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Quadriceps Tendon Rupture, Repair and Rehab - Page 127

post #3781 of 10835

StevieP, yes it is very painful when I stretch it. Since I know the knee will move (from the manipulation I had 2 weeks ago) the pain is the only thing holding me back. I take a pain med before I go into PT which helps a little. One thing I am learning, it is not necessary to push yourself to a level 10 pain to gain more ROM. It is better to go to level 5 (or whatever is comfortable) and do it for a longer period of time.

 

Also, I learned a technique from one of the PTs that seems to be helping a lot. I do about 5 - 10 reps of these:

  1. Do an extension and hold your quad pushing in the extension for about 30 seconds (this fatigues the quad muscle so it will stretch easier)
  2. Next start your stretch and slowly bend your leg (I try for about 30 seconds)
  3. At the end of your range of motion think about contracting your leg normally (or your body will be fighting it) and consciously try to bend it. (I started that last week and I noticed it actually move at the end of the stretch)
     

I go to the gym during non PT days and use the leg extension machine to do the technique above and then I do 5 - 10 reps on the leg press machine. I only use 10 lbs on the machine and use my good leg to control it and just do long stretches at about level 5 pain threshold. Also important to do deep breathing during the stretches, this will help with the pain.

 

Let me know how it goes.

post #3782 of 10835
My PT and her office manager said to stay away from the leg extension machine like the plague. It puts way too much pressure on the knee. My personal trainer at the gym says the same thing. Others on this board have received the exact same advice.
post #3783 of 10835

Hi tomnorth, if they are telling you to stay away from the leg extension machine then you may want to. The PTs in the office I go to and my surgeon advise me to do it and it is definitely helping me. Thanks.

post #3784 of 10835

Hi every one;

 I'm 5 weeks post op, at week 4 i had my second follow up with OS.he started me on PT 2 times a week.

PT is 60 ROM, basic streching, ankel pumps,quad flexing & leg raisers.

My PT also admisters heat, electic stimulation, ultra sound, massage & cryocooler therapy

My question is that i can bend my knee to about 80-85 with no pain & very mild tightness.

Do you think i should bend it to 85 or should i stick to 60 ROM

Is there any other exercises i should be doing.

My next visit to the OS is at week 7

 

Thanks

post #3785 of 10835

Hi Muddog,

It is interesting to compare I am also 5 weeks post Op.

What I can do now:

120 Rom, driving car, can walk without hinges at home (straight leg). Able to raise my heel when on the back. 30 min walk in the swimming pool, knee swallowed lightly. Doing some ex for upper body.

At around 90 rom can feel tension. Can use stationary bike fo 10 min - no pain. My OS (when I saw him after 2 week post op) did not recoment any PT for now. Will see OS next week(6 weeks post op). Mesured temp of injured knee - 38 C, normal 36.2C. Leg is very weak but I can feel muscles. Had massage it is very helpfull.

Take care, Sam65

 

.

post #3786 of 10835

Hi guys,

Sam65, I have to say I think you're very lucky to get to 120° within 5 weeks of your op, I'll be 14 weeks post op on Sunday and I can only just get to 85°, so it sounds like you are doing well. Muddog, I would say that if you can get to 85° without pain then I would do it, and i would read QT159's advice to me a little way up this page, I've been trying it for the last couple of days and think I might now be up to 90°, I will find out tomorrow at PT. I have to say thanks QT159, my leg certainly feels a little bit better since trying those exercises.

 

best of luck to all of you

Steve.

post #3787 of 10835

Hi Steve,

I feel bad and hope I am lucky. From what angle you feel tension? My starting at about 80

Sam

post #3788 of 10835

Ki Sam65

 

I too could lift my straight leg with no pain laying down or sitting in chair

Around the house I ocasionaly walk with out brace or crutches & it feels Ok

My OS & PT want me to use brace & 1 crutch 50 percent weight

At week 4 follow up I was able to do 85 ROM no pain small amount tension

OS limited me to 60 ROM ????

