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Quadriceps Tendon Rupture, Repair and Rehab - Page 100

post #2971 of 10797

Hey Quad,


I've read a few of your past posts.  You opted out of surgery - ballsy.    You had partial tear but did not rupture from the patella - correct?   Just curious.  

Interesting the comparison.  I had done high rep deads (12 reps) up to 8 weeks out of competition.  I was working up (and dropping reps).  I had just pulled 585 for 5 reps and then moved on to squats.  I warmed up for 20 minutes and was going to hit a double (unwrapped) at 525.  I've found in my late 40s I pull much more than squat.  I was just six weeks away from the meet.    Gotta tell ya, I never gave the high rep deadlits a thought (contributing to the rupture) until now.

What part of the deadlift did you experience the tear?   If I was a betting man I would bet right after completion a split second after you started to lower the weight.   But I've been way wrong before.  I am more-than-curious at what part of the movement your tendon failed.  

The only other guy I've ever heard of having a QTR during deads was a guy in SoCal - Mike Muniz.   He slipped during a heavy dead (I'm sure it was over five) and experienced bilateral failure!!  

His recovery is well documented on youtube.    I guarantee I'm using non-slip tape when I deadlift again.


Looking forward to your response.



Edited by bigggfred - 5/11/11 at 8:58pm
post #2972 of 10797

Bruce, a termite mound?  Amazing.  That tops my weak snowmobiling story.  I just wanted to respond that I too had 2 anchor suture screws placed in the top of my patella for my repair.  I saw the hospital bill, they alone were way expensive, like $600 just for them.  My OS really likes them.  Continued good luck to your and everyone's recovery.   Andy.

post #2973 of 10797

Hi Andy,


Thanks for the feedback on the anchors.  Mine cost $R 3500, equivalent to $2000 US, I guess raw materials are more expensive here in Brazil.  The bill for the whole thing put together, though, hospital overnight, OR, surgeon, everything, was a little under $10,000 US, including all followup visits with the OS.


I know a termite mound does not sound too impressive, but these things are huge and packed as hard as rocks: 




post #2974 of 10797

Hi I would like to share my story. I will be going in for my 2ND quad tendon repair next Thur 5/19/11. The first one happened to my left knee about ten years ago. I will be 43 yrs old  in Nov. I completely ruptured the left knee tendon playing basketball. This time around I just completed a leg workout consisting of squats and lunges . I got through my work out fine but about a half hour later my right knee swelled . The MRI showed the quad tendon was barley hanging on and I also had some loose cartilage. So I will be getting a scope to  remove the cartilage and surgery to repair the quad tendon at the same time. The doctor said that part of my knee did not full develop as a youth and remained soft which caused the cartilage to eventually to give way. The first time around it took me bout six months to get back and about a full r year to feel 100% when playing sports or running and lifting. I Will say my left is stronger that ti's ever been and have not had any trouble not even any pain so I hope the right knee has the same result. I know I'm ten years older now. I also have a heart valve replacement about 12 years ago . I will post my progress and hope it is helpful for someone

post #2975 of 10797

Not sure why, but I feel the need to post on the 100th page of this great thread.


Welcome to all of the newbies and sorry to hear of your plight.  This is a great resource to answer questions, get a little sympathy, and provide your own insight. 




I'm really interested to hear if your first time around ten years ago, had the same type PT and recovery plan as you experience this time around, as well as if it is similar to what we've gone through over the past few years since this thread started.


Good luck to all in your recoveries...



post #2976 of 10797

Hey Fellow Quaddies:


Five months (almost) from surgery, walking without cane, no pain, doing weight work and biking in the gym, lots of outdoor walking with "sticks". Stairs up OK, stairs down, still hanging on to railings. OS is happy, but is very stern about walking with support outside esp. since she is going to do a knee replacement on my left knee ( the other one) in a few months. She says she doesn't want me ruining her work on the right knee, lol. I'm a little frantic right now as I am trying to get in adequate shape to handle an upcoming trip to Peru.


