Quadriceps Tendon Rupture, Repair and Rehab - Page 124

Texas
Your there dude.. After those first few pt sessions you will feel the difference. On another note, a while back someone by the name of kallen posted a lot about a running program and it seemed to work for a few on here. Anyone lately try this program and if so how is it working for you? I'm around 20 weeks post op and can run a little (2 mins) before the gait goes down hill lol.. Just looking to get better. Stay in the fight!
Steve

Did anyone else have severe quad atrophy after surgery? My leg still feels like jello 10 days after getting my brace off. I'm getting worried.

My muscles are too weak to do a straight leg raise.
 

 

 

 

Three months post op  PT session confirms bikerboys comment about PT sessions speeding improvement and may give encouragement to chicadivertida. Here's a brief summary(it was an hour session).

 

Continue muscle rebuilding and toning, as well as ROM work. Recieved cold laser treatments to stimulate healing (ATP) and started on exercise machines:  stationary cycle and  eliptical trainer. Also learned several at-home exercises: quad sets, ankle pumps, glut squeeze, hip flexion and abduction, hamstring sets and straight leg raises. PT underlined one exercise for rehabing one of the quad muscles that gets overlooked: VMO. The "short arc quad" exercise has you lay on your back with bolster or rolled towel under the knee. Lift foot up to straighten knee, keeping knee on bolster; hold for five seconds; slowly lower leg to start position. (Chic, muscle rebuilding and toning starts with quad sets and ham sets. Even at 3 months I was told not to do straight leg lifts at this time. )

 

Encouraged to walk short distances with cane and, most importantly, to get on my bicycle for flat rides! Yeah!!!!I have 100 degrees ROM and need a few more degrees to do a complete pedal rotation, but using flat pedal on my injured leg and clip in on my good leg I can "one leg" it until I get full rotation.

 

PT noted what my doc has said all along: they see best results when tendon is allowed to heal completely before too much aggresive treatment, i.e., three months. At least that's the Mayo Clinic mantra. PT said that, if I take it easy and don't push it too hard, I can look forward to a complete recovery.

 

Thanks again for all the encouragement and advice.

Patience and peace to those still cast or braced or otherwise still impaired.

 

Padre

Hey all, Sadly, I'm a newbie here. My story:

 

42 years old guy

Active with cycling, hiking, but most importantly, I've been skiing bumps hard core for the last 10 years or so. 

 

Injury: July 25, 2012

 

I was at Whistler at a mogul skiing camp. After skiing hard in bumps 3 days straight, I stupidly got on a trampoline to practice jumping, which I had done just the day before. After about 2 minutes of jumping, landed on the trampoline without any obvious instability or loss of balance, when I heard the dreaded pop, buckled in agonizing pain. Immediately, massive swelling, although I was able to bear some weight. Unable to walk up/down stairs with the left leg. 

 

Flew back home early the next day, saw an OS, got xrays and MRI. Preliminary look is a "partial tear" on the left. I'm set to meet with the OS again tomorrow, 5 days after the injury to discuss options. After combing through this thread, looks like with a partial tear, the indication for surgery depends on the extent of the tear. Of course, at this point I am extremely depressed. As all of you guys have said, I am just running through my mind how this event has likely completely changed my life. 

 

At this early stage of the game for me, I wanted to see if someone could offer some advice: my goal is, just like all of you, to get as close back to 100% of what I was doing before with physical activity. However, my specific worry is mogul skiing. If you guys have seen competitive (World Cup) level bump skiing, I'm not close to that level, but I really aspire to get there. What are your thoughts about being able to get back to that level of skiing? My worries about that are (1) the need for really quick, reactive and aggressive quad/knee/leg movements, (2) need for constant eccentric load on the knee during the repeated absorption in the bumps, and (3) how long might it take to get there? 

 

Thanks for any advice in advance - I'm definitely just beginning to wrap my mind around the severity of this injury. 

