Quadriceps Tendon Rupture, Repair and Rehab - Page 121

Hi Brew 22, your injury was very similar to my husband..... landing on a hard wooden floor!  He's 7½ weeks post-op.   Your first surgeon obviously didn't have any beside manner, glad you found another one.  You're in control of your body and you acted on your instincts, good on you..!

One big difference I've noticed that here (Aust) they don't use the braces that lock at certain degrees. (well, atleast not in our area).   My hubby used a full leg brace with velcro strapping for 6 weeks - no bending & minimal weightbearing.  Once the 6 weeks were up (11th June) the Surgeon was happy and away my husband went to physio.  Will go back to see the surgeon in 1 month.

I can't believe the difference in the last 2 weeks.  He's gone from walking frame - crutches - walking stick - needing nothing around the house - full weightbearing.  Today he got into the car and has driven himself for the first time in 10 weeks (accident was 20th April - Operation 2nd May). 

He has started hydrotherapy ie walking in the pool, forwards, backward and sidewards - and is now getting back to his 3km per day swimming.  He finds walking in the water is so beneficial because he's able to walk correctly without pressure and at the same time the water is gently massaging the whole leg.  Then it's into the warm spa....mmmmmm....  very

therapeutic.

I know some days he's very stiff in the morning and takes a bit to get moving, but that does vary.  The biggest obstacle was getting the brain to start working again, telling all the leg muscle to fire up.  Muscle waste starts very quickly, ie after about 3 days.  So 6 weeks immobilised is huge.  He still isn't walking correctly, ie leaning a bit, but I'm forever reminding him to "walk straight, don't compensate"., and fortunately he listens!  .  He's very intent on doing his exercises, and although obviously I want him to progress, I'm very mindful of doing anything that hasn't been programmed, I'm sure all will happen in time and without pushing toooooo much, but at the same time not to 'baby' the situation. I think he is doing just wonderful and the results are there. 

The physio said he still has a long way to go, ie getting on to a bike and increasing the ROM.  At the last session the physio massaged his knee which was really good and took away a lot of the tightening feeling.  Of course it came back, but that was to be expected.  He'll do more and more as time passes.

I would suggest you find a good PT just to be sure you are doing all the right things, it's too nasty an injury to muck it up now.

Quote:

Originally Posted by bikerboyz1000 

brew 22

 

Sounds like your second opinion ortho is the "protect rom early guy" there are a lot of others on here that used the same same concept with no problems. My orhto was was like your 1st. he protected the injury with little flexion in the brace (30-40 6 weeks) and every week i increased the brace 10 degrees. I was allowed full weight bearing right after surgery. I didnt start PT until 12 weeks. Im at 14 weeks with 100 rom and weight training. walking 2-3 miles a day and a lot of swimming.

 

pdub

 

one of my favorite stretches is lie down on your stomach with a strap around your ankle, pull your leg towards your head getting a real good quad stretch. works for me..

That was one of my favorite stretches too. I was able to increase ROM significantly with that stretch.

Hi Jemma. Sounds like your husband is making rapid progress. I can't wait to be able to drive. Monday will be six weeks post-op.With two different OS instructions I'll combine the two. Keep doing some exercises on my own before starting PT after next week.
 

bikerboyz: If you didn't start PT until week 12, what exercises did you do before? When did you start the one where you lay on your stomach? I'm kind of in the dark and don't want to do too much.

brew 22

Honestly, after week 6, I walked a little about 1 mile using my cane. I also stretched the knee using various stretches given by my PA. Hanging the leg off of the bed using gravity to bring it down to the ground. Quad sets such as sitting around the office or house and tighten my quad for 10 to 20 seconds as often as possible. Straight leg raises while keeping the quad tight. you might have a little lag but dont worry because that should clear up once you engage that quad and get it strong again. Week 8 I walked a little more about 1.5 with a whole lot more stretching of the same. By week 12 and my first PT appointment I felt comfortable doing all the PT exercises..  Its my 14 going on week 15 and this morning i did 3 miles on the eliptical at level 5 and seated sled squats with 1 leg at 40lbs and 100 with both. Here is a little example of my PT visits

biodex bike warm up

heel slides for 3 sets of 30 seconds

leg raises straight 3 sets of 20 (killer) lol

knee extension with towel under knee and no resistance 3 sets of 20

quad stretch on stomach pulling knee towards butt 3 sets of 1:00 min

quad tightners.. place leg on table flat while seated with towel under thigh and press the back of your knee through the table and rais your heel off the table at the same time.. this should help with the lag

standing 1 leg and balance for 1 min with the knee bent for 3 sets (killer)

lie down squats 2 legs  then injured leg by itself..easy lift with good stretch all the way to 90 degrees

eliptical for 10 mins

lie on stomach and keeping injured leg straight raise it up and hold for 10 seconds.

i might have forgoten one or 2 but this is what you might be seeing soon.. Good luck..

