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Quadriceps Tendon Rupture, Repair and Rehab - Page 144

post #4291 of 10802

Eric, I hate to be the bearer of bad news but you will find this rehab MUCH harder than a knee replacement.  I haven't had a replacement but i have been around a lot of them and they seem to be a piece of cake compared to this.  However, after six weeks or so a quad rupture gets much better with consistent hard work in rehab.  I am four months post op now and I can do everything but run.

post #4292 of 10802

Just finished my PT session today (I am 6 weeks and 3 days post-op) and now I can walk with my brace open but locked out at 90 degrees.  What a relief, it makes getting around so much easier.  I see my OS tomorrow and since I am spot on in my rehab plan, we expect that I can ditch the brace altogether in another 2 weeks.  Hoping large for that.  BUT, there is still much work ahead.  My flexion was 91 this morning, with goal being 135.  We have really just begun with the active extension work, and the strength re-building, I suspect will take more months.

post #4293 of 10802
Thanks PatB. I'm just using some Vit E cream right now, but I'll look for some Kelokote.

Today I'm 5 weeks post op. The 30 degrees of flexion in my brace is awesome! Looking forward to next week when I'm allowed to open the brace to 60. Have started very light 30 degree extensions and engaging the quadriceps muscles together with side leg raises to keep the adductors honest. I'm noticing this is helping a lot in getting back to a 'natural' walk with the brace. That 30 deg of flexion is invaluable to be able to walk without crutches and fully weight bare on my right leg. Getting in and out of the car is much easier and driving again has greatly helped the mindset. Never been one to be stuck in one place! Things are already looking better and I'm celebrating the small victories.

Eric - I agree with others about the general! I was offered consciousness but quite happy to be out for this procedure. My pain levels were very tolerable with just some Advil level pain relief being all I needed for the most part. I did have a couple stronger meds immediately post op but that was it. I can see this being an outpatient procedure but I'd definitely try and get a night in hospital especially if you take the general.

One thing I thought I'd share is that I've been incorporating whey protein shakes, BCAs and glutamine supplements to my diet since I returned home 2 days post op. As a bit of a gym junky I've used supps a bit and my theory is that in rehabbing the leg muscles and trying to avoid atrophy of my right quads, boosting some muscle builders can't hurt. My quads are not what they were, but I haven't lost what they said I would lose either. With the strength I can already feel coming back in to my leg, I'm hoping this is a contributing factor. Be interesting to see what the PT says when I finally get to that point in a few weeks.
post #4294 of 10802

Surgery set for Wednesday AM as previously noted. Any thoughts on long distance plane travel (Spain) four months post? Be honest now, or am I dreaming? Was planning a visit to see my daughter in mid-June. Would involve a 12 hour flight (in coach), can't afford the 4K bump to business, and also some getting around over there.

post #4295 of 10802



I had the day surgery, got the femoral block, and they put me under.  I can only imagine how painful it would have been had I not received the nerve block but I'll have to say that my experience might have been fairly unique because I had zero issue with real pain.  The block lasted 24 hours and they gave me hydrocodone to take every four hours.  I wanted to stay ahead of the pain so I made sure to take the two pills every four hours, even setting my alarm to wake me up to make sure and take is I didn't awaken in pain.  Within 48 hours after surgery, I was only taking one pill every 4 hours and then I started stretching out the time to 5 hours and continued to increase until I was off of them and I still had a lot of pills left.  The doctor wanted me to keep them handy to take before I did physical therapy once I started that.


Only one time during the process did I feel I was behind my meds and started to feel uncomfortable befor the meds kicked in.  It wasn't even really painful as much as I just couldn't get comfortable. 


Another thing that might have made mine easier than some is my surgeon had an Iceman cooler that helped a lot.  I had a wrap on my leg and then there was a thing that looked like a really thin hot water bottle that wraps around the swollen area with a way to attach it to a motorized pump placed in an icechest full of ice and water.  It would flow the ice cold water all day.  A really really big ACE bandage was then wrapped around it all to keep it all in place and compress the area.  It really kept my wife running to keep it full but I used it every day for a couple of weeks because anytime the leg would want to swell or get hot, the water would bring it all right back in line.

post #4296 of 10802

I gave the wrong number for my first post operative post- if you click on my name you can see all my posts- I think its the second one. I have pasted some of my entry below.