Started PT & driving  next day but get discomfort after 1/2 hour of sitting in car

Today I trimed 5 palm trees in the front of my house (they were out of control)

I still cant go back to work I build off-road trucks & it would be too demanding & hazardous

post #3789 of 10835

StevieP

 

I do 85 ROM normaly & feel i could do more with no pain but my OS tells me not

I dont understand why he stops me if i have no pain & no stiffness

post #3790 of 10835

HI guys,

SAM65, I start to feel tension at about 60-65° and then at 80-85° it just gets really tight and painfull.

 

MUDOG, I would say he's telling you that because at 5 weeks the tendon won't be properly bonded back to the bone yet, i dare say he doesn't want you

to risk re-tearing it, I really don't think you would want to go through it all again, I know I wouldn't!. Saying that, it is starting to look like i may have to go for a second op

to try and get some more movement in my knee as it seems to have reached a plateau that it just won't go past. I'm off to PT a little later and will hopefully know more.

all the best to you all

Steve.

post #3791 of 10835

Hi Muddog,

I am in Toronto - no pulm trees - in few months I will deal with snow

Will update my progress next week - after 6 weeks post op and visiting OS

Good luck to all of you (to all of us)

Sam

post #3792 of 10835

Stats:

42 year old male, very physically active

Injury: Near-total Left quad tear whilst trampoline jumping

Injury Date: 25 July, 2012

Surgery: 31 July. 2012

Now 5 weeks postop

 

Hello all,

I was hoping to get some opinions here. I'm just getting into the PT routine, now 5 weeks postop. I'm at about 30-40 degrees ROM, doing wall slides and heel slides. My question: how much discomfort should you feel when trying to stretch during these ROM exercises? I'm getting a tugging/pulling feeling at about 40deg ROM, and I'm not sure at this stage I should go beyond that. My ortho's protocol puts me currently on track, but I should be shooting for 70degrees within the next week or two.

 

Thanks for the advice!

post #3793 of 10835

Hi oldbumper, welcome to the gang.

 

Firstly, I think you are lucky to be starting physio at 5 weeks, I don't know which side of the pond you are, but here in the UK the ortho surgeons are quite conservative in their approach 

to this type of procedure in respect of rehab. I was in a cylinder cast for 6 weeks, which caused my quad muscles to wither to mush, and caused the tendon to tighten up, this of course is the reason I'm having to endure lots of pain stretching the tendon and muscles every week. 

 

I would say that at your stage of rehab, you should only push yourself as much as you feel comfortable with, I've seen a few posts on this forum that seem to promote the idea that it's 

not really safe to push it too much until about 4 months, that said, everybody seems to have differing ideas on this matter. Me personally, i think it is better to promote movement

early on, if I'd had the chance to start PT earlier then I might not be going through so much pain right now, on that note, I saw my PT today and he got me to 92°, so I'm quite pleased with that.

 

I have to say thanks to quadtendon159 for the advice, it has really helped me this last week, at this rate I might not have to have a second surgery after all......with a bit of luck!!.

post #3794 of 10835

Hi StevieP,

 

Glad to hear you are improving.

Thanks for the advice,

I'm afraid that my knee might get stiffer with time if I don't move it now.

But I definately don't want to hurt it again.

post #3795 of 10835

Welcome Oldbumper,

 

I'm also 5 weeks post op I could bend my knee to about 90 sliding it on the floor wile sitting but  I have no pain or stiffness

If it hurts you or feel to tight I would not push it

My problem is the oposite my OS wants me at 60 even though I could do 90 or more

post #3796 of 10835
Quote:
Originally Posted by QuadTendon159 View Post

Hi tomnorth, if they are telling you to stay away from the leg extension machine then you may want to. The PTs in the office I go to and my surgeon advise me to do it and it is definitely helping me. Thanks.

