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Quadriceps Tendon Rupture, Repair and Rehab - Page 65

post #1921 of 10860

18 Months Post Injury - Rgt Leg QTR

 

Injury: 01/09/09    Surgery: 01/11/09

 

Good Morning All,

 

18 months out, my leg unfortunately remains stiff, sore, numb & ultra-sensitive to touch. It's not bad, as long as I don't use it!! The sharp bone I have protruding from my kneecap gets more pronounced & sore as the swelling continues to improve.

 

Will continue to fight the battle.

 

All the best to everybody with their rehab.

 

Steve  

 

 

post #1922 of 10860

Interesting evening. Four months and one week post repair, five weeks and two days since the brace came off I did a 5 mile mostly uphill run Thursday night--my 14th year in a row. I finished in the top 1000 mainly because it was limited to 800 and was filled in early April. My running style used to be soar with the eagles then crash, burn and come in with the turkeys. This time I started at the rear and planned to take a mile to warm up then start passing people. It didn't work that way.

 

Knee pain during the race was minimal, but I had a pretty obvious limp and when we got to the top of the first "little" hill and the road leveled off  the stragglers I was going to pass weren't even in sight. A couple of power walkers was about all I could see.

 

And there was no energy. Nothing. Nada. I hadn't realized how not running since February would effect me. I was drained from the start. We started at 7:10 and it took me an hour and a half to climb 1540'. I couldn't pick up my pace no matter how hard I tried. Total deconditioning.

 

But the tendon did fine and the next morning I was pleased to see the knee wasn't particularly swollen or stiff. Yesterday was a lot like the day before.

 

That was yesterday. Today knee is ok but the quad is very sore and stiff, tender all the way up, I think the lesson here is we spend a lot of time working on the knee and we probably need more time on the bikes and elipticals, getting our heart rates up and getting some work out of the quad and other muscles.

post #1923 of 10860

Hi Rob and other "victims",

 

Good news at the OS office yesterday......brace is off !!  He felt around my knee cap and asked if it hurt, and I said it didn't.  He had me bend the knee, and it went to 90 degrees, and of course, it was stiff.  He then had me walk with crutches.  He wrote a prescription for PT, 3 times per week for 4 weeks.  I had read, somewhere on this site, about the wire sutures used to repair the tendon "dissolving".  I asked the doctor about that, and he said, "no they won't dissolve, you take them with you to the grave."

 

So Rob, you must of had about 5 PT sessions  by now.  How can you go wrong when you have a 7 yr old praying for your leg to heal!! That is cute!  Hope your progress is still going well. 

 

I read about people exercising on treadmills, stationary bikes, elipticals, etc; I wonder if I were to invest in a piece of equipment, which type would be most efficient for this type of injury?

 

I really enjoy this site!  Thanks for all you guys, and gals who contribute.  Tim 

post #1924 of 10860

Tim

Only been to 4 PT appointments so far as I had to be out of town most of last week.  They did recheck my range of motion at the last appointment and I am happy to say I am now at 123 degrees and we are shooting for 145 to 150.  They have added lunges and step downs to the other exercises.  Something a little disconcerting is I started to have numbness in my outer toes and a strange pulling feeling down my calf.  Not sure if I have a pinched nerve issue or what.  I have been really pushing the home exercises and stretches to try to recover quickly and I think this is happening, but I have experienced some shooting pains in the knee when simply putting weight on the leg.  Hopefully this is simply some cramping or healing pains.  (If there is such a thing.)

 

Good luck to all and continued success in your recoveries.

 

Rob

post #1925 of 10860

Definitely another female here to be "lucky" enough to have this injury in 2/08.   Life has been busy with my 3 boys so I don't check in often.  Speedy recovery to all the newbies.

 

I'm able to go pretty much what I want to.  I was even racing my 8 and 5 year olds in the backyard telling them that they better be able to beat.   I just get nervous down steep hills since that is how I injured the knee by finding about the only section of ice on the driveway.  The 12 yr old still likes to kid me about the fall when we go down to the bus stop and come to the area of the fall since he was with me when it happened.

 

Since the weather is nice I've been doing lots of laps in the pool.  The treadmill died recently so hopefully DH can fix it for when the cold weather hits us again.

