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Quadriceps Tendon Rupture, Repair and Rehab - Page 58

post #1711 of 10804
Hi aggie96 -
An unfortunate welcome to the forum.  I did my QTR on Anegada about 14 months ago.  You're 20 years younger, so your recovery may go faster - although that also depends on your particular injury.  I think you may be trying to push things too hard and too fast.   At 16 weeks your QT repair hasn't yet fully healed and there is a danger of re-rupture or other injury.  You should be doing closed chain exercises (lunges, squats, etc.) to rebuild your quads as well as exercises to rebuild your balance, core, glutes and general body fitness.  Bicycling is great -either easy road riding or on a trainer.   I'd avoid running, extensions and other open chain exercises for at least a few more months.  My PT and OS told me never to do another weighted extension no matter how good I feel.   The fact that the leg is still severely swollen may indicate that you're overstressing it.    No way you'll be 80-90% at 16 weeks.  the benchmark is hitting 80-90% in six months and 90-95% in a year.   Most important thing - make sure you have an OS, PT or athletic trainer familiar with the QTR injury to help you with your program.  Learning what not to do is perhaps the most important - especially for aggressive folks eager to reclaim their lives.   Best of luck!
post #1712 of 10804
I'm another ""here we go again." I did my right quad in fall 2006 and my left two weeks ago. I'm an MD and have pulled all the literature I can find. These are largely injuries of athletes, runners, jumpers, skiers who have quads strong enough to rip the tendon off the bone. There is really only one treatment--drill the patella and reattach the tendon. The only question is how long to immobilize the knee, with 6 weeks being a lower limit. I spent 3 months in a brace last time. I have a younger orthopod this time and he's more aggressive on the rehab--at least I hope he will be.

Almost all of us did this in a simple slip and fall. Mine was mud the first time and ice the second. I don't know how I angered the gods, but withing a few days prior to both injuries I had said--"I think I need to run another marathon." Boom. I'm 64, and have done 27 marathons (4 Bostons). I was running 10Ks again  within 6 months of my first rupture and I think I'm sticking to the short ones from now on. Two days earlier I had X-country skied 7 miles with just my dog in an area with lots of dead cell spots. I'm just happy I didn't go down at 10 degrees and freeze to death.

Happy rehabbing,
post #1713 of 10804
Thread Starter 
Hello all: I'm  almost 2 weeks removed from my 2nd QTR surgery to repair the 1st surgery of two years ago that had failed. 

Brewman:  Nice to hear from you again, but sorry about the circumstances - I'm guessing though, that  you would rather have a broken patella than a QTR?  At least there is some good news for the rest of us - the repair can be made very strong.  Good luck to you on April 1 - let us know how you did.

Aggie96:  Welcome - what Wanasail said.  In my experience, it takes a looooong time to come "all the way back" from this injury - it is possible, but 16 weeks is not even close.  Keep at it, and you'll get there!

cdavant3:  very sorry for your second QTR.  I'd be interested in hearing how you think it might be possible to avoid the injury in the other leg - would yoga help?  If it is simply the strength of the quad vis-a-vis the strength of the tendon, then perhaps it might be better NOT to get "too strong" before ski season?  I spend a lot of time outside nordic skiing away from others - I'm glad, like you, that my 2nd QTR didn't occur on one of my excursions this year . . . . .

Went to my first PT session yesterday.  Passive movement to 40*, quad sets, manipulation of the patella, e-stim and ice.  I'm to -5* on my passive hyperextension already - I think that is good.  Go to the OS on Friday to have the staples removed.  Hopefully they'll let me shower without covering the wound . . . .  Also, hopefully they will give me a hinged brace along with the authority to do some minor active extensions and flexions.

Stay positive, stay positive, stay positive - we could all live in Haiti right now - if you can read this, you are fortunate - there are many others in the world who are not as fortunate as we.  I just look around and see a lot of folks who have it worse than me.  Hang in there, all . . . .

post #1714 of 10804
Hello All,

Tomorrow is 12 weeks and all is well. Almost full ROM (within 10* of other leg) Walking normally, going up stairs is fine but I feel it after a flight or two. Coming down is getting there. If I concentrate I can come down slowly with full control but most of the time I kind of drop down to the other foot a little because I'm usually in a hurry. I need to work on that more. Stationary bike is helping to build up the quad.

