Quadriceps Tendon Rupture, Repair and Rehab - Page 117

ORG

 

Glad to hear you are back running. I have some good news about my extremely less ambitious goal. I am 15 weeks post surgery today.

 

For the past five weeks, I have been chipping and putting once or twice a week. About 2 weeks ago, I started hitting some balls on the range. It was hard to pull the trigger on my first real swing (with a pitching wedge) for fear of injuring the leg. In any event I worked up to my goal of 45 shots (using all of the clubs) at one time on the range without any great discomfort or additional swelling and before trying to play on the course. I played 4 holes on Saturday (was afraid to push it) and then played  9 holes on Sunday. To my surprise, my knee felt better today than at any time since surgery (my fingers are crossed as I type this). I actually played fairly well also with only a little loss of distance. I did not have any downhill lies and would be concerned about trying such a shot. I think I played ok because I swung very easy (hard to believe that I had to rip a quad to learn that lesson).

 

The knee is still swollen and tight. I go to therapy 3 times a week and I know I could not run on the leg. A knee sleeve makes all the difference for me in terms of easing discomfort (I don't know if this is all in my mind or if it actually does something). I ice after every activity which helps also. However, after 4 months, I think I can see a light at the end of the tunnel. My ROM is 130 to 136 - depending on the swelling - and I walk pretty slowly up and particulary down hills. Still, I was out of the house, walking and playing golf, and that felt great!!!

 

As many of you have said, patience is the key. I never pushed ROM and I took days off from therapy or at least reduced the amount of exercise when the knee hurt too much.

 

Good luck to all of you.

 

Gil

Will run again..

 

The 3 x 1 mile was my way of breaking up the work and less focused on hitting a specific pace target.  8 min per mile just felt right.  Any slower and it felt like I was plodding and much faster it felt like I was pushing it too much.  I did the workout on a treadmill set at a slight positive incline (1%). That said, I did wear an heart rate monitor and saw my heart rate climb to 180 bpm (90% of my HRR).  It dropped quickly during my 2 min walks, back down to less than 120 bpm.  My other runs have been on the track, there is a really nice 8 lane track about a mile from my house.  I have found that anything with even the slightest bit of downhill feels creepy so I am sticking to the track or treadmill for now.

 

Also, your advice on using shorter intervals is well taken.  I started with 100's, 200's and 400's moved up to 800's and then I jumped up to 1600's too quickly.  I should be sticking to the shorter intervals.  At this point it is less about building fitness through running and more about building up coordination, strength and the ability to run.

 

To give you some perspective, two months ago walking at 15 minute miles produced 150 bpm which is firmly in the aerobic training zone.  You will run again.

 

It will also take a while to regain a natural walking gait.  Mine still requires attention, particularly if the injured leg is tired or there is any kind of downward incline to the terrain. It just takes time.

Hi SocalMan

 

Reading some year-old posts and noticed you and some others have same cycling interest I do. Enjoy hearing the positive results of going slow for first 6 weeks. I've been 19 days post op; 22 days post injury. Am seeing my OS on the 16th. Hope to get a cast/brace with adjustable hinges so I can start PT.

Imagine you have returned to cycling by now. Hope to myself by next fall.

To Will Run Again...OLD Colonial...Break Par and all other Quadripper readers....here is some personal rehab info on me:

.....after 6 1/2 months from surgery I made some big baby steps today. After many long months of endless rehab exercises I actually did my first land running today. I have an outdoor oval 400 meter track at a high school near my home. Although as I have reported earlier I can bike...elip machines...and stride in the pool but have had trouble striding on land. Well today at the outdoor track I started with 100 meter slow runs followed by 100 meter walks and kept repeating this routine for 1 mile. The stride was short and slow but I accomplised it. For someone who has run 36 marathons, including 3 Boston Marathons and once ran 151/2 years straight without a running day off this gave my great satisfaction. I then rode my bike for 10 miles and weight lifted for one hour. I tell all you guys this....not to kudo myself but to be an example of how long and hard and painfully slow our rehabs are. I think most of us have to find satisfaction in little triumphs.....getting the brace off for the first time....driving a car again....getting your ROM back....etc. To you guys and gals behind me in rehab keep working and take that satisfaction in liitle triumps. You are all inspirations on this site. Keep working and be patient....coming from a guy who was not good at that pre injury. PS: After the short run workout my knee is stiff ....but bearable and my quad is coming along. Believe me when you take these first running strides you notice every stride and your mind says can the leg hold up but it does. Will take it slow and advance with increasing intervals. Everyone: Make It A Great Day !!

