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Quadriceps Tendon Rupture, Repair and Rehab - Page 143

post #4261 of 10804

Cdn wrestler -- Those are some amazing goals.  I know I won't be there at 20/40 weeks, but I'm looking at this the same way -- it's an opportunity to come back stronger than I was.  At age 45 now, I've been stuck in a little bit of a rut the past couple of years athletically.  I've been able to maintain fitness but haven't had much improvement.   Now, I've really got some motivation to move past that.

post #4262 of 10804

I don't know if we have a self selecting group here but I have read a lot of these posts now and very few of us appear to be   sedentary couch potatoes- most appear to be 45+ men who have either been recreationally very active or have physically active occupations. I wonder whether this higher level of physical activity has actually placed us at increased risk of this injury. Certainly there is evidence that chronic inflammation of the extensor mechanism - sometimes called 'jumpers knee'    is a risk issue in people who play active sports- this may be a result as a result of cumulative small muscle tears. It seems that some persistent deficit in quadriceps mass and power is almost inevitable in this injury.



post #4263 of 10804

Catinthehat -- Your observations match mine.  Most of the folks on the thread seem to be very active guys in their 40s, 50s and 60s.  It was a bit of a relief to find this thread since many of the other online sources of information about quad tendon tears make it sound as though the injury is very unusual except in sedentary senior citizens who suffer a bad fall.  On the flip side, I've done a lot of Googling and I can't find one article about a professional athlete (i.e., someone very active in their 20s or early 30s) -- other than one professional wrestler -- having suffered a quad tendon tear.  Maybe it's happened, but I haven't found anything about it.


The article you linked to was very interesting.  I think we all hope to be the exception to the general rule that post-recovery quad tendon rippers  have less mass and less strength in the affected leg.  In other words, ideally, you turn out to be this guy:


One patient showed a better

score for his knee flexors at the two speeds, compared to the uninjured side. For his knee extensors
there was a small deficit at low speed and no deficit
at high speed. He was a highly motivated patient
who followed a very intensive rehabilitation program
post #4264 of 10804



I know of two recent QTRs in the NFL - :   Adam Carriker - a defensive lineman for the redskins, and Darryl Sharpton - a Texans linebacker.   I was watching a game and witnessed a ref suffer a rupture.   But, to your point:   few a far between.   There was one week this season that the NFL experienced four patella tendon ruptures.    


I do believe y'all are on to something though.   This injury does target active athletes in their 40s & 50s.   My personal believe is we all experienced minor tears early in our athletic careers and the injury finally manifested intself as we aged.   IMHO.

post #4265 of 10804

Great catches, Fred!  I’m a lifelong Steelers fan but live in the middle of Redskins territory so I should have remembered Carriker.  It’s interesting that neither of these guys has had a lot of success post-quad tendon injury.  Carriker went down the second week of the 2012 season and didn’t return the rest of the season (not too surprising!).  Sharpton didn’t return for more than a year after the quad tendon injury and then went out with a hip injury that was related to his comeback from the QT injury.    http://bit.ly/Z9cnLx  and http://bit.ly/WTMQm6.  That also isn’t too surprising to me -- since my injury, my hip flexor on the affected leg has been really tight. 


I did a little more research and did find at least one NFL player with a recent QT injury and a positive story.  Jeff King – a TE for the Cardinals apparently suffered a partial tear, had surgery in May 2012 and was back for the 2012 NFL season.  http://bit.ly/126PeuR, http://bit.ly/L2GETS  That’s pretty impressive! 