Overall, things got much better after about the third month (12 weeks), then seemed to flatten out at about 14 weeks, now I'm seeing improvement again. Funny, as other have noted, it's not a straight line recovery - lots of plateaus. Strongly suggest pool exercises ASAP. I can't remember who suggested it here, but it was a LIFE SAVER - thanks so much!


For the new folks, sorry about the injury. I can only reiterate what others have said - you will get better, 100% recovery is the norm. I hope this doesn't happen to me (or any of us) again, but if it does, I know this thread is here. Take care all, Mel.

post #2977 of 10797

Hey Bigggfred:

As the injury was in Canada, there was no MRI but the OS said he should operate immediately. I could not lift the leg up laying down and could not stand on the leg. He said it was a major tear without the mri he did not know the extent. in Canada the wait time for an MRI is about 6 weeks, unless you pay and do it privately. Anyway it occured when I exploded with the weight off the ground. I am not sure if I slipped slightly but I was down and the leg looked freaky, there was nothin but bone right above the kneecap. I could not straighten the leg, when I did the pain of a spasm was unlike anything I have ever felt. I slowly worked out doing a lot of light straight legged deadlifts, with the knees ever

so slighly bent as it is easy to hyper-extend as the quad is so weak. I also did a lot of rubber band exercises, lifting the leg straight up while standing, but not bending the knee. I hope to compete again someday, but like you achieving a squat below parallel will be tough after this injury. but for now I am happy just to be back in the gym, and being able to get around walking.

Have a great recovery!


post #2978 of 10797
Quad fraud That was definitely a partial tear. You would never rehab a complete tear without surgery because the quad muscle rolls up and the two ends of the tendon would be too far apart to heal, leaving you with no connection. A partial tear can heal with slow careful rehab
post #2979 of 10797

Almost 8 Months

I can honestly say, I am feeling real improvement.  Many things I do now, the injury isn't even a thought.  I can finally squat again and I feel completely safe doing so.  I'm still concerned about making basketball type moves.  The sudden starting and stopping might be pretty dangerous.  Does anyone worry about the other knee?  I feel a burning sensation right where the left tendon ruptured in my right knee and I just can't help but pray I'm not in for round two. 


Page 100.  I feel honored. 



post #2980 of 10797

HELL YEAH MY QUAD 29!!!!!!! I am freaked about doing it to my other one. especially now at 6 weeks post op....cant imagine trying to heal a fresh injury with my other leg barely recovering. I am not so afraid of doing it long term. My recov has been good so far. had my 6 week post op and now out of the brace and walking without any assistance. my OS recommended crutches for a while but i have been pool walking since 18 days post op and felt prepared for walking without a brace. day one was iffy, day 2 (today) much better, am pretty sure by another weeks time i will be walking fine. My ROM is at about 95 degrees and i think that will improve rapidly now that i am out of the brace. I think in another 2 weeks the real hard part will be passed...should be walking fine by then and pretty good ROM I am hoping 110 degrees and likely able to start the elliptical and bike. If that is true then it means the worst of the injury is over in 8 weeks. also if the recovery is good i understand the leg is pretty strong and probably better then before....and if that is true i know I can handle doing it again, once this leg is recovered....if that happens at least i know after 8u weeks of hell i will be well on my way to having both wheels at 100% and at the age of near 50 (by then) that would all but assure me the ability to compete at athletics the rest of my athletic life unhindered by these damn sore quad tendons. that being said I am currently rehabbing my unrepaired tendon with US daily( bought my own machine) as well as 3x a week SASTM(Graston technique) and EMS(STIM) as well as once a week closed chain low stress work (light hacks and single leg squats). we'll see how it goes. getting out of that Iron maiden has been huge. Now i can sit at restaurants and in a car and at this computer without that uncomfortable straight leg crap. hang in there everyone it gets better. Pool walking was huge for me IMO.

post #2981 of 10797

7 Weeks PostOp








I am now measuring my progress against your gains (albeit I realistically put myself two weeks behind you in process).    Our surgeries were two days apart, we were both performing athletic moves at the time of injury, we both have lifting backgrounds and we are close in age.  

