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Quadriceps Tendon Rupture, Repair and Rehab - Page 85

post #2521 of 10797

cnydiver  I had good results applying heat and my PT applied heat before each session.  I tried a lot of different measures to increase ROM, but when I read TexasDiesel's wall slide exercise those seemed to improve ROM the most for me in the early to mid stages.  Once I was able to ride the stationary bike (about 110 deg) I'd keep adjusting the seat to increase ROM.  I have never used the electrical stim so can't speak to that.



post #2522 of 10797

Injury Nov. 21

Surgery Dec. 2

Cast Removal Jan 10th

First Rehab Jan 12th

Today 3 week evaluation by PT


ROM today was just under 120 degrees.

Added or modified a number of exercises to focus more on only the injured leg. Upgraded to the gold band for all exercises including the crab walk and the tensioned waddle, definitely an upgrade in challenge. Doing the scooter drag with an additional 50 pounds of weights. Changed the leg press to using only the injured leg and reduced the weight back to 8 pounds.


PT is very pleased with the leg strength and the ROM and is calling the surgeon today to check on some things like freeing me from the brace inside the house and extending the ROM settings on the brace.


post #2523 of 10797

I'm writing this post to keep a promise I made to myself some time ago.  I was trying to work through the pain of increasing my ROM and wondering how far I would be able to get.   I read a post or two from people who were 1 or 2 years post-injury and found confidence in their recoveries.  This meant a lot to me and I promised I would do the same.


I had a complete rupture of the left quad tendon at age 57 in late January 2009 on a sailboat charter in the British Virgin Islands.  I completed the trip and managed to limp around for three weeks until they finally diagnosed the injury and scheduled me for surgery.  In retrospect, my recovery was steady and uncomplicated - although it didn't seem that way at the time.  In 4 months I was riding my road bike 50 miles and racing on my sailboat.  In six months I was riding 100 miles and set a personal record for my fastest 100 mile ride.  By 10 months I was downhill and cross-country skiing.  I'm not a runner, so that never entered into the equation.  Two years down the road I'm doing everything I did before the injury - and more.  I'm fully recovered. 


What does that mean.  On the positive side my injured leg has recovered about 90-95% of its muscle mass.  You have to look closely to tell the difference.  I still feel the "tightness" and some soreness in the knee, especially if I work it hard -- but no pain, swelling or other signficant problem.  The injured leg has about 95% of the strength of the other leg.  A trainer told me that very few people actually have identical limbs, so I am more or less normal.  I can see the difference on my power meter when I try to do a hard short sprint at the upper end of my power range.  I can do anything and everything about as well as I've ever done it.  One area I notice is that my balance is still a little off.  I've been trying to work on it.  I'm also continuing to do squats and lunges to keep building the quads -- never leg extensions.


Some lessons.  Be patient.  Be patient. Be patient.  Your body will heal at its own pace.  It may feel good to show you are still in control and can take the risk of getting ahead of what your OS or PT tells you to do -- but you're playing Russian Roullette.   Exercise your entire body.  Everything gets out whack and you need to bring it all back into balance.  You'll need to make accomodations - make them with grace.  Set realistic but challenging goals and work hard to achieve them.  Make sure to thank those who have been kind and patient in helping you.  Be thankful for your recovery and for being able to reclaim your life.


This forum became part of my family when I needed it most.  I wish each of you the very best as you work your way through your recovery.  Fair winds and calm seas.   Rich

post #2524 of 10797


Thanks for your words, I often wonder if I am going to ever get back to near where I was.  I am scheduled for surgery tomorrow and will begin my long climb back.  I will heed your advise and exercise patience above all else.


Once again, thanks for checking back in.  I will promise to do the same for others when the time has come.



post #2525 of 10797

I believe that wanasail had his injury around the same time as mine, and he was one of the regulars when I used to post here. Of course, he had the good sense not to DO IT AGAIN like I did!


Just like he said, after two years, there was very little noticeable difference left. As a bodybuilder, I am extra-sensitive to these things, so I am aware that my left quad never did get quite as big again as my right one (although now I guess they'll even out, for better or worse, heh).