 

Jackie

post #1926 of 10860

Ten trips to PT. Today he bent my knee to 90* but it did'nt like it. Nothing snapped but it hurt. Tomorrow I have my follow up with the stand in Doc. PT guy said to set my brace to 90 and wear it in to see the Doc. I have'nt had the thing on for three weeks but  will do what I have to do. Tim, I'm jealous you got 90 right out of the brace. You go guy. I'm still hitting the pond and walking and I've been working on my portable sawmill getting some logs sawed that I drug in last fall. So I hope the Doc will clear me to go back to work cause this injury has had my unemployment messed up. I asked the PT guy if he thought I would be ready to run a 5K on August 2nd and he snickered and said "yeah right". I've still got my eye on the AF half in Dayton in Sept. but that's probably not going to happen either. Maybe next year. I dreamed I was running the other night and it felt so good. Hang in there guys and gals. Dave.

post #1927 of 10860

Hi everyone,

 

Had my first PT this afternoon!  It went well, did a lot of exercises, none of which were weighted, just using leg weight.  He gave me a paper, showing all of the exercises I had compeleted in the office, to take home.  He told me that we worked the leg enough today, so rest it tonight.  He said my scar was tight and, I think he called it "ropy".  He suggested I purchase Palmer's Cocoa Butter and rub it on the knee, perpendicular to the length of the scar.  The purpose is to soften it and smooth it out.  He said to rub it for about 5 minutes.  My wife stopped at the pharmacy on the way home.  The PT said for me to ice the knee before bed for about 20 minutes.  He also said to continue using the crutches, as the OS instructed.  He said the quad is weak and we should not take the chance of it buckling.  I forgot to ask him what the degrees of motion was.  I can tell that it is getting better all the time since the brace was removed last Friday.

 

Rob,  I forgot to ask him about the electric stimulation.  I go back tomorrow afternoon.  I also get those shooting pains in the knee, but very seldom.  Hopefully you will be in pretty good shape for your vacation.

 

Dave, I also forgot to ask about water therapy, but I think that you going into the pond and kicking in the water, has to be good exercise.  I would also like to know what piece of exercise equipment is better for this type of injury, a stationary bike or a treadmill.    

I just noticed the name of your town and I like it.....Coolville

 

Take care,   Tim

 

 

 



 

 

post #1928 of 10860

Meigscoboy, I did an uphill 5 mile 17 weeks post op to keep my string going at 14 and managed to finish ahead of a couple of fat ladies and probably half an hour behind a guy pushing a kid in a stroller. Knee held up well, but I had nothing when I tried to pick up the pace. The ambulance guys kept offering me a ride.

 

No problems the next day (it was a 7PM start) but day two the quad--not the knee was sore as hell. I'd bet you could do a 5K but you'll not be proud of your time. But this is a time just doing it means a lot. As I hobbled across the finish line at 5181' I mumbled something like "I'll be back..."

 

My first QTR was fall 2005 and I didn't push hard that winter being paranoid about ice, but my spring 10K times were almost where I was a year earlier. Right now you probably won't be able to hurt the repair--but you pride will take longer to come back.

post #1929 of 10860

Guys

Today is exactly ten weeks since the surgery.  I had my sixth PT session yesterday.   I am very happy to report that my ROM is now at 135 degrees, and my therapist has upped the exercises to weighted machines including leg presses, curls, and included more lunges and wall squats with the exercise ball.  I am very pleased at how quickly the strength is coming back and that I can now climb the stairs and "sort of" go down them.  I am still experiencing numbness in my outer toes and heel, but the therapist said that most likely that is a symptom of nerves being stretched along with the muscles and has now added more stretches of the calf and hamstrings.

 

Dave, how many weeks are you out from surgery?  So you had the brace off and they want you to go back to it?  Keep pushing it and I am sure you will make that run if you keep that as a goal.  My goal is just to carry my seven year old to bed!

 

Tim, glad to see you on the PT trail.  Sounds like you are starting out just as I did.  It is important that you do those home exercises religiously in order to speed up your recovery.  I am convinced the effort you put in when away from PT is what makes the most difference.  I asked my PT about the pains and he felt it could just be cramping, especially if taking the weight off the knee and bending it relieved the pain, which it did in my case.  I have not had the shooting pains for about a week, just the numbness now.

 

Continuing Good Luck to all.....we will all get back to what we want to do!