For those who don't know me, briefly I ruptured my left a year and a half ago, and have tendinosis in my right, My rehab has been stalled/going backwards the last several months. Part of it is the unruptured tendon on the right with the tendinosis, another part is sig remaining scar tissue on the left. All the Pts and orthos I know recommend "closed chain exercises for rehabb, like squat and hack squat, and see the leg extension as evil. Oddly enough the only exercise that doesn't cause me pain is the leg extension of those three. I move the foot pad up so my leg starts the move at about a 70 degree angle as opposed to 90 or beyond. No pain. Squat hack squat, can't go more then a 1/4 rep without pain. So I agree perhaps its because no two people have the exact same body mechanics, but if extensions don't cause pain in the tendon.....they are not causing injury....the body is smart like that!

post #3797 of 10835

Muddog and StevieP,

Thanks for the replies. After reading through most of this entire thread, I've definitely gotten the impression that 5 weeks is still within the healing period. I'm trying to push the ROM without getting to the point of any pain for the time being. I'm guessing once I'm at about 8 weeks or so, I can really start to push it.

 

It feels like I just finished the first mile of a marathon - glad that it's over, but I know there's still a long road ahead.

 

BTW, I'm in California.

post #3798 of 10835

All newbies.

club. I'm almost 5 mos post op. Full rupture right quad tendon. Mayo Clinic. Two months in casts (straight leg for one month, hinged for one month) then immobilizer for one month. Mayo insists healing comes first, taking three months, then tendon stretching for ROM and rehabing muscles. PT twice weekly for four weeks. Work on my own now.

Walking normally, upstairs good, downstairs dicey, cycling every other day about an hour on the flats with full pedal cycle, walking in pool (can't swim well). Icing after any phsical activity or after standing a while.

Will hope to begin Tai Chi and Yoga soon. Both are very slow movements that strengthen core muscles and nerves.

Appt with surgeon in two and a half weeks.

 

My advice: patience, let it heal first; then slowly into streching, rehabing muscles. It will happen.

 

Active Padre

post #3799 of 10835

Lost the first line of my last post:  Welcome to the Club!

post #3800 of 10835

Wow Muddog...you are making major progress so quickly after surgery! What does your Ortho say about this type of progress?

 

A little about me. I'm 36, great physical shape, have lifted weights since my teens, always active and on the go, and knowing that, I still managed to pop the right quad jumping off a diving board. Very unspectacular way to go down, but it was enough to pop it. I've been lurking here since I injured myself 5 weeks ago and honestly, it's a lot to absorb. Aside from not being able to walk like a normal human being, not being able to drive, not being able to go to work due to a no crutches policy and being camped out in the recliner for hours on end like a coach potato is hard to deal with. My wife tells me to relax, but it's hard. I know all you other type A personalities can relate.

 

I'm seeing no two people are going to rehab the same. I'm currently just a little past 4 weeks post-op and started light PT 2 weeks ago. I'm just doing whole leg leg exercises, light quad activation, electro-stim, and I just started doing heel slides and knee bending this past Wednesday. I'm at a whopping 20 ROM, but I'm in no rush to bend too much too fast as I'd rather not pop this thing again and have to start all over again. During bending and heel slides, the knee and quad area above it are stiff and tight, which is to be expected. My PT and Ortho both said once I clear the 6 week post-op period, they will get more aggressive with the PT. 

post #3801 of 10835

Hi chitownbob,

 

My ortho thinks its great but is concerned that I may reinjure it if try to push to hard or to fast

his concern is that i have no pain and small amount of stiffness so its easy to over do it

He is right because I feel more cofident than I shoudl and the concern is that the tendon is not fully healed

post #3802 of 10835
Quote:
Originally Posted by catinthehat View Post

Having just had a repair in the UK privately (covered by my work health insurance) as the wait on the NHS was going to be too long- had the misfortune of slipping on a path while on holiday in Devon and was seen there in A&E but could not get a referral to the orthopaedic surgeon from my GP because the receptionist would not allow me to talk to the GP on the phone and insisted I had to return and see the GP in person. The irony was that when we did eventually get back I ended up having a telephone appointment anyway  and the referral to orthopaedics that the receptionist allegedly faxed to the local  hospital never arrived and I had to go to the GP surgery and pick up a copy and take it into the hospital myself. Privately referred  I saw the orthopaedic surgeon in under a week and had an MRI the same day and was in for surgery within 3 days.

