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Quadriceps Tendon Rupture, Repair and Rehab - Page 108

post #3211 of 10802

My therapist has told me to sit in a chair and try to move my leg into a 90 degreee ROM. And to sit and try lifting my feet/leg off the floor up and down.  Nothing else was recommended until I can move the leg to 90 degees ROM on my own.

post #3212 of 10802

Twice ruptured


my extreme empathy goes out to you. I havent posted a lot myself lately because my recov has gone quite well and I didn't want to come off as bragging or depress those who have had a rockier road. I am not much on malpractice suits because I am a doc myself and have been sued several times frivously and its such a pain in the ass having to justify yourself to the world repeatedly because there is no regulation whatsoever(anyone can sue you even if its bullshit) that being said, a PT machine failing and thus re rupturing your repaired tendon is outrageous and devastating. I believe you have a very strong case against the PT company. I would be livid if I were you. I hope you sued. Again, I am no big fan of law suits, but there are times, such as yours, where people suffer immensely thru anothers negligence, whether it was the machine's manufacturere or the pt  practice, you should not have had this to deal with. The setback was enormous. My OS repeatedly told me how devastating a re rupture would be, and generally is rare, if proper rehab is performed. So are u suing? U most certainly have a very strong case, worth quite a bit, and while money doesn't buy happiness, it sure helps with the practicalities of life.

post #3213 of 10802

I'm sharing a brain with Auscoach.  I'm 15 months post surgery, doing well and still showing gradual improvement.  For me it will be 24 months of hard work before I forget which leg suffered the injury.  Damn, how I wish I was one of those fast-healing folks who was skiing in 6 months. 


Postieged --- I had a similar problem with pain under the knee cap.  It was explained to me that the pain is caused by the kneecap not tracking properly.  The kneecap wasn't tracking properly because my IT band was tight and was pulling the kneecap up and out.  I stretched and massaged my IT band and pushed my kneecap down and in at about a 45 degree angle.  It took a couple of months but the pain went away.


Best to all.

post #3214 of 10802

Hi again. Yesterday my foot swelled up quite a bitand it made everything difficult. The swelling takes place with my foot resting on the floor at about 45  degrees with the brace on. I don't know why. My exercises were done very poorly. I didn't sleep well so went to my OS this morning and he said it was part of the process that there would be ongoing swelling for a few months more. Had PT this morning after the OS and with a lot of pain and difficulty the ROM was close to 100 degrees. Now this is with the therapist pushing as hard as she can on my leg. Pianful!!! She wants me on the bike next session on Friday. How much ROM do I need to ride the bike? I can get to maybe 75 degrees on my own. She wants me off crutches asap. Is that possible? I am afraid of falling and re injuring the leg. Any comments would br helpful.

post #3215 of 10802

Frank. My therapist would not put me on the bike until I had 110 degrees. Swelling is a VERY normal thing. I am at 11 months now and still have occasional swelling. Ice is the key. Use it before therapy, after therapy, and any other time you feel swelling. Your OS or therapist should have had you doing this from day one. Have you? Losing the crutches while still using a brace seems reasonable now. How far out from surgery are you? About 8 weeks? Like many of us have said, every ones situation is unique. Like Texas Diesel I always took pain pills before therapy. Are you doing that. It does help. After the therapy started getting fairly easy, and I no longer needed the pain meds, I still took Advil beforehand. As I said earlier in the thread, a little fear of reinjury is not such a bad thing. And you need to ask your OS if he agrees that the injury is not fully healed until about the 6 month point, as mine told me. After that I am told reinjury is unlikely.


Rick - Inpatientguy

post #3216 of 10802

Hello, I have not written for probably a year and an half; I ruptured my right quad on august 22, 2009 and was active in this forum for about 6 months. Since most people disappear at about the same six month duration (and unfortunately are replaced by new people) I kind of guess the worst is over at about that time. After a year I could do everything that I could before hurting myself; just not as well. I had a PT who was conservative and a Sports Doctor Ortho who was a firm believer in "use it or lose it" I stuck with the latter.  I started jogging, clumsily, less than two and a half months post-op, and when I told my PT she absolutely freaked, so I did it anyway and just didn't tell her. I quit going to PT at three months when she was having me do things I believed to be ridiculous: doing squats on a styrofoam ball for example; I just wanted to get better, I wasn't trying out for cirque de soleau.