I kind of broke into a 1/2 jog the other day just to see how it felt. A slight twinge on the first step but felt good after that. No after effects so I might be trying it again. I'm trying to be careful and hold myself back a little. I don't want to do any damage by pushing too hard.

IDG - Glad to hear you're doing well. Be patient. As you know already 6 weeks is where the good stuff starts to happen. Glad to see your OS is one who lets you move it early. I am still amazed at the different schedules from different Dr's. Then again you still had 40% attached so early motion might be different than if it was a full tear.

Tugboat - Is your OS smoking crack? How does he justify giving you a set of directions and then changing it and yanking on your leg? My motto has been to not do any impact or too much forcing of the leg. Last thing you want to do is hurt it again (like I did) so I have never let anyone yank on it but me. You have to go by the feeling in your leg, not a specific set of numbers that you should reach. As long as you're making decent progress you're doing fine. If you get stuck somewhere then you might need to force it a little but it sounds like you were making normal progress. At 6 weeks I was only allowed to go to 30 and progress 15* a week from there. If the Dr. changed his goals then I would accept that and try for it over the next few weeks but I wouldn't let him try to do it all in one shot in his office. Threaten him with violence if he tries that again!

Cdavant3 - That's my new explanation to all who ask why this happened. My quad was too strong for my tendon. LOL!

Brewman - It appears that the tendon was the weakest link. Patella seems to be next weakest! My sympathies. Maybe we all shouldn't be trying for 100% recovery - we'll just keep breaking things until the whole leg is bionic or something! Big strong quads seem to be a curse for us :)

Everyone stay positive like IDG said. In the big picture this is just an inconvenience and we can recover fully. In some ways it can be a blessing because it forces you to be patient and also appreciate the little things in life like walking. Some others in this world would trade places with us in a heartbeat!
post #1715 of 10804

Are you sure your OS remembers that you have a QTR and not a quad muscle tear?  Based on everyone elses blogs and my own, your OS is in left field... My doc didn't want me to do much of anything until six weeks, and at that point I might have been 45 - 50 deg...but progress is pretty fast after that---you would get to 90 deg in a week or less.  I'd take it easier the pain should not be to the point that you are yelling!!!

I am at week 17 and running two miles every other day, with heel to butt ROM (I have to tug on it a bit), and I started out as I said at week 6+ behind where you are at!!!
post #1716 of 10804
 DoOver and bballwal>>  I talked with my therapist and found out that my OS is one of the best there, but with him being so young he has been looked at by some of the therapist there as weird being that he begins PT never longer than one week after a surgery and has even sent a person in for PT on hand surgery the next day.  He believes in fast results doesn't like to get muslces time off.  Also they said that he can get ahead of himself and has all the confidence in the world in his repairs and hasn't had any bad repairs that they had heard of.  

They made me feel better about my OS, but I still don't take well to someone pushing my leg so far without warning.  Besides, my therapist and I wanted to push my PT harder being that things have been going good and we just took it as our sign to really start working it.  I went from 60*-80* in two days and I think am shooting for 90* by the end of the week.  So I am going to make the best out of my crazy OS.  I know that I am not fully mended, but the way he pushed on my leg, I am not scared to push myself.

Idaho Guy>>  Thanks again for this thread which keeps everything positive and helps me mentally just as much as the PT is helping physically.  I wish you the best, even though you know better than most of us that these injuries are just small set backs which we all can come back from.  Also when you do your PROM, do you go until discomfort, or do you go until its painful?  I am just wondering what others consider the limit.  I know that I will try to push myself sometimes more than I really need to and I was just wondering what was "enough" to help you through.

Best wishes to all!
post #1717 of 10804
Surgery and rupture 22/08/2009
7 months down the line!!!!Haven't posted for a while.

Welcome and commiserations to the many new  QTRers that have filled the pages over the last few months.You all make for interesting reading and commiserations.Don't give up guys and ladies there is success and recovery ( albeit maybe gingerly and less robustly for a while!)
My update:  progress has been coming along so so!!Pretty happy with it generally.
Done a couple of 100 km road rides and a few 50 km mountain bike rides...all kinda on the gentle side when done... no dynamic charges to the front if get my gist!!!.Still I must admit I have had lots of mutters and groans from inside the knee and the scar tissue from the ruptured retinaculum but afterwards it has felt a lot easier and generally much better fluidity of movement that still remains.I am teaching spinning several times a week as well.