I came across this thread some weeks ago during one of my darker days, I would like to thank anyone and everyone who has posted their story, it has really helped me in lots of different ways. Firstly that I'm not alone, secondly in what i need to do and how hard to push it. I'm 9 weeks in now and it has got better every week, that doesn't stop me getting frustrated with it however which is where reading other peoples stories has helped get it into perspective.

My biggest issue initially was that no-one was prepared to tell me anything i got that frustrated that i searched the internet and found a rehab program which I started with straight away. Massachusetts General Hospital Orthopaedics "Rehab after repair of the patellar and quadriceps tendon". This was a massive help as it gave me a structured approach to work towards recovery and guidance as to where I was in the process. When I gave it to my Surgeon as suggested best practice he shunned it saying it would involve him in too much paperwork, however the Physio did take a copy. He did not have a protocol for the injury so had to go off guidance notes from the Surgeon for the first 7 weeks which consisted of not very much, so I was very happy when he took it positively. He now has a protocol but won't share it with me and my visits are down to monthly now, but this doesn't bother me as I can monitor my own progress against the above program. I started driving short distances last week which whilst it is still uncomfortable was a massive relief. My wife is due with our 3rd Child in 2 weeks and ever since waking up from surgery my goal has been to be able to drive her to the Hospital when required. Men are not much use in birthing situations other than getting her there and taking her home and I was deeply upset when it happened. My first question to the Surgeon was when could I drive, he told me 8 weeks which I achieved but it would have been less given a more perscriptive approach.

Once again thank you for all your stories they have been inspirational.

My prelimary diagnosis (by observation, palpation and ultrasound) was also a "partial" rupture. The OS wanted to go with surgery ASAP ... and I'm glad he did; since he told me at my first post-op check that it had been a full rupture after all.

I'm now 8 weeks post-op with 80 degrees ROM on my brace and get to add 10 degrees each week. I still have the cane around (somewhere) but don't use it much. I work on the fourth floor of an office building and "treat" myself each day to one trip up and one trip down by the stairs. Still no PT yet since my OS seems to subscribe to the Mayo Clinic's "three months healing before PT" approach.

I think I'm about two weeks from setting my bike up on the trainer and giving it a go.

Recovery is slow. But i keep thinking of the one poster who said that his "repaired" leg is in better shape than his OEM quad tendon. *That's* something that keeps me going.

Paul

I thought I would share the joy today.

 

Just had my last follow up visit with my orthopedic surgeon.  After almost a year and 2 surgeries to repair and re-repair the same ruptured quadriceps tendon I am finally through with the medically supervised portion of my recovery.

 

I have not yet fully resumed normal activity but can get out and put in a 90 min bike ride, 30 min run or 2 hour flat water kiteboarding session without having an angry flare up from my knee.  The surgeon did warn me to continue to be measured and careful and to continue to do my PT exercises which are in my nature anyway.  I don't know when or if I will be riding a century, training for a marathon, playing ultimate or telemark skiing but I am grateful for the function I have gotten back.  Its definitely a time to focus on what I have gotten back and not on what I have lost.

Chica;

 

No te preocupas.  Your leg strength will come back.  Very slowly at first ( this will scare you), then seemingly very quickly and then the last bit as you return to full strength will be very slowly again.  Think of an arc tangent function.

 

I spent 6 weeks in a cast and then another 6 in a brace with my second ( reinjury ) of the quad.  I was concerned for sure.  The injured leg now shows muscle definition and is capable enough to walk up and down stairs comfortably and is supporting an increasing amount of sports related activity.  It will take time, but it will come back.  As you are young, it will come back faster.

omg Mr.Miller i did the exact same thing you did. i did it off a diving board at a public pool. only it was my right leg and my left leg slipped, old board i guess, but i had a complete rupture of my right quad tendon and on top of that i tore the outside of my quad muscle in half. it didnt show up on the mri cause the images that were taken were only of my knee. the surgeons realized something was not right when they were attaching my tendon back to my patella and started to see shredded muscle tissue as they put it. but anyways i am 4 weeks post op. 2 weeks in a straight full leg cast and now at week 4 in a brace locked out at zero. my background is i am a personal trainer and a fitness nut. im used to going 100% all day long and now that i cant its driving me crazy. my ortho says it will be a full year before i can be at 100% again. but for now its just all upper body lol. i do have one question though im pretty sure most were locked out at full extension but did anyone have the problem of it hurting when it was and had to take the brace off to put a pillow under your knee for some relief?