This year was going to be my big comeback in competitive bodybuilding....it may still be doable, but I don't want to push it, and I had mixed feelings about competing this summer anyway.


On a weird note, I had begun to get some medium-level arthritis in my knees even before the first rupture, but over time, it has been the "good" knee that has given me much more trouble in that area! I have heard that somewhere before. I don't advocate a QTR as a cure for arthritis, but there may be a strange silver lining there.


Likewise, from a bodybuilding perspective, the calf muscles on the leg I hurt 2 years ago have developed MUCH better than the good leg...I suspect that the muscle is a little shortened or something. So again, maybe a twisted sort of silver lining for this clumsy muscle-head.


I go in next Thurs. to get the stitches out and have it looked at. If I remember correctly, I will start PT soon after that. I guess I'll go to the same folks as before...they were fine, and I can take the bus there.




post #2526 of 10797

Rich  Thanks for the words of wisdom.  You specifically mentioned not doing leg extension.  Is that because of medical advice or is there some other reason for not doing the extensions?


Craig  Best of luck to you tomorrow and the weeks to come.  Will you be having outpatient surgery or do you have a hospital stay?



PadreBear a ROM of 120 after 9 weeks seems like pretty good progress.  I'm at 11 weeks post op today and am trying to get that last bit of ROM to equal the good leg.



post #2527 of 10797

PadreBear, congratulations on your progress. Keep us in the loop!


Wanasail and gymdude, thanks for returning Rich.  I was hoping that some of the QTR legends would eventually return to apprise of their lives 1 - 2 years post op.  Rich, your case has special appeal to me in that I really want to get back to the road bike.  I am 8 weeks post op and at 125 degrees of ROM but my conservative PT is thinking that I must wait for the 6 month mark just to get on the bike---and you were riding centuries at 6 months!  I try to restrain myself and follow her protocol but it is so light compared to most of the PT regimens on this forum (could be because she is married to my OS and doesn't want to risk his handiwork!)


Jim, again thanks for returning to this forum ---although I hate the reason for the return.  Your optimism and competition goals really throw a positive light on how we can be victorious over this hurdle in our lives as active adults.

post #2528 of 10797



I asked my PT about extensions and she was not much in favor of them. She says that recent studies show that there is more strain transmitted through the knee joint than was oiginally thought.  This could account for the soreness and swelling you had in the days after performing these.  Grain of salt:  my PT seems to be the most conservative when compared to what I have read on this forum.


Are you still doing the extensions?  If so have you worked past the pain/swelling?  (I really want to start doing them).



post #2529 of 10797



Thanks for checking on the leg extensions with your PT.  I haven't done any more extensions since I had done them last Thursday.  The aches and pains resolve themselves after about a day and the swelling has been reduces quite a bit since not doing the extensions.



post #2530 of 10797



Maybe my PT is right about the extensions or we just have to wait a lot longer to incorporate them into our routine.  I am not doing any leg presses either--just freehand squats.


I see her again today so I will share anything else I learn.


Take care,


post #2531 of 10797

Ken - I was given two reasons by my PT, OS and trainer not to do leg extensions.  First, they put too much strain on the tendon repair during the healing phase.  After that, they discouraged me from doing exercises that target only a specific muscle group.   They cautioned that developing a muscle without the counterbalancing related muscles puts your body out of balance and makes you more susceptible to injury.  All three recommended exercises like squats and lunges in multiple different forms with hand weights to increase the training stress as you get stronger.


Steve - Your ROM at 8 weeks is about the same as mine when I started on the stationary bike.  You may want to have a heart-to-heart with your OS or PT and tell them that it is important for you to get back on the bike as soon as possible.  My OS had two concerns: (1) the damage I might do if I fell and (2) the damage I would do by overstressing the repair too soon.  Both concerns were valid.  You'll find your balance is off and you don't respond as effectively to all the little problems you run into on the road.  There is also the temptation to push too hard once you get going.   I made some "deals" with my OS to get back started.  Only easy, flat rides on neighborhood roads or bike trails.  Never standing on the pedals.  Limited time and distance.  I also used easier gears and a higher cadence to reduce strain.   As I progressed we eased the rules until about six months when I got the "all clear."  Suggest some alternatives and see what they say.  Keep in mind that every injury is different. Good luck.



