Quadriceps Tendon Rupture, Repair and Rehab - Page 125

Padre 120 day post op report.

 

After 90 days of healing, 60 days in two types of casts, 30 days with immobilizer, in other words, pretty inactive, I've gone 30 days with PT 2x/week of fairly aggressive rehab. Now at 120 degrees ROM, walk without aid 30 minutes, pool walk 20 minutes, workout with eliptical, stationary bike, and upper body exercises; and can bike on the flat for 30 minutes. Also continue quad sets, ham sets, etc.

PT predicts I'll get back full ROM and should have muscle rebuild by 6 months-one year. See surgeon in about a month for final assessment of things.

Again, for the newbies, the Mayo Clinic program for the best results: 3 months of healing comes first. Then mildly aggressive PT and slow return to former activity.

So for that's worked for a 68 year old skier, hiker and cycler. Have already gotten on track to getting back to the last two; hope this winter to see how the first goes.

Patience....

 

Padre

Glad to hear it's working for you AP

20 weeks. 67 year old cyclist/walker. Never enough snow here for skiing, though it was late snow which sent me falling down the steps in April!

Similar progress. This week was less good as I think I over did it at the weekend and have had to slow down a bit. Recovery still on going but I can't seem to hurry it up!

This PDF is good - as recommended by several earlier posters, thanks for that. Similar to UK NHS treatment I'm getting, but with a lot more detail.

http://www2.massgeneral.org/sports/protocols/Quadriceps%20and%20Patellar%20tendon%20repair%20rehabilitation.pdf

Yes, Skip. We're about at the same point in recovery and vintage. I forgot to mention that my knee is almost always a bit swollen. But after walking, biking, standing, etc. for a while it gets worse. Ice for 20-30 minutes helps reduce swelling. Also do spot ice massage when experiecing localized pain.

 

And, for newbies, PT taught me the acronym: PRICE

Protection  - keep affected area from moving. Casts, immoblizers, wraps, canes, crutches, etc.

Rest - avoid activities that produce pain, swelling or discomfort.

Ice - to decrease pain, muscle spasms, tissue damage. Ice pack or massage.

Compression - elastic wrap over affected area to prevent, reduce swelling (my PT has me wear light cotton wrap.

Elevation - Toes above the nose. Whenever possible but especially at night.

 

Active Padre

Hey guys, I'm new to this site and this injury. Thanks for sharing your experiance, It was so encouranging to hear all the stories and paths to recovery that I desided to join, From what I've been  reading i must be very lucky, almost no pain, My injury was on 7-3-12 compleate tear at the patella OS said the tendon had a separation of about 1/2 inch but attached nicely.For a month I walked on the leg with no pain OS could not beleave I was able to walk from day 1.Sugery was on Thursday 8-2-12 had very little pain in the knee but my back was killing me. They gave me pain killer went home 1 hour later. Knee pain was not bad the same day of surgery, Friday pain was pretty bad but manageble with pain killer Vicodin 500mg 2 every 6 hours, by saturday went to 1 every 6 hours, Sunday only to sleep, no more pain since.OS has me in a leg brace light walking on cruches toe step 10 percent weight. I remove it when siting on recliner and ice it about 2 hours 3 times a day. Went to follow up this wednesday 8-15-2012, OS has me flexing my quad but no bending. He asked me to buy a ROM brace, my insurance dose not cover it so I'm searching for the best one for the money dose any one have any sugestions, somany to chose from, what is every one using do you like it Help. I need it by my next visit to the OS on 8-29-2012. He told me I can start PT 3 times a week to 45 degree after that, not coverd by insurance. I'll try keep posting my progress.

Haven't posted for a while. I find it very helpful to read all the different approaches to this insane injury and to know others have also suffered. Here is my update. I'm 70 yrs old. Have always been physically active playing competitive basketball until 65, hiker, and regular at the gym. It does seem that almost everyone that has this problem has been very active. On May13 I fell backward down some stairs and completely ruptured my left quad. Had surgery the next day May14. Was completely numb right after the fall and even after surgery so pain was not a problem. Was in an imobilizer at zero degrees for 7 weeks. However could put full weight bearing right away. Started doing heal slides and quad tightening after 4wks. Imobilizer set to 45 at 7wks. Started PT after week 8. Quit wearing brace entirely then, Could drive after week7. Now 13 wks, Just released from PT as I now have full ROM. Can go up and down stairs fairly normal. Just this week the numbness has rapidly started to go away. Even though I'm relatively pleased with my recovery so far I know it will be several months before complete recovery. I will have a true test tommorrow as I'm taking a 5hr flight. Thanks to everyone who has previously posted as my surgeon gave almost no advise or feedback.