I do have two questions:   was your injury a full avulsion from the patella?   And was the repair 'drilled holes'?   I thought the answers were yes I just wanted to make sure. 

Since deviating from my OS's ultra-conservative, neo-nazi approach on Monday - I'm at 40 degrees ROM and weight bearing 70% with little to no pain.  



post #2982 of 10797

Gee, don't we all have OS's who have a  vastly different approach to the rehabilitation of our injuries post surgery.


My OS has taken a cautious approach, however he doesn't necessarily know everything I have been doing. My physio has been really good and now at 8 weeks post op I am at 90 degrees ROM. Tightness in the leg continues but I am trying to get that out with massage and stretching. OS doesn't want the PT to push too hard, but we have been achieving about 10 degrees improvement each week. Obviously the pain levels will increase as we try to maintain that improvement and he has advised that I might like to pull the pain meds out again for use after treatment. Not too keen on that as they have been locked away since not long after surgery.


Its a shame that the number of people that need to access this forum continues to grow. I wish you all a speedy recovery, although patience will be needed as it will take a long time to fully recover (or at least that what I keep getting told).


Hang in there everyone.



post #2983 of 10797

yeah bigggfred I had the top of the patella ripped off with the tear, could see it on the x rays. The OS drilled 4 holes top to bottom of the patella to run the sutures thru. FYI although I have been doing a lot of things at PT it seems my OS feels the ROM stuff and the straight leg lifts are the most important. even now that seems to be what he is most concerned with. I am up to doing 100 straight leg lifts with ten pounds around my ankle and no brace(actually 105, 7 sets of 15) So my advice to you would be if you want to wear the brace fine but do lots of straight leg lifts a day, if they are easy without weight buy some 1,2,and 5 pound ankle weights and start adding weight. You will see it is easy to progress in strength. obviously be cautious and listen to your body. So far I have found normal weight lifting common sense is all you need. You know the difference between a "good" pain and a "bad" pain(like I experienced trying the leg extention the other day....right away I knew..."ok that didnt feel right".


I would also recommend walking in the pool and doing slow cautious partial squats in the pool. You should be very focused and be sure not to let your knee buckle. start in deeper water and work your way up to the shallow end as your proprioception and strength improves. When you do the partial squats hang on to the side of the pool and squat till you feel a bit of tightness at the surgical site, hold for 10-20 secs and repeat. I think the pool stuff will be very emotionally satisfying for you....you get out of the brace and you improve day by day, a very liberating and encouraging thing. best of luck. be careful.

post #2984 of 10797

Right Quad Tendon Rupture

12 weeks post op

13.5 weeks post injury


Not much to report, progress has been frusratingly slow :-(  Good to see a lot of you making great progress though!

I'm only at about 80 degrees when measuring in a sitting upright with my lower leg hanging down position and still only about 60 degrees when lying down.


Which raises a question - what is the standard position to measure ROM in?


Having PT 2x/week and I feel sorry for the PT's as they are doing passive stretching and we both end up dripping in sweat!

Since the PT's have started this more aggressive approach, I'm gaining a few degrees each week.


But I saw the OS yesterday and he said that we may have to consider the dreaded MUA if I don't have 90 degrees flexion in my next visit on 2nd July. He is reluctant as he stated there is a risk of tearing the tendon! But the longer I'm left with limited ROM the harder it will be to gain it back.


Although he told me to continue with the strenghening work, I think I'll stop asI feel this might be counter productive as it might be making the quads tighter. An example is, I was doing very partial squats with 132lb to see if it will help me bend further (it didn't) but it helped me gain back the lost muscle.


I'm also wondering whether I am over doing the rehab as I'm probably doing a stretch/strengthening exercise/routine every couple of hours (even on PT days).