Congratulations Old Runner Guy. How inspiring for all of us. 

 

I celebrate my 6 weeks post op today. Seems like months ago instead of weeks. Four weeks ago I just could not imagine being where I am at today. As everyone says, patience is the key.

 

The Doc unlocked my brace on Tuesday to 40 degrees. I was terrified to walk, but made it OK. I am at 86 degrees ROM and was able to get a few revolutions on the bike. It was slow and not at all pretty, but encouraging never the less. My goal for the summer is to be able to ride my road bike again and maybe do some easy hikes in the mountains.

 

Regards, Steve

wk 5

Just had splint set to 90deg. Am told to start partial weight bearing at about 50% to be checked on bathroom scale.

But I forgot to ask - how do I walk whilst partially weight bearing? With crutches but lightly, one crutch, a stick? 

 

I'd be interested to hear of others experiences of this as we all have to do it I presume.

 

PS to answer my own question - I just googled 'partial weight bearing' and there is masses of info:

http://www.youtube.com/watch?v=iqe5bt-pd7Q

http://physicaltherapy.about.com/od/typesofphysicaltherapy/p/weightbearing.htm

http://physicaltherapy.about.com/od/devicesandorthotics/qt/WalkingwaCane.htm

 

More googling!

http://en.wikipedia.org/wiki/Crutch

I have forearm crutches. I wondered about the under-arm alternative. They seem to have the advantage of leaving both arms free (for cooking etc) if you lean against the furniture.

Edited by skip intro - 5/10/12 at 9:00am

partial weight bearing

 

Funny story. I had just finnished my 6 wks post op appointment and I was forcing myself to walk with both crutches until one day the rubber wore out at the bottom of one of my crutches lol. I chucked the one crutch and started to use one crutch just fine. i almost get the feeling as if the crutches were holding me back a little because i was so dependent on them. Im walking pretty good in the morning but after work im reduced to a limp and some swelling. From what Im reading is this goes with the terrortority. Im at 9 weeks post op and im just using a cane for high curbs or not so friendly stair cases.. other than that im walking 50/50 with and without brace and it feels pretty good.

 

Old runner guy, great job! Your proof that just some patience will see this injury through..

 

Stay in the fight.

3 weeks post op today. Reading recent posts from Old Runner, Funko, Skip and Biker have bouyed my spirits once again. Just beginning to get around fairly well with full leg cast, sleeping well, and off all pain meds. Looking forward to next Wednesday's appointment with OS at cast room to check out surgery after cast removal and decide on next steps (figuratively, for now). Hope to recieve cast/brace that allows some ROM and begin passive PT. But, I need to remember Old Runner's advice about patience. Thanks. But,my aim is to be at 6 mos and able to begin to cycle and hike again.

Keep up the posts.

It is interesting to read all of the different post op doctor's directions. Mine said bear as much weight as I wanted and felt comfortable with. I'm now five weeks postop. Yesterday, I walked to the community mailbox location with my straight brace locked at 0°. Round trip is a little less than a mile. I used hiking poles rather than crutches. Took about an hour to get there and back. Fortunately, there was mail. Given the comments I've read here, I was worried about knee pain after that long an excursion. But, I've had none.
Knee and leg swelling has gone down considerably. In fact, my brace keeps slipping down my leg. Next Wednesday I attend my six week postop visit with the doctor. I'm sure hopeful that he will start my PT and begin to open the brace to the 30° mark. Given that I'm now hardly ever using my crutches I'm wondering if others have experienced their first 30° walks and required going back to crutches? I am expecting having to do that. However, given that I've been allowed to bear weight during these first weeks I'm wondering if I will be able to walk fairly well without the crutches.
I'm sure looking forward to that six-week mark.