Anyone here who has had a unilateral rupture had any problems with the other leg? I believe my rupture was partly due to tendinosis(long term chronic tendonitis) of the quad tendon. My repaired leg is doing pretty good, but despite lots of PT ultrasound myofascial release, light weight training, I still have pain in my unruptured Quad tendon. my OS says there is nothing he can do until it ruptures. Anyone have similar issues? Anything past a quarter squat seems to aggravate my unruptured tendon. Lunges....forget it.

Blue Belt,

Other than the quad  tendinosis - how have you been?!   Did you get back on the mat and start rolling?

Bigggfred.

hey big man! Yeah Ive been rolling since Nov. Just won a silver medal in the senior 2 division of the states here in AZ yesterday. Unfortunately the pain in my other knee(right where the tendon inserts on the knee cap) flares up every time I train, so I can hit training hard 2-3 times a week, which is OK, but I can't really train as balls to wall as Id like, and my strength in the gym is limited not from the repaired leg anymore but from the one that didn't rupture. I feel like its holding me back. In the gold medal match the dude I fought was strong in the stand up, and I don't have confidence in that unruptured quad tendon to really push it against a strong competitor, so I pulled guard which is not my game. I fought hard, but couldn't sweep him, and lost on points. I swear if both my legs felt like my repaired one, I would have taken him down and probably won.

    Whats been happening with you and the powerlifting? U ever get out to AZ?
 

Fell hiking 6/20 (friend and OS 10 feet in front of me so very quick analysis of problem)

surgery 6/22.Any suggestions what I can do in first few days to help down the line.I am

in a straight line velcro brace and have an ice machine going full blast. Lot's of med's

so pain is ok.

As I recall, the 1st week or so, you will be pretty sore and unable to do much. Be careful as you need to heal. You may want to take a stool softener as it will make one job easier.

As so many have said before, patients is the key right now.

Blue Belt,

Congrats!!   Yeah, pulling guard on someone who's strong and can get some seperation has got to be hell on a suspect tendon.    Nice to see you competing at that level.   Way good.  

I did a warm-up meet in AZ May 5th and then went on to Denver in mid-May.  Benched 451 and pulled 633- both raw.   Not bad for a 50 yr. old 14 months after a full avulsion.   My deadlift is currently #1 this year for dudes over 50 in my weight class (fat).   

I'm not squating in competition.   Can't wrap my mind around heavy squats.   I just do box squats with 225 for reps.  Thinking about moving that up to 275 x8 over time.   This will help the dead.   But..... after reading about your "other" quad tendon I'm somewhat concerned.   

Does wrapping help at all?    Is there anything you can do?     With a healthy quad you'd be a beast rolling at the masters level.   

Hi everyone...I've been casually stalking this thread since my surgery 3 weeks ago. I had a 75% tear in my right quad tendon, and it's been a huge bummer. The weirdest part is that I'm a 23 year old female..and apparently this injury is seen mostly in men over 40- so my doc wasn't even sure what was wrong with me at first.

The first few days after surgery weren't bad because I was in the hospital..so I was able to get IV pain medicine whenever I needed, and nurses were there to help me use the bathroom. Coming home was the hard part. My doctor, for some ridiculous reason, put me in a full leg hard cast, from almost my crotch all the way to my toes. Considering I'm 6 foot, this cast is like 3 feet long and pretty heavy. The physical therapist thought I broke my leg when she saw the cast.

The hardest part of recovery has been supporting the cast. I walk up and down stairs on crutches extremely slowly, and any day that I venture on the stairs is always followed by extreme soreness..then I have to load up on pain medicine, which I'm getting sick of. I'm scurred my kidneys are going to be messed up after all these pain pills I've been popping...but am I supposed to just sit around in pain all day? :-/

I typically get around (by around I mean to the bathroom and back) on my walker, because I find it's more stable than crutches (23 and already on a walker...).

I haven't been able to shower in 3 weeks. My skin is getting dry and dirty, and my legs need to be shaved. I want out of this cast so badly! Sleeping is uncomfortable. My knee isn't in pain (except when the incision rubs up against the cast..ouch!), but my whole body feels weak from dragging the cast around. I still take pain medicine (ibuprofen and such), but only because my back, shoulders, and good knee are sore all the time. I don't understand why my doctor didn't just put me in a knee immobilizer that I can remove. I feel like this cast is doing more harm than good.