I'll check with my  PT but any thoughts/experiences - is little and often better than more work but with more rest?



post #2985 of 10797

15 weeks post op.


What is the dreaded MUA??? Why the big difference with every-ones ROM... I reached 90 degrees in about three weeks and 130 in week 5. I still can't lift my leg straight out even now in week 15, and have been told I will continue to have a buckling problem when walking until I can lift my leg to horizontal. Does the length they leave the tendon when they repair it in surgery make the difference?


I would have rather struggled to gain ROM than now have to walk with a cane or concentrate on every step to prevent the buckling, at least I think I would.

post #2986 of 10797

I'm just grabbing my chance to get onto page 100!

The dreaded MUA = Manipulation under anesthesia.

Your fear of the knee buckling might go away once the hamstring has been sufficiently strengthened with specific (hard!) PT exercise. Consciously tensing the hamstring can make the knee feel a lot more stable when walking or standing. Also, the parts of the quads that attach via tendons that run down either side of the patella can be trained to sufficient strength to support your knee even if the main quads tendon is weak (or too long?). I know, because that is how I managed to walk, drive and swim (badly) while my quads tendon was still detached in the period before surgery.

Scar tissue is a terrible thing stopping progress with ROM, and it is the PT's job to identify it early and treat it straight away (and teach you how to combat it before it gets any worse).

post #2987 of 10797

MMA = manipulation under anaesthesia, ie knock you out and then bend the leg breaking scar tissue etc.

There are people on here who have successfully had this performed and had good results.

However there are stories of people having the tendon break as a result of this op!

So I don't want to go down this route as a) I don't want to be back at square 1 and b) I'm a wimp and don't like general anaesthetic. So now have 5 weeks to reach 90 degrees or will likely have to have the MUA.


I assume the length of the tendon is one of the variables affecting the ROM.

I also from years of powerlifting and a major neglect of stretching have very tight muscles which clearly is another (self inflicted) factor.





post #2988 of 10797
Originally Posted by lakeswimmer49 View Post

Scar tissue is a terrible thing stopping progress with ROM, and it is the PT's job to identify it early and treat it straight away (and teach you how to combat it before it gets any worse).

I'll ask at my next visit. Do you (or anyone else) have any good tips?


post #2989 of 10797

LakeSwimmer - I had a MUA.   In the same procedure my OS went in cut away the scar tissue via two portals.   He then immediately performed the MUA after cutting away the scar tissue.    Yes, there is a chance the tendon will rupture which the OS will state but it was a chance I was more than willing to take as I was stuck at 90 degrees after 12 weeks and could not improve or even turn the pedals over on a stationary bike.   The MUA procedure worked well for me.

post #2990 of 10797


Originally Posted by getting there View Post

15 weeks post op.


What is the dreaded MUA??? Why the big difference with every-ones ROM... I reached 90 degrees in about three weeks and 130 in week 5. I still can't lift my leg straight out even now in week 15, and have been told I will continue to have a buckling problem when walking until I can lift my leg to horizontal. Does the length they leave the tendon when they repair it in surgery make the difference?


I would have rather struggled to gain ROM than now have to walk with a cane or concentrate on every step to prevent the buckling, at least I think I would.

hey GT what happens when u straight leg lift? U should be doing that no problem now.

post #2991 of 10797

Blue Belt,


I have good power at the bottom and mid range when trying to straighten my leg from a seated position but can't lift it the last 20 degrees or so. The home electrical stimulation machine was supposed to help make the muscle "fire" correctly, but has not seemed to help. I have used it every day , for an hour a day at between 40 and 50 setting, for about three weeks and no improvement. At PT I have been working it by the therapist resisting my efforts at the lower end to lift it and by holding it out straight and having me try to keep it from droping, but I can't see any improvement yet. I still wonder if the swelling or as the OS called it the gel in my knee is keeping me from improving more quickly, it looks like it is still 1 1/2 times the size of my "good" knee. It is going on three months since the OS said it would be reabsorbed in the body but nothing yet.