My doctor freed me to do anything that I wanted except kick extensions. I found that I could do everything that I needed at the gym (I have gone to the gym all my years: then 52.  Now after 2 years and a few months I look back at the whole horrible experience and feel I have learned a lot. I pushed much harder than most people on the site at that time and still believe that this helped me recover more quickly, however I don't believe that I would not have recovered as well if I had gone a little slower, I also believe unfortunately that the quality of the surgery is a BIG factor in your ultimate ability to heal I feel that my surgeon was especially good, even with a complete rupture I regained my ROM almost immediatley.

Unfortunately I also need to add a kind of depressing side note: YOU WILL NEVER BE THE SAME AGAIN!  I can do everything I did prior but my right leg is still just a little weaker than my uninjured leg, very occasionally I still feel like my right knee continues to go forward when I walk and makes me feel like I am going to fall (I never do, it always catches in time.  Further this happens less and less often though after two years it still occasionally does) I jog 4 miles a day, go to the gym 4 times a week and 2 of those times include heavy leg routines (I still have to watch myself because if I don't concentrate my good leg lifts way more than it's share). I also go on steep hikes: this was the weirdest thing to get used to since it took so long to be enjoyable again, at first it was constantly watching where my feet went and not looking at scenery, but each time I went it seemed to get better, now I don't even think about it and it feels the same as before injuring myself. But like I said its never as good as before.

       I guess I  am just trying to say: It gets better, but it takes time and lots of pushing yourself, its that or the option of never regaining your ROM and abilities.

        Lots of Luck    John


post #3217 of 10802

7 months [post op and back to jiu jitsu. not quite full time yet. The first three classes resulted in major swelling at the surgical site which lasted about 48 hrs then was fine. The fourth class i had very minimal swelling and am ready to go again at 48 hours. i feel like returning to my jiu jitsu has accellerated the healing because about 3 weeks ago i was feeling very inpatient w the progress. Now it feels like in about a month(8 months post op) I will be close to fully recovered. It takes some luck, a good surgeon and a lot of hard work on the patient's part, but it does heal. Good luck everyone.

post #3218 of 10802

Hi everyone. Thanks for the updates from all. I have an urgent situation that I have not read about anywhere on this forum. My PT is continually trying to bend my knee manually with extreme pain. When I cannot endure the pain anymore I begin to yell and scream. Now she tells me that yelling etc. is not permitted because it bother others in the open concept area. I think my pain tolerence is fairly good with all the sports that I play. I take pain killers before my sessions. Any ideas as to what I can do to tolerate the pain? With the phhysical exertion she places on my knee my ROM is maybe 100 degrees. Currently I am 7 weeks post op and 2 weeks of therapy for a total of 6 essions. Thank you if anyone can help.

post #3219 of 10802

I endorse Brianfay's comment.  ITB tightness and over development of the adductor were a problem. Both muscles were trying to compensate for the loss of strength in the Quad group.  A foam roller was a life saver as it released the ITB and adductor.  Tennis balls or specialist trigger point aids are also available.  You will know the they are playing up because your patella will not track properly and hence cause pain. Once you know what you are looking for then you can sort out the problem. 


Clumsyhiker has a point. Scar tissue is never a good as the original.


However the aim of the game is to get a close as humanly possible to your original strength and flexibility and that will only be achieved by single minded commitment to your rehabilitation.


I refuse point blank to accept defeat. I may not gain perfection but if I strive for that, and if I fall short, then I will be in a very good place indeed!


Some injuries a life changing, accept the fact you have been screwed over by fate and accept that challenge. It is often said that the journey is more important than the destination and this is true with this injury.


You will learn what is is to face adversity, to fight depression, pain, fear of the unknown, financial difficulties and you rise above it all (because you have to) and at the end be a better person for it.

post #3220 of 10802



In my opinion, you should not be bending your knee to the point it causes you that much discomfort.  I tried to read through all your posts, but can you refresh me on the timeline of your injury please?  I suggest you try a new therapist as that sounds highly unreasonable to me.  How is it even possible they think that is a good idea?  You might ask that therapist about their past patients who have had the same injury.  You may find out that therapist doesn't have much experience in rehabilitating that particular injury. 