Quick update: After talking with the OS, despite the appearance of a partial rupture, I decided to go for surgery. Now I'm POD#1. It turns out, the tear was more severe than what the MRI showed. The OS originally estimated about a 40-50% tear, but it was well more than 50% - probably 75%. So I'm definitely glad I went for surgery, even though right now the pain sucks. 

 

In this early stage of the game, for anyone who may have just found this site (like me a few days ago), I would definitely recommend a femoral nerve block post-op. It really helped me get over the first 24 hours of pain. 

Hey, get well soon

Just sharing my thoughts after 4 1/2 months out from right full quadriceps tendon tear, received when falling off a ladder trying to mount a glass backboard to a pole. 39 years old.

After week 5 of ROM being 50 degrees, way behind according to the Dr , I am now at 138....at one point it just loosened up, at about the 105 degree mark......I can go up and down stairs fairly easily without a railing, but cannot go fast, and am deliberate in my movements.  I can run, but I don't really trust it yet for that, will probably give it another month.  The scar has faded a lot, and my knee resembles the other one, with just less definition, is more rounded off slightly. 

 

It aches from time to time, 80% of the time I am aware of it, but what is awesome there are times when using it or walking I feel that it is almost normal, and occasionally I even forget that it was injured.  I am hoping as time goes by that percentage will drop..

 

this injury is insane, I have had a bicep tendon tear as well, that was a scratch compared to this.  I tell you what, what I have learned from all of this is give the tendons on your body a chance to load if possible.....when I lift weights now I always gradually lift, getting the tendon time to prepare.  I used to be gung ho, hit it hard! no way anymore, just nice slow reps, heavy is fine, but no jerking.  Good luck to all you guys, full recovery from this disaster can be done. 

Hi, I am new to this forum. I am 4.5 months post surgery for a complete quad tendon tear. I have about 65 degrees ROM and have worked my butt off to get that far with PT, DynaSplint, Gym, and stretches at home. My doctor does not want to do the Manipulation under Anesthesia as it could damage the repair. He is talking about arthascopic surgery to poke holes in the scar tissue to loosen it up. Has anyone had that and did it work well?
 

Quadtendon 159 -

 

I definatley don't like the sound of that at all.   Seems like that if counterproductive to long term success with this injury. 

 

A few questions if you don't mind:

 

How old are you?

How did you rupture the tendon?   Was it a full avulsion?

How long after injury did you have surgery and what technique was used?

How long were you in a straight brace?

Are you athletic?

What work do you do?

 

This type of info will help those on the board provide a prospective of what they experienced.    But, I wouldn't want anyone poking holes in my tendon without a second, third and fourth opinion. 

Hi bigggfred, I left out a lot of details. I am 51, I have been very athletic all my life and done many sports and activities and have lifted heavy weights for over 20 years (at one time was competitive). I ruptured my tendon by slipping on wet concrete on my backyard patio, tendon popped before I hit the ground. It was a near complete tear, only a thread left hanging on. I had the surgery one month after the injury (took 10 days to get the MRI and another 20 days to get an appt. with a surgeon!). so it was immobilized in a brace for that month too. The surgeon opened up with a 7" incision, drilled 4 holes in the patellar (knee cap), sutured tendon to patellar, and sutured everything else back together, roughed up bone to improve tendon to bone fusion, etc. After surgey I was in immobilzer brace for 6 weeks, then began very slow movement, etc. I am a software engineer so am sitting at a desk all day. I have been working VERY hard at getting range of motion and getting discouraged. The surgeon says that the scar tissue matures in 9 months so getting it move after that point is very difficult. I did have an x-ray a few weeks back to check for calcification (heterotopic ossification) and I had a little. Thanks for any info.
 