I did get out Saturday and played nine holes of golf, keeping my injured right leg straight and the quad locked. The biggest problem was hills, going up is fine but going down is another story completely. I had two pars and nothing worse than a boggy so that was much better than expected. Did not hit the ball as far as normal but made some good guesses on which club to drop down to, and my putting was very good...several one putts. If you have any suggestion on how to get the last 20 degrees please let me know

post #2992 of 10797

do u have a lag issue GT? I mean is there a laxity at the straight leg position where your lower leg just sags 20 degrees when you try to straighten it? I have heard sometimes the repair could be too loose and it would need to be tightened to fix that lag issue.

post #2993 of 10797

That may be it, I don't think it is from a lack of trying because I have worked the hell out of it to try to get it to lift out straight. I want to walk again and to be able to use both arms at the same time!!!!!

post #2994 of 10797

Thanks Blue Belt, It was a major tear but not complete or it could never attach. I dont recomend not having surgery if the OS prescribes it, if my case I had no chance with my situation to be out for even a week.

My Quad: stay away from hoops until at least one year, it is the worst exercise to rehab your leg. Skiing helped me, but it is a more fluid, concise move, and it uses all quad, provided you stay away from the moguls/ice. Hoops are hard on the knees/tendons even when you are healthy. even turning your ankle landing on someones foot, could spell disaster. The hard floor is a shock to your healing tendons. Try "horse" or "21"/round the world"


By the way speaking of hoops, did you hear phil jackson had kidney stone bypass surgery after the laker were blown out by the mavericks? The doctor said he had "KOBE STONES, THEY WOULDN'T PASS"


post #2995 of 10797

14 weeks post complete tear and repair.  Doing OK and pretty well active all day gardening and walking about.  I do the gym twice a week, stationary bike , and try to do regular quad exercises at home.  Thigh still week but making progress.  Can do stairs up and down if I think about it.  Over did the gym last week so have decided to put less pressure on the knee for a couple of weeks.  The bike was the thing which got my knee bending.  Reverse peddling first then forward.  Almost full range movement in the knee now.

I was told that stiffness was a recognized problem due to scar tissue build up.  I am sorry that some have had MUA.

It is strange how long the quad takes to respond to increasing use.  After immobilisation due to a fracture leg muscles recover much quicker.  I get a slight tremble in the quad on controlled flexion which I suspect is I think fasciculation seen in nerve damaged muscles.  This slight lack of control on flexion is the reason going down slopes is worse than going up.

So progress is made.  It is slow.  For the new recruits hang in and don't rush things too much a natural recovery will occur whatever we do.

post #2996 of 10797

can u explain what u mean by nerve damaged muscles Fergie? I gat pretty severe fasciculations in my GOOD leg now from quad work; I know I have pretty bad quad tendinosis there as well, and it has weakened a bit because I can't squat or hit legs hard now for the last 7 weeks due to the injury to the other, while at the same time it has been bearing a good deal more of my weight then usual compensating for my rehabing quad. I am a bit shocked at how shaky it is and I am having difficulty doing one legged squats or even light single leg extentions or leg press. it gets shaky real fast. I have asked mu OS and PT and hsaven't gotten any good answers. I wondered about a nerve issue....what do u mean by "nerve damaged muscle"