My injury, Sept 23, 2010

Surgery, Sept 29, 2010

13 Months post-op


I never had any problem getting back my range of motion.  But the strength of my left leg is very different than my right leg.  I have played basketball a few times (it looks pathetic); my ability to play will never be the same.  To this day, I am very aware of the injury and it factors into almost everything I do.   I am going to try to start some serious strength training soon.  But this is a life altering injury for certain.  My best advice to anyone new here is to allow the injury to heal before you start trying too hard to exercise.  That tendon must have a chance to heal before a patient begins to start trying to use it.  I will say, I am confident in my repair.  My advice-wear your braces and be patient.  When sleeping, lay on your side if you can and place a pillow between your knees.  It helps a lot!














post #3221 of 10802

Thanks for your response Mitch. My surgery was on Sept. 16/ 11. So I will be 8 weeks post op on Friday. My therapist tells me no matter how much she hurts me by bending my leg she can do no damage to my leg. Not sure if that makes sense. She wants me walking now.

post #3222 of 10802

Excellent advice from Mitch. My therapist would only take me to the point of minor discomfort. Even my OS said that the therapy did not have to be too painful. The pain that the therapist is putting Frank through is not normal. There are times when these things hurt, but never to the point of having to scream out in pain in my opinion.


Frank, request a new therapist. At very least ask this person how many torn quads she has worked with. Not many I'm guessing.

post #3223 of 10802

Thanks for your responses. I was very worried with the pain I was being forced to endure and the stress it was placing on me.

post #3224 of 10802

It's been ages since I wrote on the forum, but had to reply to clumsyhiker's post.  I had a full rupture of my left quad tendon in Jan. 2009.   To make a long story short - I'm doing everything I ever did before the injury - and more.   From a functional standpoint, I'm recovered 110%.  However, like clumsyhiker wrote it will never be the same.  I feel the tightness and soreness in the knee, my balance is a bit off, the muscle mass never quite came completely back and my strength is a bit off.  A friend got my head straight asking, "Do you think you're the only one recovering from an injury?" and then we proceeded to talk about just about everyone we know that has one or another injury or medical problem that has resulted in some adjustment.   I'm thankful for the full functional recovery and that coming on 60 I can still go out and play with the best of them.  I guess you just live with the aches and pains, which for me also include arthritis and some residual problems with my right foot from corrective surgery.    Best wishes to all for a speedy recovery, Rich

post #3225 of 10802

Week 5 from surgery


I found this thread a couple of weeks ago and have been reading through the comments.   I certainly appreciate the info that has been accumulated to date.  Here is my story


Oct 5, had a little wipe out while riding my mountain bike.  It was really quite a fluke that I was hurt at all, let alone rupturing my quads tendon on my right leg.  I managed to get in to have surgery on Oct 7.  I was told all went well and that I should expect a full recovery.


From day one I was told to use either crutches or a cane.  I don't like using the crutches so I used the cane from pretty much day 1.  Right from the day I had my surgery I didn't have a problem with putting weight on the leg.  The surgeon said that if I am able to put weight on the leg without pain it is okay to use the cane.   My movements for the first two weeks were pretty limited and aside from moving around inside the house I stayed put.  I am lucky that my house layout has my bedroom, living room, kitchen and bathroom all on the same level.  I took a few days off work, but have been able to work remotely since that point.  I was given a softcast type of brace to help stabilize the knee and prevent unwanted knee bend.  For the most part I kept this on full time for the first 2-3 weeks.  After that point I started removing it for periods around the house. 


I saw the OS (not the actual surgeon that fixed my knee but a resident) 10 days after the surgery to have the staples removed.  The OS said I could start flexing my leg to the point where I try to contract my quad muscle to push my leg straight.  No bending as yet, but just try to fire the muscle so it stays a little active.  Starting to go a little stir crazy already.  Surprisingly my back although a little sore and tight has been better than I though it would be.  I usually do a few back exercises and some stretch in the morning, but these require the ability to bend both legs.  So I have reverted to lying flat on the ground and trying to do a small set of core exercises.  It terms of any back stretches all I am able to do is legs up the wall.  When doing this I have to keep my butt approximately 18 - 24 inches from the wall.  I still get a little bit of a back stretch, but limit any strain on the knee.


At the end of the 4th and into the beginning of the 5th week I am no longer using the brace at all.  I have started doing some passive knee bends using gravity and my good leg to support the damaged leg.  I am getting approximately 60-75 degrees.  At that point there isn't really any pain, but the level of restriction against further bending seems to be a good place to stop.  My next visit to the OS will be on Nov 18 at which point I will also start doing physio with a PT and hopefully get some additional help to get further ROM and push past the limitation.