 

What I would say that post op the pain was absolutely unbelievable, I was given oral pain relief paracetamol/ibuprofen/oromorph but because I had post operative vomiting I was essentially without any pain relief for about 8 hours until they finally gave me an IVI antiemetic to stop the vomiting and then IVI paracetamol and oromorph by mouth- I was finally approaching comfortable after 12 hours post op, the pain was so excruciating I am going to suggest to the orthopod that he should recommend a narcotic drip initially for people who have this procedure- that is what my mother had in Australia for  her hip replacement which she described to me as virtually pain free.

 

I now have a backslab on with my cricket bat brace- due to have it removed in 10 days time then hopefully will have an articulated brace.

Sorry you had such a hard time. I had completely different experience of NHS. Rescued by ambulance, prompt attention by team of doctors/surgeons, operation about 24 hours after the fall,

excellent treatment thereafter. Derby City hosp.

About 22 weeks and recovering well. Back on my bike and hill climbing (with care). Walking better, still difficult down hill or steps but improving.

Main thing is take it easy - if it hurts stop doing it. You can help the recovery but you can't force it.

post #3803 of 10835

Muddog and chitownbob,

Looks like we're in the same boat in terms of date of injury and surgery. I'm really interested in seeing how we all progress with the rehab. It seems, like lots of folks on this board say, the rehab plan varies tremendously from person to person.

 

Just had another PT session yesterday - got to between 40 and 50 degrees ROM, but there was definite stretching sensations involved at the tendon. I'm definitely concerned about taking it slow and not reinjuring the surgical site, but on the other hand it also seems like if you take it too slow, you risk limited ROM, excessive scar tissue, need for things like MUA. Seems like it's a tight balance to maintain.

post #3804 of 10835

I think the big weakness in the NHS is the lack of connectivity, if you have your accident in one location and you cannot return  home immediately then getting a timely referral to my local NHS orthopaedic department seemed almost impossible. I was told in A&E in Torbay that it was my responsibility to organise the referral they could not do it for me. They would not organise an MRI in Devon because I would be returning to Northampton and I was told I would have to have one there. The receptionist at my GP surgery would not allow me to speak to any of the GP's I had to make an appointment to see one -and guess what -there were no routine appointments with anyone for over 3 weeks!  I tried to get an emergency appointment, in the end when I returned I could only speak to a GP on the phone. The staff a the acute knee clinic were pretty unhelpful and gave me a date for a further 2 and a half weeks which meant I would have been over 5 weeks without getting an assessment. If I had injured my knee locally and taken to A&E by ambulance I may well have had a similar experience to yours. Getting injured in the middle of the summer holidays when many doctors (like myself)  with school age children are on leave probably didn't help either. 

post #3805 of 10835

hello i'm glad i found this forum. after reading many of the post i noticed that there is not hardly any discussion on supplement use. i am currently going on 7 weeks post op from a bilater quad rupture.

 

 hear is what i've done ...

 

used the following supplements: {CISSUS, MSM,CHONDROITIN,GLUCOSIMINE SULPHATE,} BROMELAIN, TURMERIC AND FISH OIL. right after surgery

 

 

{   } will strenghten the tendons and make for speedier recovery

 

 

in my 4th week i started using magnotherapy to increase the blood flow in the effected area. i would place the magnets inside of the flex/hinged brace sleeve and perform various exercises. this improved circulation and reduced pain

 

i was 78-85 ROM in my 4th week, continuing into the 6th week in now have 90 degree ROM. The Dr. was baffled that i was not tight was able bend my leg that far without any pain.