Rob

post #1930 of 10860

Hey Everyone, 12 weeks post surgery. Had follow up appt. with stand in doc yesterday. He told me I could quit using the brace that I haven't used for four weeks. So that was good news. Had me bend my knee and said I was good to go. Wrote me a return to work slip and said so long. No how does it feel or more follow up. I asked him about PT and he said that was up to me. Some doctors #%&@. So since I can barely bend it to 90* with great effort and I think they are doing me good I will continue at least for another week. They worked me a lot harder today and I don't feel like cutting the cord just yet.  Tim if you are thinking about buying a machine I would ask my PT about it. I wouldn't know what to tell you. All I have is a mountain bike, running shoes and some weights. I guess the main thing is don't stop moving or you'll rust up. Thanks everyone for the input and encouragement.

post #1931 of 10860

Hi

 

Three weeks post surgery and another three to go in plaster. Weather been unusually hot for England 88 degrees and we don't have aircon in our houses. No pain but found sleeping difficult and the knee has been swollen despite being elevated in bed. Ventured out to the pub, can just about manage a couple of miles in the car. Full leg plaster on left leg means I can drive the auto but I am so far back from the pedals I can hardly reach the steering wheel. Trying to keep weight of the left leg and using crutches all the time.

 

Working from home and keeping busy so days passing reasonably quickly. Feels like I am wishing my life away to get shot of the cast and into a brace.

 

Black tie (tux) Garden party tonight. Will wear the top half but shorts and a plaster cast rather than trousers.

 

Stephen   

post #1932 of 10860

Hi guys and gals,

 

Today makes 7 weeks post op!   I had my 2nd PT session the other day.  I finally had the electrical stim and ultra sound that you guys have talked about.  PT added a few exercises, like shallow squats and one where he put a thick phone book under my bad leg, then while standing, squat till the good foot touches the floor.  I forgot to ask the PT what my ROM is, but the knee is bending way past the 90 degree mark. 

Rob, thanks for the advice about the PT exercises at home, I will do mine as soon as I finish this entry!  I have not had the numbness that you have had.  I did have a bad night's sleep, constantly changing positions in bed, trying to get comfortable.  When I first change positions, knee feels o.k., then soon I get that dull ache, and have to try changing again! 

I wonder if walking long distances, with crutches, would be beneficial at this stage in rehab?  I have not been doing too much, physically that is. 

Dave, sounds like that stand-in doctor is not truly dedicated to your best interest.  With you ROM at 90 degrees, I would definitely want to continue with the PT, it can only help.  Hopefully your insurance will help pay.  I will ask my PT what his opinion is on what type of equipment I should purchase.

Stephen,  I can just picture you at the black-tie affair, all dressed up and wearing shorts!  So you had a plaster cast, wonder why you didn't start off with an adjustable brace?  Guess OS each have their own treatment plans.

 

Take care everyone!  Tim

post #1933 of 10860

Stephen is in England with the NHS. Breg braces are much more expensive. I hope he'll get one or something similar later on.  I could put on several dozen plaster casts for the cost of one brace. Six weeks in plaster must be six weeks of hell. I don't do much casting, anymore, but I haven't used anything but synthetics for years. Get 'em wet and dry them with a hair dryer

post #1934 of 10860
Thread Starter 

Hello all:

 

I am at 4.5 months after my second QTR surgery on the same leg in two years.  Went to the OS yesterday where I was expecting to be "set free" to pursue any and all activities that my heart desires and . . . .  it was close, but not all the way there.  He has given me the go ahead to add graduated mountain bike rides, and graduated hikes to my repertoir of outdoor activities, but says "no backpacking yet."  The reason is the downhills with the additional weight in a location a few days from a vehicle just might be too much.  Also, I go back to see him in November to discuss the "issue" of alpine skiing with him.

 

Now, it is my intent to take my limitations as far as I can - I did a 55 mile road ride on Saturday, another 20 miles on Sunday, and despite being sore yesterday, immediately went and climbed some steep hills on the road bike because he said I can start standing up in the saddle.  I intend to mountain bike, hike, road bike and even rock climb to my heart's desire, and continue with lifting weights in preparation for the ski season in the anticipation that I will be able to spend quite a bit of time on the downhill boards this year. 

 

This time, the leg is now stronger than it ever was after the first surgery - feels good!  Having a good feeling about this one . . .