I agree too on the theory of having minor tears over the years.  I had a very odd bruise on theinside of my knee after the partial quad tendon tear that I had surgery for.  It was a very dark/deep round bruise that I had seen a couple of times before on the same leg and been puzzled by it.  It looked like I had been hit really hard on the lower/inside quad by a soccer ball but I couldn’t remember having been hit like that (and it looked like something you would definitely have remembered).

post #4266 of 10804

Have not responded for a while....but some recent comments peaked my interest. I am almost 16 months post surgery. Have done extensive rehab and strength routines. Can bike....squat, elip machines, stair climb as good as ever. But....still can not fully land run or stride normally from pre injury/surgery. I express it as tightness not allowing a full normal stride. I am very physically active having done 36 marathons....including Boston 3 times. All of my surgical followups show no further damage....I have no pain just tightness on running that no stretching or roller rolling program has helped. The medical pros keep saying it takes time. But for me going on 16 months I do not know if true running will ever return. I am 65 years old....so I realize I will not recover like a 25 year old. Maybe I should be satisfied with what I can do....but I am way too competitive to do that. Previous observations on some damage....even minor pre quad tear I believe. As a real active runner I believe I had some slight tearing from all the pounding over the years and a car accident led to my complete tear and surgery. But...I believe that the pre quad tear inflamation can lead to a complete tear given the right jolt....in my case banging on the dash of a car in an accident. Interesting observations on middle age and older active men !!

post #4267 of 10804

5 weeks, 3 days post surgical repair for LQR.  At therapy this morning, flexed to 83 degrees and doing mini-squats and leg presses of my weight with the slant set at 30 degrees.  All feels real good, stretching, but no pain.  I'm rather impressed that my OS started me with flexion and quadsets on PO Day 3.  I found some articles that support early motion and placing some stressors on the repair, as this is thought to stimulate increased collagen production, which then fuels healing.  My goal for this week is 90 degrees and I am pretty sure this will happen, as 83 degrees really didn't pull all that much.  I now can walk w/o any crutches, but still locked out at 0 degrees.  While in therapy, they have had me walk unlocked with a safety lockout of 70 degrees, to see how I do.  I am fearful of buckling forward, but my therapist assures me I now have sufficient strength to stop that.  All I know is it felt so good to walk normally, even though it was only for a short time at therapy.

post #4268 of 10804

I am 50 years old and tore my right QT slipping and falling on ice in the parking lot at work. 

I began PT two weeks out of surgery mostly motion and some isometrics. I was told by the surgeon not to begin strengthing until 3 months from surgery which for me is this week 2/13/13. I had the brace on my leg at home except at night all the time.  I began taking it off in the house only when I was at 6 weeks post op and the surgeon told me to take it off at 10 weeks post op.  I have swelling and stiffness when I "over do" for example out shoveling snow from this weekends storm.

I am at 90% right now for a bend (the total expected for me is 130 degrees and I am at 95 degrees).

Dont' know what to expect, I just want to be able to get on my motorcycle in a month or so and ride. 

Good luck to all who this has happened to; it is one of the most debilitating injuries I have ever experienced!


post #4269 of 10804

Hello fellow quaddies!


It's been a while since I've posted - I wanted to give an update that I hope is a positive sign for those of you earlier than me in the recovery process.


I'm a 42 year-old guy, very active physically, had a near-complete left quad tendon rupture during a bad landing on a trampoline. Injury was on July 25, 2012, and I had surgery July 31, 2012. I'm now just about 6.5 months post-op.


I'm happy to report that recovery is going well. I'm not even close to 100%, but I can see huge progress over the last 4-5 months. Here are some updates:


- my ROM is only about 5 degrees less than my uninjured leg - it is currently 143 degrees

- strength is about 70-75% the uninjured leg, but I am guessing it's not so far off from my quad strength pre-injury, as I am certain the uninjured leg is stronger and larger than it was before the other side was injured

- PT now primarily consists of (1) active stretching of the knee, (2) some massage work on the residual scar tissue in the area, and (3) a combo of strength and agility work. These exercises include plyometrics, which I have found to be incredibly helpful in getting back to running, jumping, and the like. The injured leg is still weaker, slower, and fatigues easier, but the trajectory of improvement is still good.

- my Ortho has finally discharged me from his clinic!


Best of all, I have the green light to try a little groomed run skiing this Spring, which should be around the 8 month post-op time frame.


Overall, I feel like tremendous progress has happened, but there is still a good 6 months before I will hopefully feel as close to "normal" as possible.