Update after 10 months.....65 year old...wont bore you with my background as I have mentioned it on many previous posts. After extensive rehab still have trouble running. I feel it is because of injured quad still being about 1 to 1 1/2 inch smaller than right one. Have done a lot of quad strength work. Saw my surgeon about a month ago and in his opinion it will come back to normal size....but may take longer than 1 year. He did order an MRI and the results were good....no ACL or mensicus damage to knee. But...a surprise to me was the tendon damage to the patella tendons. He said this is all part of the healing process and is considered all part of the quad/knee area. This is why this is such a devasting injury.....there is a lot of area to heal....not just the quad alone. More biking for me......did a 50 mile ride with no problem .....but going weight bearing still slow. Would be interested if any of you at about my stage still have the size difference in quads. Get out a tape and check....you may be surprised. Repect all of you on this site....its a journey !!

brew22

 

Glad you mentioned the numbness you have. I've had the same ever since I got out of the casts after 8 weeks. OS pointed out a nerve on the outside of the leg below the knee that gets irritated during surgery and from the cast. Things have slowly gotten better. Have some numbness down the back side of leg, but mostly in foot and toes.

Also, I'll put another plug in for icing. Do so after each period of walking, cycling, exercising, or whenever knee looks swollen.

AP

Hi I am new here
65 yo tennis player
Two weeks post op started my exercises starching Able to bare full weight
Not my best days lacky to find this forum
Please suggest best brace

ORG

 

I am 7 months out and just had an MRI that also showed swelling in the patellar tendon area. OS injected some steroids to promote healing and to help diagnose why the knee is still swollen and sore. I can't sit with my knee bent for more than about an hour or so. Shot gave some relief and I am hoping that I am back on track. He estimated 5 more months before I feel "normal."  Leg is still about 2.25 inches smaller than the non-injured leg despite extensive PT.

Break Par

 

Good to see you on here again. You are about 3 months behind me. Yes...we can damage those patella tendons also. You are having the atropy in the injured leg also. It is very difficult to get that muscle back. With all the PT and exercise I do I still am 1 1/2" smaller on the injured side. Interesting that you are getting the injections....did your surgeon recommend them.?...have not heard of them from my surgeon. Everyone says it takes 1 year to get near normal....but I think it will be longer if ever close to normal. Keep up the good work everyone. TOM, aka, ORG !!

Greetings,

  A few people have been asking about ROM braces,if you live in a warm climate,the

Ossur Innovator Cool Model is a good choice. It is easy to adjust and to keep clean.

  I am still trying to find someone who has used the K Tape (Kinesiology Tape) system??

This type tape was very popular in the Olympics.

 

                                                                        All The Best,

                                                                         Calhiker

Hello.  I had a complete rupture of my quad tendon 26 Feb., 2012.  I purchased my ROM brace from EZY-WRAP.  The brace is called ADVANCE REHAB DESIGN (ARD).  My OS approved it.  I did not like the one he offered me.  This one worked very well.

Thanks for the info on the ROM brace ill look them up.

I live in Miami Florida and it's definately hot.

I have to buy one by 8-29-12

Hi everybody!

Now when I am able to sit in front of my computer I can give you details

I am 65 YO active person gym, tennis, bike, reasonably fit for my age.

Had right leg tendon rupture Aug 2, next day surgery. After surgery climbed to second floor of my home using good leg and butt. Not talking about pain. After day 2 stopped to take any pain killers. 9 Aug – 1 week later can walk with slightly stepping on right leg. Aug 15 - started to do isometric  exercises for injured leg. Able to walk with full weigh on injured leg. 2 weeks – first post op visit to OS.  Left me in full leg brace. I am not supposed to do any PT.  More exercises for leg and upper body. Aug 19 (2 weeks and 2 days) Cut Nails Hooray!  Drove my car!!! I can raise  my heel from the floor!!!  My ROM is about 95. When I compare our progress it is something strange – too fast? What do you think?  Maybe a new technology? Or something wrong with me?