 

Take care all, your efforts will pay off in the long run . . . .

 

IDG

post #1935 of 10860

hello all,

 

IDG, my OS told me that the problem for those who had QTR is the eccentric strength, common practice for those who ski or surf. I feel much difference between jumping or riding a bike and ride a skateboard, the force applied on the leg is different. I'm training skateboarding few days a week and notice a significant improvement in leg strength. I think that skateboarding could be a good workout to sky, what you think about this? Want to try?

 

Best recovery for all,

 

BS

post #1936 of 10860

HI, I'm a new member to this "club".  Lucky us.  Sounds like my injury is slight compared to a complete tendon tear. 

 

Partial tear at top of patella, from heavy backpack and slip on wet rocks in Yoemite.  Surgery with one anchor into the patella, 4 weeks post injury, 2 weeks post-op.  Doc said I can walk on it , but use crutches to be safe with the leg brace with 30 deg ROM.  Next Doc visit in 1 week.  I ski some, but I've been a cyclist for over 30 years, still train 6000 to 8000 miles a year.  I started cycling in college to get strong for the ski season, and wound up racing road bikes for 15 years or so...but still train and do big mountain rides...Triple Bypass, etc

 

Just wondering if they will increase the ROM 30 deg every 2 weeks, and when I might be allowed some easy riding on a indoor training.  Also, sleeping is problem....I'm off the pain meds other than Tyenol....perhaps I quit too soon?  I wake up with pain every 3 hours or so...just go back to sleep...get up exhausted.

 

Like all of us active Type A people, my spouse probably needs my pains meds worse than me.....she has to be around me an extra 15 hours a week now.

 

thanks for any tips or advice

post #1937 of 10860

Hi everyone,

 

Welcome Merlin55!  Today I am exactly 8 weeks post surgery of a complete tear.  Last Thursday was my fifth PT appointment.  I am fortunate with my ROM, because at my first PT, which was 6 weeks post surgery, the therapest measured me and said I was at 125 degrees.  Lost the brace at 6 weeks, still use the crutches till I see the OS August 6th, although I feel I could probably go without them, but afraid to take any chances!

 

Merlin55, at my first visit to the OS, they set the Breg brace at 10 or 20 degrees, then the 2nd visit 2 weeks later, set it at 30 degrees.  When I went 3 weeks later, he set it at 50 degrees.  I still have a rough time sleeping, seems like every few hours I am turning and tossing, trying to get comfortable, but then it starts aching again.  I try not to take Advil everynight.  I wish I knew how long this sleeping problem is going to last.

 

Thank God for our wives with this type of injury, they have to do so much for us.  You can't even carry a glass of water while using crutches.   

 

Take care, Tim

post #1938 of 10860

My Doc let me walk on the leg with 30 degrees ROM and crutches for stability 1 week post OP.  I don't use the crutches in the house, but do at work and outside as I'm faster on the crutches.

 

I found that sleeping with a pillow under the bad leg is a big help.  When I sleep on my side the pillow goes between my legs....also I take OTC NSAIDs if the knee is sore from too much walking during the day.

 

I wonder if the sleeping issue is due to the sudden change to zero aerobic excercise after 40 years of almost daily training?

post #1939 of 10860

Hi all,

I just stopped by to look at the site and catch up on old friends and the newcomers.  I'm 18 months post-op and back to doing everything that I did pre-injury - plus.  My knee sometimes feels different - a kind of tightness.  It's not sore, painful or swollen and I have regained both full strength and fexibility.    I know I am very fortunate.

 

The best advice I can offer (remember - do as I say, not as I do) is patience.  It's frustrating putting up with the brace and restrictions on activities -- but you need to give yourself time to heal.    Looking back, it really didn't matter that I did some activity at 8 weeks versus 12 weeks or even 8 months, the important thing was to heal properly and reclaim my life. Listen to your body - throttle back when you have pain, tenderness or swelling.  Go for the long-term win - no setbacks and a complete recovery.