I still find the leg collapses like a drunk's every now and again ..usually on uneven surfaces when the ball of the foot of the damaged leg brushes against some resistance going forward and I fling my arms out to catch my balance...a bit like a child learning to walk, usually much to the embarassment of any one walking with me!!

Has any one out there found they suffered from some patella tendinosis after getting to a pretty good level of activity.I have a just started to get lot of pain and sensitivity to touch where the patella tendon joins the tibia .Apparently it is caused by a combination of things but basically caused but strain from the QTR and the patella probably be slightly out of alignment...any bright suggestions on how to handle it cause it is starting to niggle!!Am icing it regularly....

 IDG.... bummer to hear you've done it again..especially after so much progress!........but you made this thread what it is and it has helped a huge lump of people.Thanks for that  and get strong soon !

Aggie: patience bud...slow is good with the tendon repair(and lots of ice packing after exercise.Don't let any one kid you otherwise.

Tugboat..I agree with Do over... i don't think any excessive forcing is good..I would tell your OS where to go....Pushing is good up to a point...too much and you're back at square one.

Any way guys...that's it from the southern hemisphere!!!!!!Take care and hope your range of motion, strength and general recovery  progresses nicely.Treat your injury like it is ...a temporary set back .......but also serious injury that needs careful rehab.



post #1718 of 10804
Hi Everyone,

I have had a few bouts with Quadriceps tendonitis in my "good leg", and it hurts like hell!  You can overdo the rehab. One weekend I hit the gym hard, swimming as well as riding the bike for 30-45 minutes both days, followed by yard work, and all the other things we do on the weekend.  Woke up Monday morning unable to bend my leg.  Ouch!  

Rest is the main thing you can do, and be sure and rest it through.  The first time I went back to exercise too soon and it came back.

The other thing that helps is to stretch the opposite muscle.  In case of the quad, it was hamstring stretching (eccentric loading I think it is called?)

OS told me; don't confuse fixed with healed.  Your tendon has been repaired, but it takes a long time to heal.
post #1719 of 10804
From a medical site: http://emedicine.medscape.com/article/1249621-treatment

16 days out I'm now in a locked post-op brace, much stronger that the one I came home in, up on crutches and almost pain free. This one is going better than the first. OS commented that my patella tendon "looked pretty bad," with lots of calcium deposits and wear and tear, which is what they said about my first one which turns out to have been in 8-2005 not 2006. Kind of what you'd expect after 50 years of running. If the tendon stays stuck, I expect to run my 15th Bear in July--it's only 5 miles, but it climbs 1540' to finish at the top of Grandfather Mountain (NC). It will be my last one. I need the shirt for a quilt.

I did all the rehab stuff with my right one, but the thing I found most helpful was a seated stationary bike. Being a doc, I was able to get into the department after hours and start with my leg almost fully extended. When I could pedal through a full rotation without pain, I moved the seat up a bit, flexing the knee more. I got both stretching and strengthening at the same time. As I recall, the worst part of rehab was a blue-eyed blond therapist who kept telling me to "Get it up..." against resistance.

Everyone wants to know how you hurt your knee and taking out the garbage just doesn't have much ring to it. I'm telling folks I got hurt "fighting over a ladies honor. "She wanted to keep it...'"

Three months until running.
Edited by cdavant3 - 3/19/10 at 3:46pm
post #1720 of 10804
 Hello all, and I wish well with your recovery and rehab.  I want to continue to encourage you to keep at the rehab. April 5th will mark the two year "anniversary" of my BQTR, which left me wondering for sure whether or not I would ever walk again. At the time I thought that this was the worst moment of my life, and that I never would recover.

I am a reasonably active 48 year year old male. Not an extreme sports enthusiast, but someone who liked to exercise via walking on a very regular basis.

Then came that fateful afternoon on the 5th of April 2008 when I missed the last step on a flight of stairs, and the rest they say is history.

I learned a lot during my recovery, and I worked hard to achieve the maximum amount of strength that I could achieve after the BQTR repair. I am left with about 85% of the strength that I originally had and to be honest I now live a normal life style and am back to my regular exercise routine. I will never be able to ski again, nor can I run for extended periods. Along with the BQTR injury, I did a lot of collateral damage to the ACL and cartilage that someday I will have to deal with surgically. For now my OS wants to leave things along and see how I do without further surgery. I agree with that approach.