post #2532 of 10797


Originally Posted by Cvilleguy View Post

I asked my PT about extensions and she was not much in favor of them. She says that recent studies show that there is more strain transmitted through the knee joint than was oiginally thought.  T

I follow this kind of stuff sometimes, as a bodybuilder, and as a muscle-building exercise, extensions have fallen WAY out of favor lately for the reason stated above. Leg presses and such have been found to be much more effective.

post #2533 of 10797



Did you still do extensions up until your re-injury?  Even really light extensions?

post #2534 of 10797

Steve, Rich & gymdude,  thanks for the information on the extensions.  I'm doing the leg press now.  Maybe I'll try adding lunges in lieu of the extensions.  I'll head down to the gym after work today and see how it goes.



post #2535 of 10797
Originally Posted by Cvilleguy View Post



Did you still do extensions up until your re-injury?  Even really light extensions?

No, I actually cut out extensions years ago. I have some arthritis issues, and extensions did not feel right....then I read all the research that, indeed, they put undue stress on the knee joint. I always treated them as as secondary exercise, but around the time of my first injury (just coincindentally), I cut them out entirely. I see see no reason for them, now. As with most exercises, the big multi-joint ones are much better and safer (in this case, leg presses).


In my bodybuilding, I do only leg presses, believe it or not. I am way too broken-down for squats (knees, back. etc.). Legs have always been my week part, and I was finally getting some nice thigh size when THIS happened. :(


post #2536 of 10797

The elimination of extensions is interesting since that is an exercise my PT has just added. He has me doing low weight single leg extensions on the machine. On the other hand the rest of my workout is so diverse imbalance is not a likely issue. 

post #2537 of 10797



Thanks for your view on the extensions.  It is good to know that I can avoid them and hope to still re-gain some leg mass.  I figure cycling, hack squats, and swimming may get me there.



You probably have one of the more aggressive routines I have seen so you must be at a level where the low weight extensions pose no risk.  I did not have the pre-injury base line strength that you have (still I could do reps with seven 45lb plates on each side of the rack). Your base strength is probably good justification for your PT to put you on an agressive recovery routine. More power to you!




post #2538 of 10797

I think that as a low-weight rehab exercise, extensions are fine. I am not a physical therapist (just a personal trainer), but I would think that in terms of a QTR, they could be useful in really isolating the tendon. But at a higher weight as a real muscle-builder, not so good.


Someone at my office told me to get better and hurry back in. Um, yeah, I'll get right on that....

post #2539 of 10797

HELLO all you guys


Finally got my surgery yesterday at noon and went home around 4 and thennnn waaaoooo a horrible PAINNN came into me luckuly my wife call my OS  and told her to double the those of PERCO for 24 hours and boy it really helped.


for my surprise the OS sent me home with a CPM machine and told me to used beginnig today at 30 ROM and tocontinue to go up until 60 ROM for Monday check up, and i said surprise because i have not read of the use of this type of machine in this forum , although the OS and SPORT MEDICINE one and very up forward the PASSIVE MOVEMENT  that the machine.


I have to use this machine 3 times a day for 2 hours and the first one was painful but really help me a lot after the sessions with my pain, remembers surgery FEB 2 ,2011 also using some kind of cold water machine and told DO NOT HOP OR JUMP IN THE CRUTCHES  so he recomend 30% weight bearing after 72 hours.


hoping to rest a little bit more but as i am writing this now i feel groggy and stomach upset due  to has not ate very well since tuesday.


so a will posted with you guys and keep this page running and LIKE ALL OF YOU SAYS KEEP MOTIVATED AND CHIN UP



post #2540 of 10797

7+ weeks post op


Puetrorrican: Good to hear you are through the surgery! Sorry about the pain. It should pass soon. The few days of post-op weren't much fun for me either, but you're on the rehab side of things now. Hang in there and take it slow.