post #2997 of 10797

Week & Post op

Right QTR

44 y/o 214lbs pre-op, 209 currently


week 7 has been a good one, doc ok'd brace removal at 6 weeks. ROM has increased from a little over 90 degrees to 105. I started on the stationary bike and started doing really light leg extentions. 5lbs for 3-4 sets of 50 reps. I probably could do 10-15lbs for 10-15 reps but I am playing it safe. PT folks wanted me to do no wt leg ext for 3 sets of 10-15, but as a former muscle head and gym rat that of course wouldnt do. I do think pushing yourself a little beyond what the PT and doc recommends is healthy as long as you are very familiar with muscle building. 30 years lifting weights I believe qualifies me! Walking was a little bit challenging but not as bad as i thought. I believe no brace walking in the pool around week three is a good idea and helped me transition to no brace walking on land a bit easier.i never needed crutches since i dropped the brace and I only  experienced the dreaded "knee buckle" about 3 to 4 times and after a week of walking I am beginning to feel a good deal more confident and my gait is much more normal. I have started doing seated hamstring curls very light weight. all in all things seem to be moving well. getting out of the brace is huge. I have been able to resume 90% of my pre injury stretching routine which is huge for my jiu jitsu game. Fortunately 6 weeks with minimal stretching did not set me back much and I have returned to my pre injury limberness.stairs are not doable yet nor could I manage the eliptical(which was my mainstay of cardio). i am hoping to manage stairs and get on the elliptical by next week. to any unfortunate folks who get this injury i tell u, do not lose hope....with some work you can be thru the worst of it in 8 weeks. I have certainly learned quite a bit about PT as a result of the injury, and gotten pretty adept at the speed bag, something I always have wanted to learn. so my advice to all who suffer this bastard of an injury. Look for the positive. its there. It may not seem like it at times, but it is.

post #2998 of 10797

Week 8 Post Op

Left QTR

49 yrs., 290 lbs.


Today was a milestone day of sorts on the ol' recovery trail.   I have been working on ROM, quad pumps, weightless leg extensions and bearing weight on the leg (with crutches) for the last two weeks.   Although my neo-nazi, ultra-conservative OS simply wanted me to stay in an immobilizer for 4 more weeks (after a clean 6 week checkup) I took the advice of BlueBelt and TD and started to rehab albeit slowly.  


I've continued to lift upper body - free weight benching is difficult without a lower body base but I hit 2 x 20 reps @ 235.    The big news:   90 degree ROM and I got in the pool for the first time and walked 400 meters.   I also hit 8 sets of 6 squats at the 4 foot water level.    My knee feels good.   Small acute 'ache' around the patella tendon that lasts all of a split second and happens maybe once an hour.   My knee very much feels like it's wrapped in a roll of duct tape when I'm walking in the pool - but all-in-all, I'm psyched.  


So since I've taken control of my own recovery I could use a critque.   Basic routine:   ROM work daily; upper body weight lifting twice-a-week; continue weight bearing; walking the pool x 400 meters 3 / week; 8 x 6 reps of pool squats.    I've also bought a breg brace for crutches walking.     I plan to stay on this routine  until I can walk unassisted without a limp.  I figure 10 more days.   

Should I add stationary bike?  At what ROM do I need to be for an effective revolution on the bike?   Any other thoughts?


Appreciate it......



Edited by bigggfred - 5/21/11 at 7:09pm
post #2999 of 10797

u need to get over 100 for stationary bike. Id keep doing what you are doing and work that rom. The straight leg lifts will help with the stability at the knee. the pool walking will definately get you up to speed for removal of the brace. I would sit on a stationary bike and move the seat to as far away as you can. If you can make a full revolution without lifting your butt off the seat(usually one tries to compensate by elevating the affected hip) once you can make this revolution while seated firmly and not causing pain in the knee, go for it. Start slow though...no resistance and no more then 10 minutes.


ps re duct tape....lol, very accurate description. I didnt know how to explain that to friends, but I agree totally, for me, pool or not, walking without the brace the knee feels wrapped in duct tape or a tight ace....the wrap is gradually loosening though with time.

Edited by Blue Belt 2012 - 5/22/11 at 10:49pm
post #3000 of 10797

10 Months since I tore the left quadriceps tendon


I am doing well except it is not the same strength my other leg.  It is strong enough that I wish both my legs were the same strength, even if that strength matched the bad leg.  I can slow jog and push with my legs like doing squats.  But I know I can't run like I would do in playing basketball.  I am very concerned about the good leg.  Very frustrating.



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