One of the most important things that I learned during rehab/recovery was to push myself and fight the pain. At the three week mark my OS allowed me to start passive flexion of the knee using heel slides on a hardwood floor. That hurt like hell, but I fought my way through the pain, and by the time I started active PT, I had about 80% of the original range of motion.

Range of motion was the easiest thing for me to achieve, and I credit the early start to that success; strengthing the repair was a totally different matter and I continue to work on that in the gym.

What I have learned through all of this is yes you will recover and return to a normal life. It takes time, but sooner of later you will get out of bed and not think about the injury. Going down the stairs has once again become somewhat normal, not the exciting trip that it was as I first started recovering from the injury.

I was also blessed to have a personal nurse of a wife who cheered me and cared for me in my recovery. Her employment as a nurse in the same hospital that I was operated on made for an easier recovery and her connections with the doctors was vital.

Like I said I thought that this was the worst that could happen in life, but then last June I lost her after she battled cancer. That folks was the worst thing that could happen in your life.

I wish you allow God's speed in your recovery.

Best wishes to you all.
post #1721 of 10804

I definitely have had some on-again/off-again issues with patellar tendonitis in my repaired leg. Like you, I've done icing after exercise. I know there was a shift in my patellar location vs. the right leg (it's about an inch lower), so I always wonder if it's tied to that or just to the relative stiffness of the left quad tendon vs the right.

I've struggled a bit with my bike setup since coming back from this surgery because of trying to work with tendonitis/inflammation. I was never comfortable with my old seat position post-surgery, and it's been a process of trying to find the right position to get comfortable. I think the issue was that my left quad weakness when I started riding again was putting more stress on the left knee -- despite riding smaller gears with a higher cadence.

Now, if we can just explain why I've developed tennis elbow in the arm I don't use for tennis :).
post #1722 of 10804
DavidM, your post certainly puts things into perspective, RE; the tragic loss of your wife. Your words of encouragment are appreciated. I am just over 5 weeks post repair, and get my plaster off in two days time. I wait with increasing trepidation to see what is left of my former knee! All the best to you all.
post #1723 of 10804

DavidM - Sorry to hear about the loss of your wife. I know when I was injured, I don't know what I would have done without my Dad's help. I'm only one year older than you and my sister and friends all work all day and I was so glad my Dad who is retired was able to drive me to surgery and drive me to my PT appointments.  It was a team effort.  Those of you in the same boat know you can't possibly recover on your own.  You can't drive for a while because of the meds and brace.  My Mom would have helped me, but she passed away in 1997 of cancer.

IdahoGuy - and everyone else new injury or re-injury.  Be patient and positive. Know your injury and limitations.  You may have to modify your activities after you get your leg back to normal.  However, the simplest things are so wonderful!  Sometimes when I'm about to sleep at night, I remember how awful it was having that leg brace on night and day and not being able to bend my leg and having to sleep on the couch.  Being able to swing my legs over the bed and walk normally and go up and down stairs--those are all wonderful things.  I remember when I tried my hardest to go down stairs like normal, but you could tell there was something wrong with my one leg.  But, with patience and PT and practice, I got better and better. 


You may not notice difference week to week, but compare month to month, maybe longer periods of time and you will notice progress.



Not to be completely off topic, but what do you all think about David Beckham's chances of playing professional soccer again after he ruptured his left Achilles tendon?

There have been several professional basketball players with quad ruptures and they had to retire.  I see people with these injuries returning to normal activity but if you are a pro athlete, I don't think your speed will ever be up to normal after rupturing a tendon.

I think his management said he would be back in 6 months, but he was in tears in the dressing room and not saying much.  I think he knows how serious his injury is. 



post #1724 of 10804
Hi Twice Ruptured and Tugboat.  I apologize if this is old info, but I have not been on this thread in a couple months and was just catching up.  Regarding the issue of the blood clots, my OS had me taking two aspirin every day from the day after surgery to help prevent getting a blood clot.  I did have some pain in my calf that I immediately told my OS about and he sent me for an ultrasound right away.  In my case there was no blood clot but my OS was very concerned about them developing.  I guess my advice is to ask the OS if you should start an aspirin regimen to help avoid this concern.  Hopefully your concerns have been addressed by now!  Good Luck!!