Saw OS yesterday, released to closed chain exercises (wall slides, etc) and open chain against gravity only. She said absolutely no weighted extensions, quite adamant about it in fact. I can do straight leg lifts, heel slides, pedaling (once ROM is at 105) pool walking, walking outside in brace with crutches. She thinks I'll be doing stairs in 4-5 weeks and driving in about the same time frame. ll good news, now it's just getting it done, lol. Took my first full shower last night, blissful and scary as I had the brace off and was only clinging to a walker. Leg is weak but I swear ROM has improved overnight.


SO, my question for the group, given where I'm at and the kind of exercises I can do, does anyone have a "favorite" that you found effective? Even better, does anyone have a home routine (including pool stuff) to share that would be right for this stage of recovery? Much appreciated if you could clue me in. My PT is on vacation until the 10th (how dare he, lol) and I want to maximize this time - Peru is only 6 mos away. Got to get on it. Cheers to all. Mel

post #2541 of 10797

puertorrican,  Best wishes to you.  Stay ahead of the pain with the meds.  I never had the CPM, let us know how that works out.


melachric,  Not sure what your current ROM is, but I'd focus on getting to the stage where you can pedal a bike.  The wall slides that TexasDiesel described did wonders increasing ROM for me.  I'd just do a lot of quad sets and straight leg lifts on your back, stomach and both sides.  I also used ankle weights when doing the straight leg lifts.  I also walked quite a bit.  Once you can start on the bike it will pick up.


Well I went to the gym and did 20 minutes on the bike doing the intervals that TexasDiesel was doing; 12 minutes on the elliptical; leg presses; toe raises and body weight squats.  I dropped the leg extensions and tried doing lunges with only body weight.  The lunges were tougher than I expected.  Maybe because my balance wasn't that good.  My leg felt a bit wobbly afterward but no pain as of yet.  I'll see how it responds in the morning.

post #2542 of 10797

Hello QTR  family, well i go in for the procedure tomorrow and am a little nervous, but through the insight and advice from your own expieriences i am ready for what has to be done, thank you for the pre-op prep now be ready for the post-op as i will ask for advice through out . My doctor thinks its funny but i think after i heal a little it would be cool to watch. so i have ten mins b4 i cant eat anything else so i will talk to after its over, Everyday we get better and well wishes

post #2543 of 10797

11 weeks post op,


Puertorrican,  Good look with the rehab, keep crunching the painkillers for the next few days and I hope the CPM brings rewards for you.



Leg extensions, ( non weighted)


I've stopped doing these over the last couple of days. Not because of what I've read on here, although it does help to reassure some of my concerns but mainly due to my knee cracking all the time. Had a bad knee pre injury looks like it's coming back. I was doing squats anyway, just doing more of them now. Shame is that I can't exercise the same range with a squat.  



All the best to all






post #2544 of 10797

 Joe,  I think it is great you can do squats after 11 weeks.  I am 8 weekspost op  and only allowed to do weightless squats.


Question for anyone:  doing regular style pushups?  If so any pain in your knee?


melachric,  I recently started pool walking and it feels great.  The PT really seems to endorse it.  I have an appt with another PT next week.  This PT specializes in water-based therapsy so I will post her recommendations.  I am 8 weeks post op, ROM at 125, and I just started the stationary bike and elliptical machine.  They want me to start at 15 minutes and increase by 5 minutes per day.

post #2545 of 10797

gottagetback,  good luck today.  It's the first step in getting back.


Joe, when did you start with the squats?  I'm 11 weeks post op to and am just doing the body weight squats.  How deep of a squat are you doing?


Yesterday I mentioned I was doing my workout at they gym and replacing the leg extensions with the lunges.  Today my knee feels pretty good.  No new swelling either.  I can't say for sure it was the leg extensions causing the pain and swelling, but I'll probably leave them out for the time being.



post #2546 of 10797



I'll just add that the squats I'm doing are weightless. Been told to stay clear of gym equipment till Monday week at the earliest. .


Just tried about a dozen push up's ( need to work on upper body, seem to have lost loads of arm strength, must have benefited with my general working day on that front) and struggled. Bad leg was shaking, probably best as usual in these circumstances to get advice from PT as may do more harm than good until leg strength improves and in my case upper body also.   