15 Wk update:

 

Hit my 15th week today.  Great progress.  Almost full ROM.  I can walk without a limp but sometimes the injured leg is tight so I have to concentrate on it.  Able to stand up from sitting without any help from my arms. I travel quite a bit and use the stationary bikes and the hotel stairs as some of my exercise.

I can climb up 6 flights of stairs without much trouble only holding the handrail lightly (just in case).  Downstairs is OK but leg is still weaker than the other. (Definite hold on the handrail)! 

Still need to build my quads up but feeling pretty good about this.  Even tried to jog a bit but right away I could tell I'm not ready for that!

Old Runner Guy, glad to hear you're running on land!  running repeat 100 meters, walking 100 meters makes sense.  Just don't get excited and over-stride!  I know how frustrated you were the last six weeks wondering if you would ever run again and now you're doing it.  I'm inspired by your persistence and progress.  Please give periodic updates.  Maybe someday we can run a road race together wearing "Team Quad Tear" singlets!  :-)

 

I'm at 11+ weeks.  Starting to go for walks in the morning after doing the exercise routine.  My leg/body are telling me I have to start walking more.  Motion heals.  Have been doing PT twice a week but only have one more session unless the insurance company gives me more.  My last session next week will be 14 total.  If I get more I will go once a week to stretch them out.

 

To the newbies to the Quad Tear Club you will start to feel better at around 4 weeks.  At 6 weeks you will be more mobile with the brace locked.  At 8 weeks you'll probably lose the brace and transition to walking using crutches or crutch for a week before you drop them.  You should start PT at 5 weeks and trust me the first sessions are pretty scary when the brace is off.  The first ROM attempts are really challenging and most likely painful.  It took me until week 8 to get full revolution on the stationary bike.  After that things picked up. 

 

Based on my experience, your goal of biking and hiking at 6 months is doable. I am just over 5 months post surgery, and I can now hike in the woods and bike. I am still pretty careful when hiking, more because I just don't want to fall rather than because the leg hurts. Good luck to you.

wk5+

brace set to 90 deg for 3 weeks. Can't do 90 yet but it's coming.

Best thing is partial weight bearing which I'm doing as per this http://www.youtube.com/watch?v=iqe5bt-pd7Q

Soon got the hang of it and it's really nice touching the floor again! It's very controllable and easy to feel the amount of weight to apply.

It only takes  small PWB component to radically improve your balance and confidence, and I can stand (but not walk)  on two feet unsupported, for the first time in 5 weeks!

Haven't had any pain feedback yet so perhaps not trying hard enough, but it's early days. Not into pain but it helps to know the limits I suppose.

Edited by skip intro - 5/12/12 at 3:48am

BlueBelt - Texas Diesel,

 

Y'all still out there?   I have an update for you.

Hey Guys!

 

I'm a newbie to the forum and to the whole QTR "scene."  My story - I'm 31 y.o. female ripped quad while framing up a roof for habitat for humanity.  The roof truss slipped and came hurtling at me.  I was on an 8 foot step ladder on one end and in no good place to stop the thing from coming at me, so I got pushed off the ladder and dislocated my knee as I fell to the ground.  I was taken to the emergency room from the construction site but they basically ignored me for my stay there - did not catch the ripped quad on the multiple xrays that they took.  The x ray tech actually accidentally popped my knee back into place while taking an xray.  They gave me an immobilizer and sent me on my way, told me to follow up with an orthopod in a week, no meds or anything. The orthopod recognized the disconnected quad immediately and scheduled next available surgery.  He also wanted to do some arthoscopic surgery to shave down some cartilige under my patella.  So, I had the repair done 2 weeks after the injury occurred.  Doc had to drill holes in the patella.  Now I'm 9 days post op and still taking a bit of percocet/acetaminophen for the pain.  I'm on crutches with the 0* brace until my 15 day post op appt.  If there's no pain and swelling is gone, doc will dial my brace to 30*, but I'm really quite anxious to begin with PT! 

