'm just staring my PT and wondering what the next months have in store... it's very encouraging to hear from someone that's battled back like you.  You've also set some nice goals for me... I'd like to drop 25 lbs too... good to hear that's attainable.

Lots of walking around today.... leg is a little sore.  Time to go to sleep and rest up... driving into work tomorrow.

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