Edited by Graceella - 3/23/10 at 12:13pm
post #1725 of 10804
Hey all,

As I said above, it has been several months since I have checked into this forum.  That is obviously a sign that things are going well with me.  When I was first injured and first discovered this forum, I was on several times a day because the support and encouragement I received was vital to my recovery, both mentally and physically.

I am almost one year post injury and surgery.  CDAvant, I too injured myself taking out the trash.  The only bright spot was that the ER doc told my husband to never again let me take out the trash.  Ironically, the other night he asked me to help him with the trash, and I politely declined and then asked what he was smoking! 

At this point I am 95% percent recovered from my QTR.  I have some weakness in my quad still when I do steps but I recently discovered that I finally seem to have gotten over the mental block of being unable to run, jump and play with kids.  Interestingly, after almost one year it still hurts for me to kneel on the floor. 

When I fell, I ruptured my left quad tendon and broke my right ankle in two places.  for that reason when I had the surgery, I was permitted to stay overnight in the hospital.  My OS stated I could bear full weight on my left leg because he restricted weight bearing on my right ankle.  The first day after surgery he had me unlocking my brace and bending my knee to 60 degrees ROM three times per day, but that was it.  I was in a full locked extension for four weeks and then the brace was unlocked to 60 degrees for the next four days so that I could have some flexion in my leg when I walked.  I remained in the brace for eight weeks.  I started PT at 6 weeks post op and the first day of my PT I was around 70 or 80 degrees ROM.  I am by nature someone who follows rules, so I did everything the PT told me to do.  I know I did a lot of complaining about the pain during PT but I have rocks in my head and I refused to let the pain keep me down.  The worst thing for me was the "Russian" stim therapy, I hated that.  Someone mentioned above the PROM during PT, the first couple of times I had that done, I almost couldn't breathe through the pain but that too became more bearable.  I was in PT for about two months before I was discharged.  I have had no problems since then, I just continue to build strength in my quad and really have very few lingering effects, just a nasty 10 inch scar on my leg. 

I was very lucky to have had a wonderful OS, who was aggressive in his treatment but also very cautious. 
Idaho Guy, you have been inspirational to so many people and I am so sorry you have to endure this again, but if anyone can get through this, it is you!  There are so many people on this forum that helped me so much and I can not thank you enough.  I seriously struggled with the mental anguish brought on by this injury.  I felt guilty about all the work my husband had to do to take care of me, I felt guilty that I couldn't care for my small children and depressed about being in bed for so damn long.  I work in the mental health field and have always been empathetic with people suffering from depression but until this injury never fully appreciated what depression can do to a person.  I definitely had it short term. 

Thanks again to all for the support, good luck to all of you in your continued recoveries!!  And to quote the best advice I ever got from my OS, "just don't fall again..."

David M, I am so very sorry about the loss of your wife.  I think you have probably taught us all about what life is really about and while this injury sucks, it pales in comparison to losing someone you love.  God Bless You!

Edited by Graceella - 3/23/10 at 2:50pm
post #1726 of 10804
Hi all,
This is my first post although I have been reading to get helpful pointers on what to expect.
I am 70 year old male (not flexible) who WAS a very active cyclist and actually fell over while trying to get started after a rest on a rocky trail. Fell into some large boulders with one foot cliped in and  my foot got trapped under my hip and pop!
I am now 5 months post surgery. After being kept pretty inactive except for ROM and other light movements for 3 months I progressed prety well.
I am now at 130 (my good leg is 135). I was gaining strength by hitting the gym everyday until about 10 days ago when i apparently over did it and now I have pain in the lower inside of my knee Particularly going downhill or down steps. I also feel tendonitis in my good knee.
It was reassuring to read recent posts of others doing the same thing. I have cut back and some days feel good but the next I suffer, so I will keep easing off with some light spining on the bike daily to keep the flexibility.