Quad Tendon 159 - my surgeon went in and removed scar tissue through (2) portals - he did not poke holes in it.   The he immediatley performed a manual manipulation.   This worked well for me.   The surgeon did warn me that the manipulation could damage the repair during the procedure and I would be back to square 1.    I was to the point I felt I had nothing to lose as I was stuck at 85 degrees.    The surgeon showed me before and after pictures of the areas where he removed scar tissue.   Good luck with your recovery.

Hey MikeinMD, I am glad to hear it worked for you, that gives me confidence. I am guessing I have more scar tissue then most since I had to wait one month for the surgery from when the injury happened. Any idea why your ROM was not great at first? How long after your surgery was it when he did the manipulation? Was the recovery from the manipulation fast and how much ROM did you get afterwards? Sorry for the rapid-fire questions!
 

Quadtendon 159,

 

Thanks for filling in the gaps.    I lifted and competed as well.  Actually, I experienced my full avulsion tendon rupture squatting during a training day (March 25th, 2011).   13 months later I deadlifted 633 in a meet (can't wrap my mind around heavy squats again).   I'm now just a push-pull guy.

 

I was immobilized for 10 weeks.   Just slight weight bearing at week 8.    ROM progressed from 25 - 130 degrees in less than a month after I started working it (14 weeks after surgery).    I had surgery (exact same procedure as you) within 16 hours of experiencing the injury.    That, as I have since found, has made the biggest difference.   

 

So, it does sound like you have to have an additional procedure.   I just encourage you to get a second.   If your surgeon is concerned with your well-being he shouldn't mind.   

 

Best of luck...

Thanks bigggfred, I am encouraged after reading you lifted 633 a year later! I searched through this thread more and found other folks who had an additional procedure and it worked well. I will see my doctor next week and update the forum after the next step. Thanks again.
 

Quad Tendon 159 - in response to your questions.

1) It is my perspective that reason that I got hung up was the I did not push myself nor did my PT during rehab.   I should have gotten in the therapy pool at my gym and moved around.    It is amazing the amount of hours it takes to get back to normal every day living.   My knee was so tight is felt like they had cut about 4" of my quad muscle away as I could not bend after being taken out of a cast.

2) The procedure was done 12 weeks after the initial surgery.    My PT thought that I was crazy for having a manipulation as she felt she could bust through the scar tissue - to this day I do not believe this could have happened without a further injury.

3) The OS gave me a picture of my leg bent at 125 degrees during the procedure.   I did not have great ROM prior to the injury as my hamstrings are a tight as piano wires.  My ROM in my injured leg is better than my other leg.

4) I took me a 10 days after the procedure to get one full rotation on the exercise bike.     Once I achieved a full rotation on the bike my ROM took off from there.    My knee was still tight on the bike but one day I decided to go all the way around as I was tired of being stuck.    The first time around if felt like my knee was going to come apart (no pain just a weird awkard feeling).

5) The first thing I did when I awoke from the manipulation was to do a leg lift which told me immediately the OS was successful and my knee was still all together.   Very little pain when I woke up - they gave me a pill and it went away - nothing compared to the original surgery when the pain was not pleasant as the nerve block wore off.    My knee felt much better after the manipulation including the day of the procedure as started to exercise my knee that afternoon.

As I have said many times I am lucky that I live in the Baltimore area where we have some great surgeons and hospitals.

Today I had my last follow-up appointment with my surgeon. I am 36 weeks post surgery and 37 post injury. My surgeon gave me a clean bill of health, with the proviso that it will take a year to get full strength and control back. Regardless, he was quite pleased with my progress, as am I. I have full ROM back. Walking is getting easier every day it seems. I am leg-pressing 400 pounds, 2 sets of 12 reps. I can do 200 pounds single-legged with the injured leg (right) which is what I can do on the good leg too. For those who are earlier in this progression, the PT is essential. The most critical thing in the early stages is to regain ROM. I stretched the heck out of my injured leg several times a day. Once ROM comes back you can start rebuilding strength. Plus, once I got to about 90 degrees ROM I was able to drive again, which did wonders for my mood. I continue working out twice a week with a trainer and one or two more days on my own. I have been trying to walk as much as possible, normally doing 3 miles at a stretch. My right leg still gets achy and puffy after a good walk or workout, but usually it feels all the better the next day.