This forum is amasing - helped me to to see the light at the and of the tunnel

Sam65

By the way I am Toronto Canada

Hello fellow forum members. On Thursday, August 16 I had surgery on right leg torn quad tendon. my leg is now encased in the immobilizer. I have many questions that aren't being addressed by the doctor or his office. The first is dealing with the psychology of healing. Everyone tells me to be patient. I understand that my leg is going to be in a brace for many weeks and that I have months of physical therapy thereafter. Your insights about going from active to disabled is appreciated. My other issue is my job. I used this years vacation and sick leave while out waiting for surgery. How have members coped during the rehab time? I have a desk job and I'm hoping in can work from home a few days a week. I'm eager to hear what others have done. Thanks.

Hi Metta

How for how long u have to wait for surgery?

Sam65

Hello Sam, I sustained the injury on July 29 and had surgery nearly 3 weeks later. I had to wait for Plavix levels to drop so my blood would clot properly. I hope some members can share their experience learning how to be patient with long term rehab. So far my best teacher has been my cat who seems to have no issues accepting the day with little activity.

Hi Metta

 

As far as psychology of healing goes, this whole experience was really depressing for me. I'm 10 weeks out of surgery and I'm finally able to regain some independence. For some reason, my recovery has been a lot slower than a lot of others on this forum. I was in a full leg cast for six weeks, on crutches for 9 weeks, and unable to drive until this week. I feel great driving again and being able to cook again, but the past 10 weeks were so depressing and draining. It really felt hopeless and I was worried I wasn't making progress fast enough, especially since I see other ppl in this forum driving 2 weeks after surgery. But like I said, I think my recovery was unusually slow. You really just have to get used to having a less active, less interesting lifestyle and the time will pass. Hang out with pets, lower your standards for television and start watching lots of terrible tv, go to the library (or have someone bring you books)..these are things I did. It sucked having people  constantly tell me to be patient because I'm used to always being on the go. It was really frustrating and defeating. But all you can do is be patient and wait for your leg to heal.

 

But again, I was in a gigantic cast, not a brace..that contributed to my immobility. If you're in a brace, you should be able to get back to a desk job soon, right? If I was able to work this summer I would have jumped on the opportunity b/c being on bed rest since May was terrible. I was so bored, lonely, and depressed. I'm just venting at this point. I'm still traumatized by this whole experience. But anything you can do to stay active without hurting yourself, you should do! Good luck. and feel free to vent on this forum! I need someone to vent with. I don't think people understand how mentally draining it can be to have surgery and be effectively disabled for months..it's tough.

Hi Metta

I am sorry U had to wait for so long

I have different experience

Had right leg tendon rupture Aug 2, next day surgery. After surgery climbed to second floor of my home using good leg and butt. Not talking about pain. After day 2 stopped to take any pain killers. 9 Aug – 1 week later can walk with slightly stepping on right leg. Aug 15 - started to do isometric  exercises for injured leg. Able to walk with full weigh on injured leg. 2 weeks – first post op visit to OS.  Left me in full leg brace. I am not supposed to do any PT.  More exercises for leg and upper body. Aug 19 (2 weeks and 2 days) Cut Nails Hooray!  Drove my car!!! I can raise  my heel from the floor!!!  My ROM is about 95. When I compare our progress it is something strange – too fast?

I am working every day.

But my leg steel swallen.

Sam65

Hi Chicadivertida,
The full leg cast must be a real pain. That would add to prolonged discomfort. I'm not sure the brace will get me to work any sooner. Plus I need to find a ride. This whole experience is a downer. I look to my cat for
Instructtions in resting. - Marc

Hi mettaman,

Its definately hard to sit around doing nothing, today makes 3 weeks post op for me I keep bussy on the phone with my freinds and customers, alot of TV and computer. I own my own small business which is a blessing and a curse, when I dont work not only do I not make money it costs me money every day I dont work. I had my work computer conected remotely so i could do some work from home. This at least makes me feel like im being a little productive and not waisting my time. 