Also, I've been pretty bummed out because I had an awesome research position lined up for this summer. Of course, I had to delay it because I was going into surgery. This position will require me to walk back and forth from a lab to my desk area. I'll additionally have to drive out of state to get there. I'm not sure when or if I'll be cleared to go at all :-( I sit in bed all day, everyday. It's a waste of a summer completely. I hate the fact that I'm doing nothing, and so many of my friends are doing amazing things this summer. I also hate being in pain all the time and being dependent on others for simple things.

Today is my 3 week post-op check up. My doc says he's gonna cut my cast down. I'm going to request that he nixes the cast all together and gives me something lighter. I'm also going to ask when I can drive and go back to work.

My question to you all is:

At what point did you start driving again?

When did you go back to work?

I am new to this (surgery 6/22) but there are lots of Velcro braces

of various sizes that can be  fit to you. I had a few choices. 

How are you doing only 5 days out of surgery? As I remember, those were rough times.
 

Slow and I am learning a lot about patients.Trying to get off the  meds.

The ice machine makes a huge difference.

Old Runner Guy,

Well, I just passed the 18 week mark.  Have been walking around two miles in mornings and evenings at a brisk pace.  The last two weeks I have tentatively started to jog a bit.  First, I did 10 steps, then 20 and up to 40.  This morning I did 4X40 steps, 1x50, 1x100, and, finally, 1x140.  I even worked up a bit of a sweat.  Counting the jogging steps is a bit OCD but initially I was so excited to jog 10 steps felt like a marathon!  Go forward I am going to just pick out mail boxes and trees to run between.  All my jogging is on flat or uphill.  Am in no way near doing anything downhill.  Anyway, I'm feeling encouraged but realize how far I have to go to actually run.

So, ORG, how is your running coming along?  Also, I recall when you were at about the same point I am now you were frustrated with how difficult land running was.  I just curious how I'm currently doing at 18 weeks compares to what you were doing at the point.  Also, I would like to know how long post op you are now and what you're able to do.  That way I have you as a target!  :-)

To All Others,

Once you get to 16+ weeks try yoga.  I did yin yoga last night and the teacher gave me poses specifically for my leg.  For you non-yogis, yin is holding the pose for an extended period to work on the connective tissues for knees, hips, core, etc.  Anyway, when I left the class I walked down two flights of stairs more or less normally without holding the railings.  That was a breakthrough.  Today, however, I am holding the railings again.  Anyway, flexibility is key to regaining functionality and range of motion.

Happy healing to all!

Dan

I'm  6+ weeks post surgery. Got in my car and drove today!! My advise is to be pro active about your cast. My OS was going to keep me locked at 0 for 8weeks. I had the surgery done where my accident happened and wanted a OS close to where I live. Got a new one at 5 weeks. He told me to start bending my knee, do exercises like heal slides to break up scar tissue. Set my brace to 45 rom. I only wear the brace when going outside my house. Like getting out of jail. Went to grocery store and a committee meeting today. I know it will be a long healing process but surgeons need to know how important it is just to do the little things in life as soon as possible.
 

Chicadivertida, you are doing it tough!  .  I haven't read many threads where a full hard cast has been used, maybe there was a reason!!   I sincerely hope you have/did convince your Surgeon to transfer to a brace instead.  I can't imagine your frustrations as a young person to experience this nasty injury.  It's very hard for everyone, that's quite obvious, but for someone so young to be completely dependant on everyone and to feel so isolated from your daily activities and the prospect of your new job waiting for you makes this so much more annoying to say the least.  Annoying isn't quite the word!!

As mentioned I didn't have the injury, my husband had that joy!.  He is now 8 weeks post-op and the physio is really pleased with his progress in the last 2 weeks.  He pretty much thrown all aids aways except for first thing in the morning getting out of bed where leg quite stiff, but doesn't take long to warm up. (it's winter here in Australia - so mornings are cold to add to the discomfort level!).  ps:  he also used a walker for 6 weeks and it made him feel old... in the mind only.

He is lap swimming every day.(heated pool of course! - but knowing him and his dedication he'd swim in any conditions).   Before lapping he does, in chest deep water, some leg execises & walks for approx 800 metres then swims for another 1 -2 km using a pull bouy  -  This way he is also getting some cardio to get the whole body fit, not just the leg.  He will increase the intensity each day until he's back to swimming his 3 km..  BTW he usually does his land exercises at home before heading to the pool as well.

I attest to his good recovery,  particularly in the last 2-3 weeks, is because he was a fit & healthy man before that dreaded day, I'm sure that has a lot to do with it.