There are dark days with this injury. It does get better though. I benefitted from the stories of those who had suffered this injury before me and were well down the path toward recovery. I think it's important to keep sharing our stories. We all know that there are precious few resources available outside this message board.

Hello everyone!

 

First, I'm not a skier as there are no mountains with snow in Orange County, CA. I signed up for this BB because of the great information in this thread.  I hope you'll accept me for who I am.  Who am I?

 

-Bryan

-36

-Playing hockey goalie for 20 years.  Before June 25th I played 1-4 times per week.  I've been told I won't play again until January. :-(

 

My Quad Tendon was severed during a recreational hockey game.  A player on the other team was hooked down and he slid into me.  His skate landed directly above my right patella and his skate blade completely severed my right quadricep tendon.  I had surgery two days after injury and got laid off two days after surgery.  The OS said the cut was so clean it was easy to repair.  Surgery went very smoothly and the nerve block helped tremendously.  I'm in a full leg brace going on 6 weeks and going crazy.  I feel like I'm losing touch with the game.  Anyways, on to the important stuff...  

 

I haven't spoken to the OS since the day of the surgery.  The PA comes in to tell me what's going on.  At my first appointment she says 6 weeks until I can start PT.  At my appointment last week she changed it to 8 weeks without warning.  What the hell lady?  I'm looking forward to regaining ROM through PT.  I hope the tightness in my knee subsides slowly but surely.  After reading many stories I've realized that "Slow and steady wins the race".

 

Enough of my bitching... I just wanted to introduce myself as I'll be reading everyone's road to recovery.

 

-Bryan

Bryan,

   I am 7 weeks today post surgery.With a hinged brace I have been able to drive for

3 weeks and this is my second week of PT.Your OS sounds very conservative  and frankly

in line with many people in this group.In the long run a week might be a good investment.

  Hang in there.

                                                          Calhiker

Greetings,

  Many of the Olympic athletes have been using  K Tape (Kinesiology Tape).

Has anyone used it and  has it been successful for you? Also what tape

pattern have you used? 

                                                           All The Best

                                                              Calhiker

just checking in.. Hope everyone is progressing well. It's 23 weeks post op for me and I'm pleased to report I'm running again. Pretty much have full ROM and starting to see big improvements in leg strength. I didn't start PT until week 13.. I wasn't happy about the late start but it did give me a since of security in the healing of my injury. My short goal was to be physically and mentally able to attend my military training at Ft Leonard Wood and that's where I've been for the last 2 weeks.. I'm still stretching and doing my own rehab until I finish the course. Then it's back to Texas to my PT who I'm sure will greet me with a lot of pain.. Lol... This injury is a beast at first but with patience and soon after that, tenacity will pull you through.. Keep fighting and you will win!
Steve

I am 28 weeks from surgery for a complete rupture of the right quad and feel like I am at a standstill. I have almost full ROM and can walk 2-3 miles at a time or do an elyptical, but only comfortably if I wear a compression knee sleeve. I have decent strength in the leg but the leg is still 2 and 1/2 inches smaller than my good leg. Unfortunately, despite how far I have prgressed since the surgery and particularly after my ROM went past 90, my knee remains very stiff and rather cranky. I have to constantly ice the knee or apply an ultrasound treatment to get any relief. I have significant discomfort if I sit with my leg bent for more than an hour or so (not good for being at a desk or on a long car drive). I can play golf (but only with the knee sleeve and a number of Advil). I just had another MRI on the knee. I'll find out the results tomorrow. I suspect I have a lot of scar tissue causing the stiffness and will just have to wait another 5-6 months before I feel normal. I can't imagine how difficult it was for those of you who have had to go through this more than once.

I am new to this forum but I discovered it a few days ago and have read several of the first pages and several of the last pages.  Quite a resource!