Yearning to hit the road or trails.
post #1727 of 10804
I saw OS today for 6 wk. post-op eval.  Knee brace now at 90 deg, free to walk with it on.  He doesn't want to start PT until 12 wks. out, which was a bit disappointing.  I really want to get my quad. strength back.  Anyway, I can ambulate around the hopuse as if I'd never had an injury, except I take stairs one at a time. I still have an extension lag, which OS says should resolve once I start PT.  Honestly, though, I've been ambulating without crutches since day 1, just being careful to keep my leg straight.  (Docs don't make very good patients.)  I've found a couple of articles that favor early mobilization.  Compared to conservative therapy, there doesn't seem to be any difference.  Overall, I'm pleased with where I'm at, especially reading these blogs.  Have any of you been more agressive with your recovery?

post #1728 of 10804

From what Ive read, there seems to be two approaches; 
(1) No weight bearing, and early ROM (1 week out), then conservative phase in of weight bearing ROM as with the adjustable brace.  The theory is to facilitate return of full ROM early, but preserve the repair integrety. 
(2) Full Weight Bearing in full extension only, limited ROM exercises until 6 weeks, then discard brace entirely.  The theory is apparently that the repair is like a glue joint and must set and early ROM may disrupt it.

According to what I read, there was little difference in outcomes (as measured in strength and ROM at 1 year) between the approaches, although the sample set was low. Unfortunately I didnt save the articles for reference.  It would be reasonable to assume that the fastest recoveries would be one that balanced the healing process  with the strengthening process and would be a function of age, weight, athleticism etc.

I will say that I am in category (1).  I never used the crutches.  At 6 weeks my ortho said wean yourself from the brace and I never wore it again, but I had worn it continuously prior to 6 weeks.  I wobbled and limped for about 3 weeks until ROM /strength was good. I PT'd for maybe five weeks, then quit and am now do-it-yourself at athe Gym.  At 12 weeks I started jogging/running intervals on the treadmill, and now at week 18, I can run 3 miles @ 7.5 min/mile pace.  I am going to run a 5 K in April.  Having said that, I note that my strength is about 80% and my ROM is close to 100 %.  There are certain things that I would not attempt yet: Basketball Skiing or any kind of uncontrolled jumping or cutting is probably at least 4-5 months out for me. 
post #1729 of 10804
Whats happening everyone?  I am Just now at the 6 wk mark and sitting at 90* ROM.  I am starting to feel more and more ready to work to get my muscles back in my leg, but I am trying to hold off until the 8 wk mark to really start getting that back.  My OS has been very gun-ho with my injury and I am happy with the results overall.

ERDoc>>  I am basically on the same time table as you.  My OS is allowing me to do what ever feels right without pushing it to much.  He has told me that if it doesn't hurt the repair site, keep going.  I am working on my ROM everyday and even have days that I go to the gym to use the elliptical machine to slowly get some muscle back for walking and climbing stairs.  I don't recommend anything that I say being that my therapist thinks that my OS is a little crazy and thinks I am pushing it a bit much.  

Has anyone here use the TENS machine?  I love this thing.  Being able to push my ROM and not feel the pain until I am really pushing it. It works as an electrical pain inhibitor.  I bet others have used it and it might even have others names, but I just wanted to hear know if there has been any problems using this machine.

I don't really watch wrestling, but if you do...  I just found out that Triple H has had this injury twice in his career.  Even if your not into wrestling, you might want to see this video.  You may not learn anything new, but its something to see what we have been through and going through on TV.    http://www.youtube.com/watch?v=vULfAUbIosI

Well best of luck to everyone out there. 
post #1730 of 10804

Thank you Mr. Boise Idaho for starting and everyone who is here a full and stronger recovery.

I really hope rehab goes well for each and all.  Having had a left ACL/MCL -Patellar Graft in 2/03 and having ripped my left quad muscle 9/08 (running to catch a ball playing co-ed softball and then bodysurfing off a shallow sand takeoff the next day), I am interested in preventative exercise.  

After reading about the first 12 pages and then scanning the last 46 pages of this thread, I see that everyone is athletic and engaged in both weight and endurance training.  Is this stuff avoidable?  Obviously high speed falls and falls from height are going to wreck havoc on most joints, but what about the running, flexing,  and slipping injuries that are some common here. 

How can we avoid a next round of  purple swollen leg, surgeries, rehab, braces, etc?  I stay on the weights (heavy leg workouts), hike, cardio, etc.  but reading about athletes who have a more severe training regime than I yet still have experience the ruptured/torn quad tendon injury makes me wonder what can be done to avoid its occurrence/re-occurrence without drawing the brakes on the fast fun? 