Good luck to everyone!

post #4270 of 10804

I’m only 11 days post surgery and went back to the office for the first time yesterday after working from home last week.  It’s encouraging to read about success from PatB, Lorwoman and oldbumper in the short term. I hope that continues. 


Old Runner’s post and some of his earlier ones are what worry me.  Although I enjoy participating in many other activities, at heart I’m a runner and have been a competitive one since the age of 12 (I’m 45 now).  If I never again played soccer, skied or ran another marathon, it wouldn’t trouble me too much.  But if I knew I’d never again enjoy -- without discomfort – going for a fast run during a spring rainstorm or listening to the leaves crunch under my feet as I race down my favorite trail on a crisp fall morning, my life would be a little less happy.  Old Runner – I wish you the best.  I hope you will post some updates.

post #4271 of 10804
I'm with you BruceVA...there's a wide variance in the complete rehab of the QT, it seems, and the uncertainty of knowing what I will and won't be able to do is concerning. I'm 47 with a fully ruptured RQT and 4 weeks post op. Saw OS yesterday and now have 30 degrees give in my brace...which is a delight I will add! I have instructions s to increase this by 30 degrees in two weeks and then another 30 two weeks after that. I will have 90ROM on the brace 8 weeks after surgery, but no physio or strengthening yet. I can walk without crutches around the house, can drive again and have no pain. I'm seeing all that as very positive! But as you say Bruce, if there are things I can't do, like jogging by the lake or hitting the black trails on the ski slopes, life will indeed have lost some of the things I love to do that bring great enjoyment and satisfaction. My son and I ski/board together and a big goal is to rehab strong enough to be able to keep doing that. Way too young to give up skiing! Hiking in the mountains with a full pack is another great love that I will return to one day. Just not in 2013! It's only one year of life I guess. Best to all! Cheers
post #4272 of 10804

I am 78 years old - 21 weeks post-op. My DOC has advised me to stay off of Snow and Ice. Take heed (lorwoman) - you do not want to re-injure your leg. Find someone else to shovel Snow or let it be. This injury take 12 months or more for full recovery.


Take care.



post #4273 of 10804

Been a while since I posted here. Currently 6 months post op and things are going great. Life is pretty much normal again. Not running yet (no rush to do so), but I ride the bike extensively and do leg presses and leg curls. The key to making it all come together is to keep moving. For all the newbies, it does and will get better. Don't rush it, but do your PT and keep yourself active and your leg/knee will come around. This is a 12 month process, so always keep that in mind.

post #4274 of 10804

Had my PT visit again this morning, with Flexion now to almost 90 degrees.  The therapist allows me to walk with the brace open to 70, while in session, but locked otherwise.  I am doing alot of various exercises, concentrics and now isometrics starting today as well as the addition of some extension work..  The Iso's are "hard" but maybe thats because it all new, and my leg ihas lost so much.  (6 weeks post-op, in 2 days).  She tells me I am exactly where I need to be, and I can expect to recover ability to everything I did before, including deer hunting in the mountains (where this injury occured) by next fall.  She did add, this is one of the most devastating injuries to rehab, so be patient and it will all come together.  She also assures me now, that except for a fall with hyperflexion, there is nothing we can do that will interfere with the repair from this point on, so that is very comforting.

post #4275 of 10804

30 degrees of freedom sounds pretty good right now, so I'm a little envious of Ashb.  I'm locked out at 0 degrees for at least two more weeks before my next appointment with the OS.  I had a little scare last night.  I woke up with a fairly bad burning sensation in my knee -- not just the usual quad muscle soreness I've been feeling since the surgery.  There wasn't much I could do about it 2:30 a.m. and I wasn't going to head to the ER/call the doc's after-hours line at that hour, so I went back to sleep as best I could.  Fortunately, it seemed fine when I woke up and has been OK the rest of the day.  In the first couple of days after the surgery, I had some really strong contractions in my quad and I suspect I had one of those again, which probably gave a pretty good tug at the OS's handiwork.   