 

Best wishes to everyone on this site for an uneventful and total rehab.  Tigger44 - I am especially looking forward to seeing a post that you have seen the improvement that you've worked so hard to achieve. 

post #1940 of 10860

Hi folks,  I'm the latest person to join this distinguished club.  QTR on 7/16 on the last day of an 8 day trip in the Bob.  Slipped on a rock in the south fork of the flathead river and went down.  It hurt pretty bad for about a half hour and then wasn't too bad thereafter.  Luckily our outfitter showed up with an extra horse and I was able to ride him out.  Had surgery on 7/21/10 --- holes drilled in the patella and the

QT was attached.  It has been very interesting to see the different approaches the health care professionals have taken in treating this injury.  My MD had me in a locking knee brace following surgery with instructions to use crutches for 2-3 days.  I've been walking with the brace both on and off for the last 4 days.  Last night slept without the brace -- just an ace bandage --- for the first time.  Have been doing passive range of motion exercises to 40 degrees the last few days.  Lots of icing.  Going in to see the surgeon tomorrow presumably to have the staples removed.  Just want to thank IDG for starting this thread.  It has been most helpful to to get an idea of where this is going for the next however number of months.  Certainly the most informative source of info I've been able to find anywhere.  Good for the spirits as well.  Here's to a rapid and full recovery to all of you out there.  Regards,  Brian

post #1941 of 10860

Hi

 

Surgeon said 6 weeks in a cast post op, it's fibre glass construction. Then into a brace. Despite what you might read about the National Health Service (NHS) in the UK if you are an emergency admission then they treat you well and it's free. Discussed private treatment with the surgeon, but he said stay on the public list, I will operate on you whether you are public or private and it will be on the same day. Will switch to private for the physio though, I can choose the timings. So one week to go before a brace.

 

Stephen 58 (now 59)

post #1942 of 10860

OK, so I'm 5 weeks post injury, 3 weeks post-op with a Partial tear at top of my patella.  Surgery with one anchor into the patella.  I'm wearing a brace with 30 degrees ROM, but have about 70 degrees ROM when doing heel slides

 

Stuff I learned today at the OD, my tear was on the top layer of tendons, and only about 1.5 cm wide, which allowed using only one asorbable anchor...so I have the PG-13 version of a QTR, not the R rated full tear, or a X rated bilateral QTR.

 

he said for complete tears it is better to drill the tunnels through the patella, which allows him to better attach the 3 to 4 cm width of the tendon to the patella.  So No PT referral yet, he wants at least 6 to 8 weeks of healing before any real loading of the tendon.  He works in San Diego, and does fewer than 10 QTR per years, versus hundreds of ACLs, Clavicles, etc thanks to all us Road and Mountain Bike riding Boomers.

 

As to sleeping he suggested Tyenol PM which has some Benadril to make you sleep....but not the other NSAIDs.

 

Once again thanks to everyone for sharing their information and experience, it helps us adapt, and ask better questions of our Doctors and PT people, and live through this challenging period.  My Doc is the only person I know who saw and repaired my tendon, so I value his advice but thank to what I've learned from the rest of you, I can ask the right questions...which helps both of us.

post #1943 of 10860

7 weeks post op

68 year old female

full rupture of left quad

 

First, let me add my thanks to Idaho guy and the early contributors for getting this going. It has made such a difference in my recovery to date.

 

I was a competitive skier in my earlier years as I grew up in Vermont and went to the University Of Colorado. After school  my active interests  switched to hiking, biking and canoeing.

 

While on a trip to China this spring I took a climb up a hill to visit some temples and on the way up I slipped on a steep downhill and sat on my leg (like other I have read about here). I was alone  and had to get up and try to walk.  I fell over 5 times more but managed to walk by keeping the injured leg completly straight. I went to a doctor who took an x-ray and said surgery now!  I said I'm going home and that is what I did. He put me in a plaster splint  and I flew home a few days later.  Luckily I didn't have much pain at all except at the time of the initial injury and subsequent falls trying to get back down the mountain. 

 

the operation was as described by many of you with holes drilled into the patella. Whin two days I didn't have pain and stopped taking drugs.  I was allowed partial weight  on the leg from the start and full weight at 4 weeks. My OS was in the "keep it straight for six weeks school" but at 5 weeks he had me doing leg raises from the knee to 45 degrees and to 90 the next week (three times a day)

 

I had a PT appointment at 61/2 weeks and she gave me several more exercises to do gradually during the day. I like this method  better so far..  Seemed more reasonable to me. Therefore I took off the immobilizer and just started doing much more movement and some walking around the house.  Since mine was a left leg injury I started driving a week ago and it is fine. I still use the crutches if my leg gets tired  but my leg feels pretty strong, though very tight and I can only bend to 70 degrees at this point. Next week I have another OS appointment followed by a PT appointment.  I think I will be doing most of my PT at home using the exercises that are given to me. ( I was glad to read that Vermont Skier found this OK. ) I am trying to walk a lot and raise my leg throughout the day.