The physio now has him on the gym bike and is also massaging the whole knee which bring lovely relief and reduces the tightness.

He's driving himself around now  ...  no more sliding onto the back seat using a lot of grunt to get comfortable as in the first 6 weeks!! .. much to my relief, and his too.   I can now go shopping separately without worrying about him.  I definitely need some retail therapy which was put on hold for the last 7 weeks, but I must admit  I wouldn't have been anywhere else, it was a privilege to be here for my husband and repay his for all his wonderful deeds to me over the last 43 years of marriage. 

You've got to stay positive & patient, if you can, (easier said than done I know)  because it isn't going to get better until mother nature steps in.  The Doctors have done their bit, now it's up to you.  Time will pass quickly, believe me, and before you know it'll be 6 weeks~ and hopefully you can start physio and back on two legs and away you'll go.  You're young, healthy - all the right ingredients for a speedy recovery.  My husband is 67 so you've got youth on your side!

Good luck with your new job and I hope to read here some more of your progress. 

It is rather overwhelming to come back to this site and see so many new quad rippers joining in a steady stream. Good luck to you all! I'm writing to provide some positive news from beyond the 1-year horizon, by which time I think we all hope to be fully recovered and back to normal.

My injury occurred 18 months ago. Once I was comfortable again in daily life, I was quite desperate and determined to get back to competitive sport, to full extent. I was running regularly from about 6 months, but it was not until around 12 months that I had sufficient endurance and power to be able to increase the amount of training to pre-injury levels (without causing aches and pains elsewhere). By that time I had already been whingeing about running badly with that injured leg to the extent that my wife bought me a triathlon competition entry with the message that I should now get on with it. Over the past 6 months I gradually more than doubled the total amount of training to fit enough swimming, cycling and running in. Cycling long distances really helped rebuild upper quads strength. Endurance was still lacking a little. In my first post-injury half marathon my injured leg started to signal tiredness a long way before the finishing line, and I had to push hard to complete in a good time. Finally I was very well prepared for my first triathlon, and it went very well. The best thing was that I didn't feel like an injured runner at all, except for a short steep section going down a ramp.

In spite of those successes, when I recently consulted a PT for an unrelated injury he was quite concerned to see how underdeveloped my lower quads still are on the repaired leg, especially the vastus medialis. He told me at no uncertain terms that I have to rebuild this with specific exercises. Any amount of running and cycling will not do it! He said that if I was a professional footballer I would be having daily physio sessions for three months from now on to complete the rebuilding of the leg!!! So I've added his specific leg/knee strengthening to the program and hope this will eventually complete the process ...

Quote:

Originally Posted by Will Run Again 

Old Runner Guy,

 

Well, I just passed the 18 week mark.  Have been walking around two miles in mornings and evenings at a brisk pace.  The last two weeks I have tentatively started to jog a bit.  First, I did 10 steps, then 20 and up to 40.  This morning I did 4X40 steps, 1x50, 1x100, and, finally, 1x140.  I even worked up a bit of a sweat.  Counting the jogging steps is a bit OCD but initially I was so excited to jog 10 steps felt like a marathon!  Go forward I am going to just pick out mail boxes and trees to run between.  All my jogging is on flat or uphill.  Am in no way near doing anything downhill.  Anyway, I'm feeling encouraged but realize how far I have to go to actually run.

 

So, ORG, how is your running coming along?  Also, I recall when you were at about the same point I am now you were frustrated with how difficult land running was.  I just curious how I'm currently doing at 18 weeks compares to what you were doing at the point.  Also, I would like to know how long post op you are now and what you're able to do.  That way I have you as a target!  :-)

 

To All Others,

 

Once you get to 16+ weeks try yoga.  I did yin yoga last night and the teacher gave me poses specifically for my leg.  For you non-yogis, yin is holding the pose for an extended period to work on the connective tissues for knees, hips, core, etc.  Anyway, when I left the class I walked down two flights of stairs more or less normally without holding the railings.  That was a breakthrough.  Today, however, I am holding the railings again.  Anyway, flexibility is key to regaining functionality and range of motion.

 

Happy healing to all!

 

Dan

WRA,

To your point on Yoga, I would agree that flexibility is a very important aspect in recovery. I did a private Pilates reformer class this week and it did wonders for my tight hips and hamstrings. I will continue Pilates in a limited way in conjunction with PT. It is a slow process but the little improvements help keep me motivated.