post #4276 of 10804

Hi gang,


Just wondered if anyone has any luck increasing ROM by using a heating pad on your knee before you stretch it. I'm always afraid I'm going to "pop" something when I stretch it, and have to start over again. Still stuck around 90 degrees, at 20 weeks post-op. (walking alot on the leg now, and experienceing some back pain, otherwise good.)

post #4277 of 10804

Heating pads help to "loosen" the tissues so you can get a better stretch. Don't worry about anything popping in a bad way. I used to worry about that kind of stuff back when I was going through rehab and looking back, it was unnecessary. You will hear and feel pops in the knee...that is the scar tissue(s) breaking up. You WANT to hear that. When you start walking around without a brace, you will get all kinds of pops and cracks out of the knee as it cycles through it's range of motion under full body weight, etc. At 6 months out, I still get an occasional pop or crack out of my knee.

post #4278 of 10804
Originally Posted by BruceinVA View Post

30 degrees of freedom sounds pretty good right now, so I'm a little envious of Ashb.  I'm locked out at 0 degrees for at least two more weeks before my next appointment with the OS.  I had a little scare last night.  I woke up with a fairly bad burning sensation in my knee -- not just the usual quad muscle soreness I've been feeling since the surgery.  There wasn't much I could do about it 2:30 a.m. and I wasn't going to head to the ER/call the doc's after-hours line at that hour, so I went back to sleep as best I could.  Fortunately, it seemed fine when I woke up and has been OK the rest of the day.  In the first couple of days after the surgery, I had some really strong contractions in my quad and I suspect I had one of those again, which probably gave a pretty good tug at the OS's handiwork.   

Yep, burning sensations are normal. The muscle contractions are normal too. The burning will go away as it heals and the contractions will go away when you start bending and using the knee/leg again. Right now, the quad muscles are "not happy" that they are not being used. Being locked out sucks, but it will pass and fade into a distant memory. Trust me. 

post #4279 of 10804

For those that are having trouble gaining ROM using the traditional methods, you might want to look into this product or at least mention it to your PT, the ERMI Knee Flexionator. This machine got me past my "ROM RUT" of 100 degrees back when I was in rehab. www.getmotion.com

post #4280 of 10804

ChitownBob -- Thanks for the good advice and tips!  I hope I don't need it, but the Flexionator looks interesting.  The video includes Adrian Peterson who made a really astounding recovery from ACL/MCL surgery, which definitely gets my attention.  This article focuses on ACL repairs but it's still an interesting read concerning comebacks after knee surgery including Peterson's:  http://usat.ly/UkM4QB. And with a nod to Epic Ski folks who are graciously hosting this mostly non-skiing related thread, I'll note the article mentions Lindsay Vonn and her recent surgery.  (Looks like she may be wearing the same brace I have.)

post #4281 of 10804
Quick update
I came out of surgery about 4 hours ago after having an arthroscopy to remove scar tissue and a manipulation of the knee and am currently lay in my hospital bed on a knee flexor machine which is flexing me to 120 degrees which is a big jump from 98.
Apparently during surgery, they flexed my knee to 125 degrees and I have very little pain to speak of so I'm very happy right now and if any of you out there are having problems with being stuck at a limited ROM, then I highly recommend this procedure, I may still have a long way to go but this have given me hope.
I wish you all speedy recoveries,
Peace and best wishes Steve.
post #4282 of 10804
Great to hear Steve! You have had your share of bad news with your recovery so it's fantastic to hear that has turned around.

Major scare last night! Moving round the condo without crutches with that 30 deg of flexion in my brace, when something spasmd and my leg felt like it was about to buckle - that same feeling I had a couple of times right after I ruptured the QT when I had to walk 3/4 of a mile for help. I did fully buckle and fall on those occasions but last night the brace saved me from a major setback! Note to self - still have to be very careful!