I've been brace less for nearly 2 weeks, I'm still a little peg legged and have to concentrate to attempt to walk normally but feel comfortable enough now that I don't need the support. The hardest thing to negotiate ironically are wheelchair ramps! In particular coming down.  I've yet to test myself for any noticeable distance on uneven ground and avoid anything steep like the plague.


Not too sure whether warming the knee is bringing any benefit at the moment. I'll keep trying though as PT instructed.



post #2547 of 10797

melachric - thanks for the words of advise and hope the pain goes in couple of days


Kallen - now i am of just one perco avery 4 hours and this machine THE CPM - is a machine that help your newly operated leg to move the knee up and down while you are sitting or lying down the

            OS wanted me to do this for 2 hours three times a day at 30 degree of rom and today at 40 but boy it hurts a littlke bit but will follows his advice.


gottagetback - like everybody here said keep the pain killers med really close and do what i did not, have prior the surgery and try to take one dose before leaving the observation are and GOOD

                      LUCK AND ALL THE BEST WISHES TO YOU .


yorkiequad - thanks for the words and advise , and definetly hoping the CPM BRINGS REWARDS

post #2548 of 10797

Cvilleguy and KAllen: Thank you. I will be very interested in water therapy recommendations. Cvilleguy,you seem to be moving right along. I'm a tad behind you (7+ post op) but am only now working on 90 ROM. I'm cleared to open the brace to 100 ROM next week on my own, as PT is on vacation. I'm looking for that golden 105 ROM to start stationary pedaling etc. The heel slides seem to be really helpful right now. I think I read somewhere here that one idea is to kind of move the leg around a bit, side to side as I'm sliding toward my butt as opposed to just pulling straight back. Sound familiar or am I wrong? Good luck all! Mel

post #2549 of 10797

Hi melachric,

Your injury was a little different than mine and I think you will find that ROM will come back faster out of the brace.  I tried some heal slides but I believe much of the ROM comes from getting back into normal activity (ie, walking without the brace, stationary bike, etc).  90 ROM is actually pretty good at 7 weeks, once fully released from the brace you may see 10 - 15 degrees for a week or more. I am hoping  that hydro PT and pool walking will advance me for strength and ROM.




Originally Posted by melachric View Post

Cvilleguy and KAllen: Thank you. I will be very interested in water therapy recommendations. Cvilleguy,you seem to be moving right along. I'm a tad behind you (7+ post op) but am only now working on 90 ROM. I'm cleared to open the brace to 100 ROM next week on my own, as PT is on vacation. I'm looking for that golden 105 ROM to start stationary pedaling etc. The heel slides seem to be really helpful right now. I think I read somewhere here that one idea is to kind of move the leg around a bit, side to side as I'm sliding toward my butt as opposed to just pulling straight back. Sound familiar or am I wrong? Good luck all! Mel

post #2550 of 10797

Just got back from first official PT visit, just a couple days short of 5 weeks post-op.  My PT is my brother-in-law who was actually with me when I ruptured my L quad tendon back on Dec 29th.  ROM today 85.  He did e-stim to try to fire up the VMO in particular.  He did stretching of all leg muscles.  He did patellar massage.  Had me squeeze pillows between my legs and do toe raises.  Ended with 15 minutes icing the knee.  I'll go twice a week to see him plus daily work at home.  He says we'll get more active after 6 weeks post-op.  Still swimming, now up to 3 days a week.  I can actually flutter kick the legs in narrow ROM very safely.  Swam 3/4 mile today.  Other than having to slow down for the turns and kick off with good leg only, I'm actually pretty fast.  Still in brace, now at 60, but starting to not wear it in house and not wearing it to bed.  Walking about 1/2 mile per day, now on treadmill (always holding on) because of all the snow and ice and cold outside.  Any runners out there?  Seems we have lots of bikers and I look forward to that 7-8 week time when maybe I can ride stationary bike.  Just wondering about timeframe to start jogging from any of you runner quad-rippers out there?  I suspect maybe 3+ months post-op.  Good luck to you all at your various stages of recovery!  This injury really has reminded me how blessed I am and how I need to be much more thankful overall, you know what I mean.  Andy.

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