 

One of my questions I have for you guys, did your stitches hurt?  I feel like while I walk around with the crutches, that I just can't get the dressing put together comfortably.  It just feels like a sharp pain coming from the stitches, and maybe if I find the right combination of guaze/tape/ace bandage, it won't slide around so much and aggravate the incision.  Any advice?

Hoodwinked,

I'm five weeks post surgery. I can't recall my stitches hurting at all. However, in the first couple weeks there were stinging type pains in my knee. I've always figured that was from the holes. Have you taken the overlying bandage off? If not you might do that. See if the stitches look like they may be infected. That would show up if they were red around the stitches. If the stitches look infected you should call your doctor right away.

Was your quad tear 100%? That certainly would've allowed to patella to slip out of place.

It sounds like your doctor is moving you right along towards PT. That's good. I see my doctor next week at six weeks post surgery. It is only then that he will start PT if all looks okay. As you read the forum you will see there are many many different approaches to rehab and PT.

Hoodwinked,

 

My stitches were metal staples.  Always felt a little strange because the area was sort of numb after surgery but no pain unless the dressing slid down and the brace was pressing against them.  Mine were removed at week three.  As Oregon Bill said, if you review the many of us on our journey you will see quite a range of approaches to recovery.  This injury takes time and patience but you will get there. Good luck!  

Hey Oregon Bill!

 

Yep, 100% ripped! :)  No, I don't think there's an infection or anything, it's just that they hurt when the dressing shifts around when I'm crutching it. I'm thinking maybe it has to do with squeezing the quad muscle which I must do a bit in order to keep my leg extended out straight in front when I'm on crutches, but I was wondering what kind of dressing folks were using.  Right now I have some gauze and waterproof tape over the incisions, and that is covered by a family-sized ace bandage.  Then I have my black strappy Donjoy post op brace to keep my leg straight.

 

Thanks for the responses!  This forum is great, I like to hear about other folks' experiences with this.  I was not prepared for how serious this surgery was going to be or how much recovery it would take.  It's good to have support out there with this specific issue.

 

Thanks guys,

Have a great night!

Hey Hoodwinked,

Welcome. Sorry to hear of your accident.

My Doc had me come in the next day after surgery and they removed the dressing and ace bandage. They coverd the wound with band aids and a loose fitting cotton sleeve. I had to wear granny hose for two weeks to prevent clotting. My stitches were the self dissolving type.

I am now six weeks post op and was never really bothered by the stitches.

Good luck and heal well.

Steve

Hi Hoodwinked,

 

Sorry to hear about your accident but at least you we involved in a worthy cause when it happened.

 

I suspect those stitches in your knee are really surgical staples.  The staples dig into the flesh next to the incision and that could be causing your discomfort when you move.  I'll never forgot how my leg looked when they removed the dressing two weeks after surgery.  I had a zipper knee!  The incision was from below the kneecap to a couple of inches above it.  They removed 25 staples that day one by one.  It was quite an experience.  That plus seeing my leg for the first time and the wound and muscle atrophy that had taken place in such a short period of time was disquieting.  Anyway, brace yourself for that first appointment post op.

 

If you follow the postings on this forum a common pattern develops concerning milestones in the recovery process and the time-line for each.  One mistake we all tend to make is to assume we all have the same injury which is not true.  In my case I had a complete separation of the quad tendon from the top of the patella.  There was no question whatsoever what the injury was only whether I had also fractured the kneecap or done other damage.  I was lucky and had surgery within 3 1/2 hours of the accident.  An orthopedic surgeon from a practice I know happened to wrapping up elbow surgery on someone else when I arrived in ER.  Anyway, your injury and whatever damage you've done is unique to you.  Listen to your body, the surgeon and PT specialists. 

 

Good luck with your healing process.  Hang in there.  It will get better day by day.  At around four weeks you'll be up and around probably with a locked leg brace and things will progress from there.  Just don't do too much too soon.  When in doubt don't do it!!!  Patience is definitely a virtue with a ruptured quad.