 

Again a hugeTHANK YOU to all   of you who have contributed to this blog. I finished all 65 pages today and have gained so much knowledge. I'm so much better prepared to make intelligent choices, which in my case is especially good because my OS is not giving me much giudance. I feel like I have the wisdom of many OS's and PT's to use.                                                   

 

                                 

post #1944 of 10860

Is anyone out there using a cryotherapy device like the cryrocuff from aircast?  If so could you please tell me how often each day you use it?  For what period of time?  Do you sleep with it on?  Do you find it preferrable to ice packs and ace bandages?  Do you use it through the entire period of time you are rehabbing?  Any info would be appreciated.  I suggested getting one to the PAC and he was dismissive of the idea.  Thanks.  Brian

post #1945 of 10860
Thread Starter 

Brian:

 

I never used a "cryocuff", but I did use an "Iceman", which kept the knee cold after surgery and all the way to the present.  I used it overnight and slept with it on.  Probably did that for a couple of months on both QTR surgeries.  I thought it was essential to both recoveries, and my OS agreed.

 

Back to mountain biking again - boy am I weak compared to where I was three summers ago now!   Plenty of time to build up strength prior to ski season, though.  Hang in there everybody - this too shall pass . . . . .

 

 

IDG
 

post #1946 of 10860

8 weeks post op.

 

 Idaho Guy, I know you really think walking in water is great for this kind of injury.  What do you think of weight bearing walking on land? Is it just as beneficial? I don't live near a pool so have started doing a lot of walking . 

post #1947 of 10860

IDG,  Thanks.  It sounds like its worth the $150.00 or so.  Conventional wisdom is use ice for 20 mins at a time.  I take it that you used the "Iceman" for hours at a time and that you found it beneficial to your recovery.  Since I've needed to ice my knees after skiing the last few years this would appear to be a good investment. IDG, are you back to where you were prior to your ruptures?  Regards from Big Sky Country.  Brian.

post #1948 of 10860
Thread Starter 

Chinagirl:

 

My experience is limited to my own, so please don't take what I might opine as gospel, but I was not ready to be walking on land at 7 weeks post-surgery after either QTR.  Having said that, walking has certainly been part of my regime for both recoveries - both in the pool and on land - good luck - you sound as if your recovery is going very well!

 

Brianfay:  I did use the Iceman for hours at a time - and found it VERY beneficial.  I'm not even close to where I was prior to the original QTR 2 1/2 years ago, but I can feel it coming for me.  I'm a little concerned about being able to "rage" while alpine skiing this year - I think that activity will probably be frowned upon by my OS, my PT, my wife, my sons, and ALL of my friends . . . . .  They are all sick of having an injured Idaho Guy around that they have to be careful with . . . . .  But, I should be able to ski carefully and a LITTLE more slowly this season . . .

 

IDG

post #1949 of 10860

IDG,  I live in Bozeman and bought a pass to Big Sky for 2010-2011.  Hoping to  be able to use it at some point this season.  Usually get in 50 days a year.  I know that won't happen this year but I hope to cruise some groomers with my daughter.  Regards,  Brian.

post #1950 of 10860

Saw the OD at 4 weeks post-op (partial tear) he said do your heel slides but take it easy, and to move the leg brace to 45 degrees ROM.  I called back to say I'm getting more than 45 deg when doing the slides so he said don't exceed 90 deg before my next OD visit in 3 weeks, but leave the brace at 45 deg when walking

 

I wanted to track my ROM progress, and don't have an giant protractor (goinmeter?) so I grabbed one of the boxes that reams of printer paper comes in, stood it on end next to my knee, and just mark the highest point of my knee on the box for my warm up ROM, my ROM after 30 slides, and my passive ROM after the 30 slides....sort of like marking the height of your kids on the door.  Easy, fast, and cheap.  Looks I'll need a taller box once I exceed about 100 degrees,

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