My next visit to the OS is in 1 week, he told me i can start PT after that but have no idea what it going to be like.

ORG

 

I only got one injection and the purpose was to try to isolate the source of the continued discomfort (was it the quad connection or the patellar swelling or something else like arthritis on the back of the knee cap) and also to try to get whatever inflammation that was in there to calm down.  The injection actually helped to reduce the crankiness of the knee a little and did enable me to get back to a more aggressive PT regimine. I see the OS in 4 weeks and will give you an update. I found your comments about the patellar tendon to be right on in regard to my situation. I know that the knee will take a lot more time to heal - probably a year at least- and I know that I will be lucky if I even get near normal. I just want it to stop being sore, swollen and weak. 

Muddog,

I share your pain. One week post op for me and the "immobilizer" feels like an anchor. Does your leg twitch at night? When the alarm sounds in the am my leg muscles go nuts. It's like they want to engage and get ready for work. OS told me not to "fire" the quads. I do all I can to tell my legs we're not going to work today. Anyone else experience this and is there something you do to minimize the contractions?

Mettaman

My Dr prescribed vajium for that problem. It did help some.

I did experience muscle twitches for a bit after surgery, but eventually they went away. Icing seemed to help calm things down, that and ibuprofen.

does anyone here have quadriceps tendinosis? I am surprised I haven't heard any discussion of this with so many people with quad tendon tears. I do and my unruptured quad tendon is killing me. I have tried rest,prolonged rest,ultrasound, infrared, accupuncture, rolfing, graston technique and PT all to no avail. My surgeon tells me we just have to wait till it ruptures if PT doesn't help. I have recently started PRP(platlett rich plasma injection) and prolotherapy. I have had one treatment, I am told I should expect healing after 3-8 treatments. Does anyone here experience any problems with their unruptured tendon?

Hi Guys,

I'm 45 and have always been active, though not a skier, I found this forum whilst looking for info on my injury and was compelled to join. On 26Th May this year i was setting up my sound equipment for a gig my singing partner and i were doing in a pub and while i was setting the sound , one of the staff mopped the wooden floor of the restaurant and as i walked across the floor to listen the the sound, i slipped on the wet floor, my leg twisted and i heard a loud popping sound and I experienced pain like I've never known before.

 

When i was finally able to get up, i realized that something was very wrong and I couldn't walk. the following day I spent 10 hours in A&E only to have to go back two days later for a scan when it was diagnosed i had ruptured my left quads tendon.I had surgery five days later after which i was in a full leg cast for six weeks, which I've now been out of for five weeks and with physio I'm only up to 85° ROM so far ,which, i don't feel is very good progress considering some of the reports some of you guys in the states have been giving, it seems that here in the UK, the doctors have a far more conservative approach to treatment in getting movement back in the knee.

 

Like many of of you, i was in a full cast for long enough for my quad muscles to whither away to mush and the repaired tendon to become very tight and hard to stretch. Thanks to this every physio appointment is sheer agony as the PT tries to push my leg as far as they possibly can, and this is very slow going. Luckily I am able to drive but, however I am unable to return to work as my full time job is a commercial and industrial window cleaner, and due to the lack of ROM I cannot use ladders or walk up and down stairs properly yet, so I'm finding it all very frustrating, something I'm sure many of you will understand!

I have to say I feel your pain, ever since I've been able to weight bear i have been using my other leg much more, leading with it to climb stairs therefore putting extra pressure on it and I have been getting quite a lot of pain in my right tendon which, I assumed was down to the extra pressure on the leg. I do have to say that I have been a little worried that it could be the good tendon about to pop, and after seeing your post I am now even more concerned because I really don't want to go through that pain again, or the rehab as it takes so long and is so painful!!

Mettaman,

I too had the muscle twiching at night some times so hard my entire leg would shake and wake me up.One time I had it wile walking. During the day I had severe muscle pasms that would last for several seconds but no pain. On my 2 week follow up with the OS he said it was normal and told me start firing the quad by flexing it but not bending it 3 times a day for about 10 minutes. I have done it for about a week now and it has helped. I see him next Wednesday 8/9/12 and hopefully I can start PT. For a few day now I started using only 1 crutch on the good leg & puting more weight on the bad leg and using the entire foot insted of the tip only.