 

BTW, I am 12 weeks post op and walked for a 1/2 hour this morning with a normal gate.  I even forgot for a while that I was injured but my knee reminded me pretty quickly that I'm not ready for prime time.  I hope to start jogging again at six months but I have lots of work to do to get there.

 

All the best to you and all of the other "Team Quad Tear" members.  :-)

 

Dan

This is great!  I have probably been doing too much - I cooked two brunches this weekend for my mother and mother in law.  The doc has me on crutches, but he didn't specify weight bearing or non-weight bearing.  For the past two days I've actually been using a walker I borrowed from when my dad had knee surgery.  I hope that this is not such a big deal, but it is actually way more painful using the crutches for my knee and it feels like crutching with one leg fully extended puts a lot more pressure on the surgery area.  I basically hop mainly on my good leg, glide around using the walker and use the foot on the bad leg for balance.  I've just found that sometimes I can trip myself up whilst using the crutches whereby my bad leg tires and kind of drags and hits the ground midstride and then I nearly topple.  Super scary.  I will talk to my doc about this on the phone during office hours, but I am doing as my body is telling me first and foremost.  I know my method is putting the least amount of stress on my surgery area and that's the most important thing.  I elevate for probably half the day and I started working from home the day of the surgery actually.  If you guys have any advice on walker versus crutches, or avoiding that super scary almost falling painful thing, please chime in here.  Also, it sounds like most folks are taking leave from work - wish I could but I'm actually scheduled to get laid off this Tuesday, so then I'll be on the job hunt with this contraption.

 

Great to hear all the words of wisdom folks.

 

Have a great evening! 

Hello All,

I will be 10 months post op May 21 and wanted to check in with you guys.  I am doing well....full ROM, light jogging, resistance training is going fine. I am trying to get the quad back to the way it was before the quad pop. Getting close may be all I can do.  I feel great and am very fortunate to be able to do most anything.  I want to ski again this winter - what a victory that will be! This forum was a great help to me and it seems it is continuing to be a great help for many others. Yes, it is a horrible injury, but full recovery is possible. Good luck to all of you!

Old Runner Guy,

 

How did your jogging/running go last weekend???  Any swelling or post run pain issues?  Do you wear a knee sleeve for mild support and compression?

 

Remind me again, how long are you post op (7 months)?  It sounds like you had a month or two that was a bit of a no mans land where you didn't feel you were making progress getting back to running on the roads?  BTW, several people I know including my girlfriend are using the barefoot mimicking running shoes.  Have you tried them?

 

The other night I had vivid dreams of running again.  I was walking and simply broke into a running gate.  Kind of like young "Forrest Gump" running and his leg braces breaking off as he tilts his head and just ruuuuunnnnnnnnnssss......  :-)

 

Please keep me posted on your progress.  You are four months ahead of me and we're around the same age so you have become an inspiration and benchmark for me. 

 

All the best of healing to all!  :-)

 

Dan

Hello Everybody

 

Im 9 weeks post op and feeling better everyday.. Today is my first day without crutches or a cane. Im still wearing adjustable leg brace at work or out and about just to be safe. Im not wearing the brace at home and Im walking just fine, pain free, minor limp. Ive been doing 1 mile walks in the evening. The first time was a struggle but with in that same week it has gotten much easier to the point of now im timing myself. After my walks I go to the gym and work the bag for some cardio and I lift light weights(upper body) mostly standing. Im happy to see people still updating because it always reminds me there is a light at the end of the tunnel and patience is whats required to kick this injuries butt.

 

Hoodwinked- please be carfeul in these first weeks after surgury. Letting that quad heal is paramount. Everything else will fall into place as you go. I bounced from walker to crutches in the first month. I have slippery hardwood floors at home so the walker did the job..The crutches were used outside because i could manuver better with them..good luck

 

Stay in the fight

Will Run Again & others

 

In for first post op. Have been four weeks since surgery. Have full leg fiberglass cast. Your last post was a great summary of what to expect and how to procede this next weeks/months.