 

My story is a bit different than all the ones I have read so I wanted to get a few opinions. I am 49 years old.  I was an obsessive hiker, mountain climber, telemark skier for over 20 years.  I have hiked uphill as much as 600,000 vertical feet a year and average over 500,000 each year for over a decade.  For last few years road biking has been the only activity I can pursue relatively pain free.  I have a 100 mile charity ride in two days. 

 

I do not have a Quad Tendon Rupture, but have micro-tears in the tendon in both kneees.  This has been confirmed with MRIs in both knees.  No catastrophic event.  Mine is likely caused by overuse combined with my own biomechanics.  Knee joint, meniscus, cartiledge is all good, but the tendon is what began to break down.  I was diagnosed about 2 years ago and have been living with discomfort and limitations for about 3 years.  The surgery, especially since I will need it on both knees eventually, was so terrible sounding that I have put it off.  But I am now seriously reconsidering doing one knee done late next month.

 

My right knee in particular has gotten worse in the last year.  As of last year I could still hike 1 or 2 days a week and climb 1 or 2 peaks a year.  I gave up telemark skiing but could still use Alpine Touring gear to hike up the ski area a few days a week and ski down ona groomed slope with pretty minimal pain.  But riding ski lifts and skiing up and down all day has not been an option for 3 years.  Now hiking is limited to a 2 mile, flat trail that I walk with my dog and even that is not pain-free.  Don't know if I will be able to uphill hike on the skis this winter at all since right knee has gotten worse.  But obviously I can still walk and am functional, but limited in my recreational activities to a pretty large degree.

 

Given what I read on this forum I am agonizing once again whether to put myself through the surgery and very long rehab process.  For all of you with full Rupture of the tendon, of course there is no choice.  You can't walk so you have to have the srugery.  For me it is still a choice.  I feel like my quality of life is definitely not what I want it to be and if I keep putting it off the knees are only going to get worse and eventually (even if is several years from now) I will HAVE to get surgery.  So I think, I may as well do it sooner versus later rather than put myself through more years of discomfort and limited quaility of life.  And when I read this forum I keep thinking, I will eventually need to go through this TWICE if I really want to get back to doing what I want to do.

 

FYI-My surgeon says I will start rehab the day after surgery!  I am trying to get an answer if my surgery and rehab is any different because I do not have a rupture.  But I am pretty sure he is going to drill the 4 holes in my patella so it seems similar to me.  I live in a ski resort and if I have the surgery in late September I have about 2 months before I will have to deal with snow on the ground and I am also wondering if I do go through with it, would I better off doing it in the spring and being able to rehab during the summer and not have to deal with winter.  

 

Please give me any and all opinions.  This forum is great but it can be a scary place to hang out.

Grover74 - 8 months post surgery

 

just checking back in - have gone to 3 days of stretching and therapy in heated pool with w days in between in the fitness area doing wall squats, riding bikes, doing leg presses and doing the elliptical  - still trying to add strength to leg with quad and tendon rupture - can get up stairs and walk but leg is still weak - have not yet tried any jogging - will do the first of September - worried that leg can not support weight - we will see  - anyone have any suggestions for building up strength and quicker or a program of exercises they are using? its been 8 months post surgery that included 10 weeks in a brace -- progree is there but very very slow - have become resigned to no handball or racquetball this year - did get ACL & MCL & PCL all repaired over Memorial Day in hopes that when strength returned to leg I could pursure activities to work the ligaments  

Today is 81 days post-trauma and 79 days post-surgery.

At my 6-week post-op visit the OS set my brace at 50 degrees and told me to add 10 degrees every week - no PT - and to come back in 6 weeks with 110 degrees ROM.

With my 50 degrees of "freedom" I had enough maneuverability to be able to get behind the wheel and resume driving.

I'm now several weeks past my last use of a cane and can manage 4 flights of stairs at least once every couple of days. I'm fortunate in that I live quite close to where I work and have been able to walk to and from without difficulty.

But ... today ... major accomplishment ... I set up my bike on the trainer and managed for the first time since May to spin the pedals in full circles for 10 minutes.

I know that many weeks of PT lie ahead ... but those 10 minutes today have given me a very healthy dose of optimism.

Paul