Won't likely happen this week, but next week I will hit the pool as well.  Will look to use the pool while my son has his swimming lessons.   Will continue to update progress as I am able.  Best to you out there doing rehab from QTRs.





PS,  I started at the beginning and got about 15 pages in then went to the end of the thread and have read the last few pages.  Is the consensus still to push the recovery and rehab a little but not to the point of pain?

post #3226 of 10802

Hi everyone. Now at 8 weeks post op. My therapist tells me that I am hitting a wall with no additional ROM in the past week. She says I am 90 degrees max and that she is now forced to bend my leg manually starting with ny next session which is tomorrow Monday. As I mentioned before she tried bending my leg 2 weeks ago with unbearable pain. She backed off for a week or so and is determined to put me through the pain again. My question is can she hurt me? and does this sound reasonable? By the way the rehab clinic I attend is owned by my OS so she should be well qualified. Currently I wear the hinged brace and walk very slowly with a cane. Ay 8 weeks should I be concerned about my rehab progress?

post #3227 of 10802

the ROM you have at this point is definitely a little sub par. You should not have unbearable pain with the stretching process. Possibly your repair is a bit shorter then ideal, which might mean your ROM will just take longer then usual to come around. It is better for the repair to be a bit short then long. Thru stretching and perserverance you can obtain FROM if the repair was a little short, but a repair left a little long, will likely result in leg lag that would be permanent without a second surgery. Your PT should be more patient and stretch you to where you have bearable pain, and u need to be continually stretching at home. Are u stretching a lot yourself?

post #3228 of 10802

Thanks for the info Blue Belt. Your explanation sounds very real to my situation. What ROM should I be at? I meet with the OS on Thursday this week. Currently I am in the bulky hinged brace set with no restrictions. I asked the OS at my last appointment with him whether I can move to a less bulky brace so that I can wear pants for my work. I have been wearing shorts which won't work in this cold Canadian climate. Is there another less bulky brace and if so is it safe to wear at 8 weeks post op. Thanks.

post #3229 of 10802

Wall slides brother...WALL SLIDES.  It allows you to push your own pain threshold and gravity to help your ROM.  I don't think your PT is worth a damn.  My PT told me one time he was happy with my ROM and he was going to stretch me to the point of some serious discomfort but it never got to the point where I wanted to say anything.  Now, my IT band had some scar tissue from being stretched during the injury and he used his elbow on that until I told him I was seriously about to punch him in the throat if he didn't stop, but that was the only time he did anything that wasn't trying to get me to stop pushing myself so hard.


I think your ROM is light but I wouldn't allow the PT to push to pain unless the OS ok's it and explains why.  My OS was worried that because my legs were fairly large that I would tear the repair if my leg flexed too much so I couldn't weight bear or do anything that caused the muscle to flex for 5 weeks.  Once I hit that mark I could weight bear and start PT.  When he removed my stapes at two weeks, he told me that the next time he saw me at the 5 week date, he wanted me at 90 degrees but not to make it too painful.  I was just shy of that at 5 weeks.  I think I was 110 at 8 weeks but like was said earlier, it's probably just that you have a shortened repair that makes it tighter and the need for more stretching.  I was stuck at about 35 degrees until I spoke with a guy locally that had gone through the same thing and told me about wall slides.  I never had a problem with ROM again because it was a contstant progression of stretching that I would do on the floor while watching TV every night.  WALL SLIDES WALL SLIDES WALL SLIDES WALL SLIDES!



post #3230 of 10802

Question to TexasDesiel are wallslides controlled knee bends with your back pressed against the wall?