Especially warning about seeing leg for first time with atrophy and incision. Hardest part so far has been patience with immobility spending most of day and night with leg in "toes above nose" position.

Will see how tomorrow goes as to new cast/brace, PT, etc.

 

Active Padre

I am 8 1/2 weeks into this catastrophe, I can walk quickly with a slight limp, I can do a straight leg lift and leg extension (no weight) with some authority, but there is pain at the kneecap when I do it.  It is not severe pain, more like a significant discomfort, but it is enough to cause rehab to be laborous, but not quite torturous.  Anyone experience this?  hopefully it is normal...anyone have any idea how long this will go on for?   I also have this nice solid hard lump at the tendon insertion point into the kneecap, I am assuming this is scar tissue.  I have 115 ROM, so it is not causing too many problems, but will this scar tissue dissapear eventually, assuming I have full ROM later on?  thanks all, things have been better for me, at 4 weeks my rom was 23 degrees, I am starting to come out of this world of hell, this injury can be overcome!

Metalhead39,

You seem to be exactly where I was at 8 1/2 weeks regarding the knee cap pain.  I think I was somewhere around 12 weeks before that knee cap pain became minimal.  I'm at 15 weeks.  The knee cap pain is just about history and almost have my full ROM but struggling to match the good leg.  I had the same bump at the repair but seems to have shrunk down.  At this stage for me it is building the muscles back up that is the task at hand. 

Will Run Again.....I am about 7 months from surgery (10/28/11). Last Saturday I biked outside for 1 hour and then hopped off my bike and slokked( run with very short strides) for 1 and 1/2 miles with about 100 meter repeats between that and walking. Sunday I slokked around a Lake about 3 and 1/2 miles with the same repeats. Monday did a 2 mile same workout. Really no bad stiffness after these sessions just cannot increase run portion distances without stopping quite yet. You find if you do pain and stiffness in the knee and feel some weakness in quad. But no real pain. I like your idea of trying some type of a compression wrap on knee. I think I will look for one. One very noticeable thing is running surface....very noticeably harder on concrete surface and much better on a softer surface like dirt. Only thing on dirt is that you find yourself very aware of not stepping in a hole or uneven surface area for fear of injury. I will keep on going and hopefully gain a stronger leg. May have to accept that leg never will reach full post injury strength. Have to see what Mother Nature does. Good Luck to all. I don't want this post to sound too negative....it is great to be out with some running movement !! ORG....TOM

ORG

 

I don't believe that you will have to live with less than what you want to going forward. From these posts, it appears that we all heal at a different rate but that by 10 - 12 months after surgery almost all are fully or almost fully recovered. I am often told by the therapists that at 4 months post surgery that I am doing great because I have almost full ROM, I can walk without a limp, stand without arm help, and even play a little golf (my second attempt at playing was not nearly as successful as my first). However, I know that the knee is always puffy, weak, sore and tight no matter what I do or don't do and that set backs seem to occur without reason. It is hard not to feel negative at times, but these posts giving our experiences - whether good or bad - are really important. From my perspective, 3.5 miles seems like a great advance from the first  time that I read one of your posts almost 4 months ago.  Hang in there - we are all rooting for you - and by all means keep posting.

wk 5 and a half, 4 days into partial weight bearing.

Life getting a lot easier as 2 feet on the ground feels good and is much more stable, easier to balance, faster to crutch about etc.

Learning to feel what 50% of my weight is (40kg in fact) by pressing on bathroom scales with the bad foot. This is useful exercise as I find it quite difficult to put the full 40kg down - my leg just won't let me, not pain, just too weak.

So the scales themselves are a measure of how I'm getting on, and standing there trying to hit 40kg is a useful exercise in itself. NB they have to be the old fashioned mechanical sort - electronic ones have minds of their own!

I've hit 40kg once, and I have just about hit 90 deg with the brace, with 2+ weeks to go!

 

It gets better - slowly and steadily.

Edited by skip intro - 5/15/12 at 11:06pm