Steve 

To all newbies:

10 weeks post op today (28 June). Had complete quad tendon rupture, no other complications. Was in complete leg cast for four weeks, then split cast with hinges at knee for four weeks, have had adjustable brace for two weeks. This is my reasoning for this conservative approach:  the full leg cast was to make sure nothing moved at all to allow healing to begin. No streching of tendon, no firing of quad or ham or anything. The split cast was to continue healing but begin ROM. Still no muscle firing to allow tendon to adhere and heal. Was up to 60 degrees at 8 weeks. After cast was off began slight muscle firing, continued ROM exercises (heal slides) and "walking" with walker or crutches, weight bearing as tolerated. Now at 75 degrees. See doc next week. He will probably finally assign me a PT for futher, more agressive rehab.

Hang in there: I feel for those not able to work. I happen to live across the street from my workplace. So, I've had meetings at home with staff, and done a lot of work on my computer and phone.

But mostly have tried to find the opportunity in my injury. Time for reading, prayer, writing letters, etc., that I've not been able to do as much when active. We are, after all, human "beings", not human "doings". That doesn't take away the pain, the frustration, the embarassment, the humbling, but maybe gives it some meaning.

To others: keep up the postings. Lifts my spirits to know that progress is slow but sure. We will walk, run, swim, cycle, play other sports, etc., again. In time.

Chicadivertida

   How did your 3 week post op check go. 

My 3 week post-op was okay. My OS cut the ankle off my cast. It makes a huge difference. I feel 10 lbs lighter. It's much easier to get around now. I was able to get my leg on my bed today without using my leg lifter thing. He also said I can do slight weight bearing on my injured leg, so walking is so much easier.

I was foolishly hoping he'd cut more off so I'd be able to drive, but that didn't happen, so unfortunately it looks like I won't be working at all this summer. I was still holding out hope in the back of my mind...we can only dream, right? Also, he said I'd be in this cast for 3 more weeks (so 6 weeks total), and then move on to an adjustable hinged brace.

What was really gross/weird is after he cut the ankle part off my cast, my ankle became really swollen, and there was a lot of dead/dry skin on my feet. I feel so unkempt and ragged. I really just wanna get a pedicure, take a nice hot shower, and wear my normal cast-unfriendly clothing, but that's not happening anytime soon. I feel so whiny complaining about this, but it's how I feel.

How are you holding up Calhiker?

The Velcro brace has given me a lot more flexibility( showers etc), My wife told me that

many of the people that do pedicures will come to your home (off hours) for very little

additional money,might be a good investment.

  At this point I am 6 days out of surgery  and trying desperately to cut back the meds

and get out of the fog zone. Looks like I have a long trek ahead (one day at a time).

                            All The Best

Chic

The dead skin is awful, but when you get cast off you'll get brand new beautiful skin! Your cast time (6 weeks) sounds like mine (8 weeks). Look forward to some fast improvement when you get the hinged brace, especially range of motion (ROM). Then on to muscle building, tone.

Raisng "toes above nose" helps with swelling.

Padre

Am now 4+ weeks post injury and 3+ weeks post surgery.  Saw my Ortho surgeon the first of this week and he's allowed me to give up my walker in the house!  Hurray!!!  A little scary at first but a great feeling of freedom and first "steps" toward normal, again.  See him again in a month and may be allowed to remove the brace in the house and for sleeping - fingers crossed.  Was told that PT is in the future, possibly late Aug or early Sept, but am allowed a few really simple exercises that don't flex the knee (i.e. flexing my heels up/back, pulling my heels back, flexing quads/knees down).  Also found that I can lean forward (over my legs) and get a really good stretch of the back thigh and calf muscles without engaging the knee - my braced muscles SO want to be stretched! 

Still having a hard time with patience for the healing process.  I am a crafts person who enjoys weaving and spinning (fiber, not bikes!) and both those involve bent knees and moveable legs.  Neither of which are available to me right now.  So, I've been replaying my old games, reading many books, catching up on email, and watching HGTV.  Meant to get out my knitting but haven't had the mental energy to concentrate on a pattern - now that I'm completely off pain meds, my brain neurons may start "firing" again. 

It's interesting to read through these postings and see the very different healing directives we all receive - hard cast vs velcro brace; movement vs no movement; weight vs no weight; PT early vs PT delayed.... Guess we all have to understand our specific injuries, trust our medical advise, use our best judgement, research, listen to our bodies, and cross our fingers. 

Thanks to lakeswimmer49 for posting from the far side of recovery!  Gives me hope that this will continue to get better and there will truely be a point at which I can say "recovered" and "well".

Best of recovery to all - your postings keep me encouraged and grounded.

Funko,

   Good information,Thank you,

                               Calhiker