Haven't done these as yet, still working on getting ROM to 90 degrees.  Going to the pool, tonight to work on more exercise.


post #3231 of 10802

ridetail,  Texas Diesel got me going on the wall slides and they are great.  They are controlled knee bends with your back on the floor and your legs going up the wall.  Gravity is the only thing bending your knee. The good leg is placed beneath the injured leg to control the amount of bend in the injured leg.

post #3232 of 10802

Thanks as usual for all the comments. My therapist decided that we would add ankle weights to try and bend my leg. With me laying on my back and leg pointed upwards the weight  with gravity should help me bend my knee and add some ROM. Started with 1 pound weight and now up to 6 pound ankle weight. Even with 6 pounds my ROM is still 90 degrees. I would think my ROM should be improving with this being the 3rd day of using the weights. Could I be stuck at this ROM indefinitely?? Getting scared now.

post #3233 of 10802

Frank,  Another thing I did when trying to get to FROM was while on the bed get on hands and knees with both ankles over the side of the bed.  Then lean back getting your butt closer to your calves.  I did this when I was working on getting that last bit of ROM, but if you're not progressing with the wall slides and all you can give it a try.



post #3234 of 10802

Frank I am 6 months post op and my ROM is only 90% and have been told there is not much more movement to come.

I went last night and bought 3lb weights as I need to extend my ROM more. I don't know if it will every come but i will give anything a go to get more movement. I feel I have to be a bit more forcefull with it to include the exercise you are doing with the weights.

Over here in the UK we would not be allowed to do it after 8 weeks post op but I think that might be part of the problem I am having now.

post #3235 of 10802

agree with the wall slides approach for frank. Sitting on your feet as Kallen suggests would be impossible at 90 degrees and only bum u out. Probably Frank u should be around 100-110, so its not like u are terrible. This is a marathon not a sprint, take your time, wall slides or using a strap around your instep and a cloth to improve the gliding motion of your foot on the floor, sit and slowly pull the strap to draw your knee into flexion to the point of moderate discomfort only. hold for 30 secs and do ten sets at least once a day. You will get there.


post #3236 of 10802
Wall slides are just as KAllen described. We have a couch with leather arm rests and sides so I would lay on the floor and put my socked foot on the arm of the couch and watch tv. I would do it in intervals with rest pretty much anytime I was in the house for hours per day. I never needed ankle weight because the natural weight of my leg sufficed.

I'm not sure if scar tissue is a player here but is your PT doing ultra sound and are they massaging the area during PT sessions with you doing it at home? I had a frozen bottle of water that I would roll over any tight area until i couldn't bear the pain and after a week it was all loose and broken up.
post #3237 of 10802

Frank2009 - Like yourself I was stuck at 90 degrees ROM when I was at 12 weeks and felt hopeless.   My OS when in through 2 portals and removed scar tissue then performed a manual manipulation.    There is some risk with a manipulation but without it I did not think I would ever get beyond 90 degrees.   I quickly progressed to 125 degrees after the procedure and moved on with my recovery.    Bottom line to your question - no, I do not think you will be stuck there indefinitley.   You got to hang in there and stay positive as you will get back to a normal life.   I would think twice about a PT applying pressure which is unbearable and painful - you may want to discuss this with your OS and see if you can suggest a viable solution to you being stuck at 90.

post #3238 of 10802

Thanks for all the positive feedback. Had my appointment with the OS and he was satisfied with my progress albeit my ROM should be more. He was more concerned about my leg not straightening the way it should when I am walking. He told me to do leg raises over and over again throughout the day. He said my quads are weak and need to strengthen. my therapist is backing off some on the pain method of gaining ROM. Today I got to 95 degrees with a 10 pound weight on my ankle. Hoping for 100 degrees by my next therapy session on Monday. Was also on the treadmill for the first time today. How much ROM do I need for the bike? Also I still can't figure out how I can do wall slides? If I lie on the floor I don"t think I could get up with the bad leg. What am I missing here? Thanks for any response.

post #3239 of 10802
I used a rope where my hands were on each end of the rope and the middle of the rope was at the arch of my foot with a straight leg. Eventually, I would put the top of my foot on my good leg under the heel of my bad leg to lift it up. You lay on the ground with your butt towards the wall and raise your legs so your straight legs are up in the air with your heels against the wall. Let gravity do it's thing as your heels slide downward towards the floor. To rest, use your good leg foot to place under your bad leg heel and push it back up the wall. Repeat a lot.
Edited by TexasDiesel - 11/20/11 at 6:44pm
post #3240 of 10802

Tried wall slides today. I am lying on a sofa with my back about 12 inches from the wall and my feet up the wall. Gravity pulls my leg down to about 90 degrees ROM. Then nothing else happens as my foot pushes into the wall and won't slide any furhter. I even pushed down with my good foot and have attached weights to the ankle of my bad leg. This is day one for the wall slides. Should I have expected better results or will the ROM come over the next few days?

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