 

also before exercising i would massage with a sport flexing cream for a good 8-10 minutes on each leg.

 

i can walk without the braces and do so around the house, still not outside just yet.

post #3806 of 10835
Are you on any other medications? Does your surgeon agree with the supplement use?
post #3807 of 10835
Quote:
Originally Posted by catinthehat View Post

I think the big weakness in the NHS is the lack of connectivity, if you have your accident in one location and you cannot return  home immediately then getting a timely referral to my local NHS orthopaedic department seemed almost impossible. I was told in A&E in Torbay that it was my responsibility to organise the referral they could not do it for me. They would not organise an MRI in Devon because I would be returning to Northampton and I was told I would have to have one there. The receptionist at my GP surgery would not allow me to speak to any of the GP's I had to make an appointment to see one -and guess what -there were no routine appointments with anyone for over 3 weeks!  I tried to get an emergency appointment, in the end when I returned I could only speak to a GP on the phone. The staff a the acute knee clinic were pretty unhelpful and gave me a date for a further 2 and a half weeks which meant I would have been over 5 weeks without getting an assessment. If I had injured my knee locally and taken to A&E by ambulance I may well have had a similar experience to yours. Getting injured in the middle of the summer holidays when many doctors (like myself)  with school age children are on leave probably didn't help either. 

Sounds like I was in worse condition. No way they could have discharged me for later referral - I was in intense pain and clutching the gas and air. I couldn't move without passing out. They didn't even bother with MRI; the diagnosis was "clinical",  just Xray for broken bones (non thankfully).

Maybe they get top marks for emergencies but not so good when under less pressure. The food was appalling however!

Things can only get worse under the steady move to privatisation.

post #3808 of 10835
Quote:
Originally Posted by oldbumper View Post

Muddog and chitownbob,

Looks like we're in the same boat in terms of date of injury and surgery. I'm really interested in seeing how we all progress with the rehab. It seems, like lots of folks on this board say, the rehab plan varies tremendously from person to person.

 

Just had another PT session yesterday - got to between 40 and 50 degrees ROM, but there was definite stretching sensations involved at the tendon. I'm definitely concerned about taking it slow and not reinjuring the surgical site, but on the other hand it also seems like if you take it too slow, you risk limited ROM, excessive scar tissue, need for things like MUA. Seems like it's a tight balance to maintain.

I have PT every Monday and Wednesday afternoon for the next few months...my Ortho wanted it 3 days a week but my insurance only pays for 50 visits, so I had to trim down the frequency.

 

This Wednesday I'll be 5 weeks post op. I expect to stay "light" with bending until I reach the 6 week mark next Wednesday. I know to expect some discomfort, that's a given, I just don't want to re-tear it in the process of trying to loosen it up. My wife says to stop worrying.

 

I would love to start working out my upper body again as I feel lethargic from minimal physical activity. All I have to say is Netflix and the internet have made this sidelining of my life more tolerable. 

post #3809 of 10835
Quote:
Originally Posted by Muddog View Post

Hi chitownbob,

 

My ortho thinks its great but is concerned that I may reinjure it if try to push to hard or to fast

his concern is that i have no pain and small amount of stiffness so its easy to over do it

He is right because I feel more cofident than I shoudl and the concern is that the tendon is not fully healed

You're lucky that you have minimal stiffness. The first time they went to bend my leg, let's just say it was an eye opener. Not that it was painful, it wasn't, but the stiffness was hard to believe.

 

Are you normally pretty flexible? I know I'm normally somewhat tight...always been kind of a Frankenstein according to my wife. lol

post #3810 of 10835

Citownbob

 

Yes I have alway been very flexible specialy my legs

I never thought of it but maybe that has something  to do with my lack of stifness

I go to PT on Tue & Thu but they do nothing for ROM

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