Any advice/thoughts on the best way to heal the surgery cut without a 6 inch gash in the knee being too noticeable?
post #4283 of 10804

Thanks to all on the flex info. I'll check into the ERMI machine. I feel great knowing there are so many good folks in this forum willing to help.....

post #4284 of 10804

I'm using a product called Kelokote, which is designed to minimize the scar from surgery.  Plastic Surgeons have their patients use it.  You have to search for it, it's not something you can get at the CVS or Walgreens.  Interesting you are open with your brace on a 30 degree lockout.  How far post op are you?  Thanks

post #4285 of 10804
Hey everyone! I've been following this forum for a couple of weeks bc I had a major dirt bike wreck and ended up tearing my quadricep tendon in my left leg. I have been doing PT and I seem to be getting my ROM back but I'm stuck at 110 degrees of flexion. Any suggestions at this point? I also went back to work, I do retail sales 10 hours a day and felt a severe tear under my knee cap and have had a burning sensation and an even more severe limp since yesterday when this occurred. I really hope I didn't do any damage bc it did not feel like the scars breaking loose which I have had before frown.gif
post #4286 of 10804

Looks like I'm joining the crowd. Fell on some ice last Thursday 2/14 (Happy Valentine's Day). Was able to drive home...called my wife enroute expecting transport to the ER. RT knee gave out and fell again while waiting in the driveway. Called 911 and the ambulance was here in minutes. I'm a 60% disabled vet, so went to the local VA hospital (attached to the acclaimed U of Wisconsin hospital). They shot me up with fentinol (sp) and went to x-ray. Ortho docs finally looked at me and they determined it was a total rupture. They indicated I might have to wait a couple of weeks for surgery. Also said that rehab was easier than a total replacment I had done on my LT knee. I'm becoming skeptical after reading some posts here. Got a call from the ortho pre-op nurse the next day and now I'm scheduled for surgery this Wednesday 2/20. They also said it would be day surgery which kind of surprised me. I'm in one of those immobilization braces and have crutches. Actually, I can gimp around on it as long as I totally eliminate the chance of my knee flexing. Any thoughts on anesthesia? I've had some uncomfortable surgeries with the epidural and hope I can opt for the general. Any tips, thoughts and/or suggestions would be very welcomed. Thinking of all of you out there! Heal quickly!

post #4287 of 10804

Dear Eric,

I have some earlier posts about my post operative experience, my view is that this injury can be very painful post op because they have to stretch the muscle back onto the tendon to repair it (particularly in my case where the repair was delayed) so good post op pain relief is essential. My posts 4115, 4103 & particularly 3771 which was just after the surgery might be  helpful. Good luck!

post #4288 of 10804



I would go for a general, also don't let them kick you out the same day. I had a nerve block, after 24 hours it started hurting so bad they kept me another night. So at least one night in the hospital, maybe two. Good luck, be careful, sorry you're here, but this list has lots of good information.

post #4289 of 10804

Thanks for the feedback. Don't know if I have any choice about the day surgery. I will inquire....definitely want the general and also you can leave sooner with that versus the epidural. Anybody out there had a total knee for comparison?

post #4290 of 10804

Eric:  You can walk on it while locked out at 0, because there are no bones involved.  As for the anesthesia, I had a general, but with a Femoral Nerve Block placed for post-op pain control.  This operation hurts, no 2 ways about it.  Ask about the nerve block with an On-Q ball that you take home.  The system delivers a constant rate of 1/8% Marcaine to the femoral nerve at about 10ml per hour.  The Q-ball has enough Marcaine in it to last about 40 hours or so, and it numbs the sensory nerves to your anterior thigh and knee (The motor function isnot impaired, so you can be up without problems).  I had no pain at all for 40 hours, and by that time, oral pain pills was more than enough.  As for the comment about easier to rehab than a TK Replacement, I'm not to sure about that one.  In a TKR, the extensor mechanism is not inturrupted (i.e.; the quadriceps tendon) so none of that comes into play.  My therapist told me that this injury is one of the most devastating things that you can do tothe tendon structure of the leg.  It is titally recoverable though.  You might have some reduced muscle mass and reduction in strength as measured against the uninjured leg, but most don't or willnot notice that in the end.  In my case, I fell in the mountainswhile hunting deer.  Pretty rugged terrain.  My OS said there is no reason I won't be doing that agin next fall.

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