I wonder if the roids triple H is on had anything to do with weakening his tendons.  Thanks for the link, I am going to have to check out the vid.

Good luck to full ROM and Power.

Thanks an best wishes to the entire community on this thread. 

post #1731 of 10804

Looks like alot of these were due to the leg getting caught under in full compressed flexion.  Mine was playing b-ball but during a jump-stop at maybe 90-100 deg when it popped.  Over the years, I've had chronic tendinosis with calcification (OS said it looked like the milky way on the xray) and probably many partial tears of the tendon.  My OS even warned me about two years prior that I was at the age (now 48) and with the weak tendon that I could rupture the quad tendon playing ball.  He described what would happen, so when it popped I knew what it was right away!  The OS cut the diseased part of the tendon and reattached, and said that I would be starting new without tendinosis---so Im hoping to be better than before the injury...Now I need to pop the other bad knee!!
post #1732 of 10804


Crazy how much damage a little twist combined with a bit of downforce can do to our wierd joints.

It might work out that you recover better than new.  I had my right shoulder AC joint taken 8/04 out in a mumford proceedure due to calcification and a bunch of itisis (bursa, arthr) and after the long recovery it seems stronger than the left shoulder.  Before I could barely lift my arm above my head, which made surfing hard and jump shots harder.  Now, my shoulder is solid sans an inch of bone on the joint end.  (I am a couple months shy of 40)

Modern Orthopedic medicine works with the right PT regimen.  I too, am wondering if I should have done both joints.

Jokes aside, I know surfers, boarders, and skiers who have recovered and charged after quad ruptures, AC pops, and achilles snaps.   You will heal.


post #1733 of 10804
I am sure that steroids played a role in my situation.  I was taking prednisone prn for tendonitis in my left shoulder, as well as for intermittent low back pain.  (Prednisone helped me avoid a second lumbar laminectomy years ago.) 
I'm not sure what one can do to prevent this injury.  It seems that the stronger your quads., the more likely it will tear it's tendon.
post #1734 of 10804
Thread Starter 
Hello all:

Interesting discussion about preventing the QTR in the future.  I know that when I first did the QTR in January, '08, I was as strong as I had been in a couple of years - had a great summer cycling, and did a VERY physical weight training program from August/September through January to be strong for skiing.  It seems that the quad, when put under extreme stress on a steep slope while moving fast, was simply stronger than the tendon.  Perhaps this is a consequence of aging.  Regardless, my focus this past ski season (before the re-repair), and into the future has been and will be to ski with more grace, agility and quickness, and a little less raw power and speed.

Welcome to you new QTR folks - just hang in there, it gets better.

Today, I am a little more than 3 weeks out from the re-repair I had done on 3/21.  The leg actually feels pretty good!  I am permitted to do only quadriceps contractions, and do Passive ROM stuff to 60* - that ROM is easy, but I can feel it getting stiff.  I am still in a rigid/straight-legged brace.  The OS is being very cautious this time to avoid re-injuring the repair again.  So, I have been told we will not be doing any Active ROM stuff until at least 6 weeks, and there won't be any weight bearing on the leg until at least that time as well.  The staples came out last week.  Still on Coumadin to prevent blood clots.  

I am headed to MT, N. Idaho, E. Washington to take my 17 y.o. son to look at colleges during his spring break.  We had originally planned to ski during this trip, but that has been cut back to one day and one half-day for him alone on the slopes.  Hopefully I can manage on crutches to keep up with these college tour groups.  If not, maybe there will be a wheelchair . . . .

Keep positive all.  This is only a small part of your lives.

post #1735 of 10804
Interesting discussion - avoiding a second QTR injury is a strong motivator.   I just talked to my cousin who had a QTR about 15 years ago, fully recovered and had a second QTR of the same tendon after slipping on ice last month.  I've asked a number of people, including my OS and PT, and they all say my chance of a second QTR is the same as anyone else my age since I had no sign of degeneration of the tendon or related tissues.   The one piece of advice I have received is to avoid overtaining the quads and focus on balanced strengthening of the entire leg and core.   I'm a road cyclist and prior to the QTR I did a lot of weighted quad extensions to build up my quads as much as possible.  This imbalance may (or may not) have contributed to the QTR when I lost my balance and tried to compensate.    I promised my PT never to do another weighted quad extension, but to concentrate on "functional" and closed chain strengthening such as squats, lunges, unweighted plyo's, etc. that build the entire leg.  I'm also spending more time on hamstring strengthening and on core.   I'm 13 months post-op and looking forward to a normal bicycling and sailing season. The QTR leg is still a bit less muscular, not quite as strong and tires a little more quickly.    I'm out riding hills and able to keep up with the guys I rode with in 2008 prior to the QTR.     Best wishes to all with your recoveries!
post #1736 of 10804
Idaho Guy...Did you reinjure your quad. skiing?
post #1737 of 10804
Thread Starter 
ERDoc:  The answer is "yes, but . . . .".  My OS determined that much of my re-injury had occurred quite some time ago.  We figured out that it probably happened when an overly enthusiastic PT w/o experience with QTRs (who also knows me as a cyclist and a skier)  had me doing plyometrics by jumping off a bosu ball and landing on only the bad leg about three months after the initial repair in 2008 - I heard a "crunch" and had quite a bit of pain at the time.  I continued to try to strengthen it, but never could get back to close to my performance level.  Then I was skiing some mellow bumps in mid-february of this year when I felt a "pop" and complete instability -- I had skiied much more difficult terrain both that day and throughout the rest of the season, and had skiied much faster and harder both that day and throughout the rest of the season.  Now, I'm hopeful that with the "re-repair", I can get back to being myself on a bike and on a pair of skis.

DavidM:  Very sorry for the tragic loss of your beloved wife. . . .

post #1738 of 10804
Interestingly, I've been doing emergency medicine for nearly 25 yrs., and while I've seen some patellar tendon tears, I've never seen (or at least recognized) a quad. tear, until it happened to me...
post #1739 of 10804

Your PT is absolutely right on the Sqauts, lunges and core workouts, they are much more beneficial for a cyclist than quad extensions. Unless you kick field goals on the side.

I have heard that this injury occurs in people with strong Quad muscles which would explain the cyclists and skiers that seem to make up a large part of this discussion.
post #1740 of 10804

Hello fellow QTR sufferers. I've been reading this thread since my injury (Feb 23, 2010) and surgery ( 2/26/10). I read all about Idaho guy et al and then realized there were some more recent victims, joined and here I am. I'm probably the oldest (71) but I was in very good shape at the time I tripped over my size 13 Uggs. I walked out of the hospital on crutches a few hours after the surgery; the pain wasn't as severe as some of you but having had back surgery last October and finished that rehab, I started to get pain from that area.

It's now been over 4 weeks and I'm pretty much brace free except when I go out. Can climb stairs (gingerly)but deathly afraid to try going down. ROM about 100 degrees but 15 minutes after attaining the "stretch," it seems to contract back like two strong rubber bands. Seeing OS next Tues. 4/06 (he does 25 of these little procedures each year). I've been walking on the treadmill 2.5 mph/ 30 min and doing leg lifts, flexion/tensing, foot lifts with no weight etc.

It looks like another golf season of paying dues and chipping/putting.Does anyone care to opine on how long it takes to take full swing??

 I hope I'm not intruding; it's nice to have access to some kindred spirits. I wish all of you well. Best wishes for a speedy and complete recovery to all from Chicago.


PS: Since submitting the above drivel, I realized I was on a different thread. However, when I found that my hero, Idaho guy,
had re-injured his quads, I felt incredible empathy for that leader-- a great soldier of the the mid-leg! Most of you guys are skiers-- I found my way here via Googling the injury. I can't put up with walking with the brace because of two back procedures (L4,5, S1, both sides). The most recent right side, is opposite my left QTR so I can't put up with the "dependency" on my right leg/side. So, I decided to screw it and walked very, very carefully without the brace after two weeks.SFSG

I was a PT in the Air Force a million years ago and decided to start PRE which avoided a little of the flacidness (sic?) endemic to atrophy; we'll see. The pain from the back issues (surgery last Oct) is much worse than stretching my @#$@#$!@#$ left leg!

Idaho guy-- you have helped me immeasurably-- you deserve better and a permanent healing stability. Between injury and surgery, the thread you started enabled me to ask the right questions and and be patient with the initial agony; I thank you.

Does the swelling ever go away? Or shall I place it up there with a slightly elevated PSA?

Good luck to all; I'm seeing my OS next Tues and I'd be happy to relay any "rhetorical questions."


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