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.


On the subject of sitting on planes I had to take a Ryanair flight to Dublin from the UK for work a couple of weeks ago- my leg started to ache terribly after about 20 minutes as it was in a more or less fixed 90 degree position (with about only 10 degrees flex extension either way). I am 6 months post op. Fortunately it was only a one hour flight. A similar thing happened a couple of weeks earlier when I had gone to the cinema with the kids to see the Hobbit- happily there were vacant seats nearby and I could move and stretch out my leg.


So if you must go on a long plane flight I would suggest you take some pretty heavy pain relief just in case- in a standard airline seat there is not much leg room.

post #4297 of 10802
Eric - I currently live in New Zealand and 5 days before my RQT rupture I booked a return flight from NZ to Vancouver to begin a few weeks of selling my wines in North America. The first questions I had for my OS and PT is if I could still make that trip on March 23. No one here felt I should cancel. Fortunately, Air New Zealand recently changed how you can select your seat, so paid a $75 surcharge to get exit row seating on a 777 which means no seat in front of me. First time I'd done that and then 5 days later that was one great decision! You should be fine at 4 months. I'll be at the end of harvest after 3 weeks travelling when I get to 4 months post op. Will be being very careful while I'm away I will add!!
post #4298 of 10802


  At four months flew LA to London.Would strongly recommend compression socks

on both legs and moving around every hour if possible. Of course stray very hydrated

also very important.

                               All The Best,


post #4299 of 10802


I also recomend you to take aspirin


post #4300 of 10802

I am 78 years old and now at 23 weeks Post-Op. I am at 132 degrees ROM. At 4months (17 weeks Post-Op) I had 122 degrees ROM and got around good - drivings, walking etc. At that time decending Stairs and Walking on a down sloop of 10 percent was not real comfortable - a cane helped a lot.


So about your trip - wear your brace and take a cane just in case you need it - but be very careful.


Good Luck

post #4301 of 10802
Thanks Sam and Calhiker! I fly pretty regularly with my work and have a few long hauls each year, but this next trip will be a whole new experience I think. Cheers
post #4302 of 10802
Originally Posted by Eric308 View Post

Surgery set for Wednesday AM as previously noted. Any thoughts on long distance plane travel (Spain) four months post? Be honest now, or am I dreaming? Was planning a visit to see my daughter in mid-June. Would involve a 12 hour flight (in coach), can't afford the 4K bump to business, and also some getting around over there.

You should be fine at four months post surgery, although you'll want to get up and move about. My surgery was on Dec 1, 2011 and I took a 2-1/2 hour flight at the end of March, 2012 with no trouble. Granted, it wasn't a 12 hour flight.

post #4303 of 10802

Hello everyone! 

I just wanted to say I have been following this thread since my injury occurred in November and I wanted to say thank you to everyone who have shared their stories and advice! I wrecked my dirt bike and tore my LQT, broke my left ankle and dislocated my hip. I was locked in a straight brace for 4 weeks and then started physical therapy. Currently I am 12 weeks and 2 days post op and I was doing great until last Friday when I felt a tear in my knee getting into my truck. At first I thought it was scar tissue popping loose then I went to the doctor and found out I partially tore my ACL :( so its a little bit of a set back but hopefully I heal quick! 



post #4304 of 10802

Eric- good luck in surgery! 


Ashb- when I had recieved 30 degrees I was over joyed! Glad to hear your qt is coming along. Even better news you can drive now!

post #4305 of 10802

Two days short of 17 weeks post op and besides running, I'm pretty much healed.  I just did 900 lbs on the leg press for 20 reps and finally did pain free extensions.  Full ROM and no limp or pain.  My upper thigh on the injured leg measures 3/4 of an inch less than my good leg and lower leg 1/2 inch less........that should be equal within a month or two.  


This was by far the worst injury I have ever had but I can't stress enough that once the physio process starts, it is constant progress provided you give it 100%.  I noticed at the physio clinic I went to that very few were actually there to work hard and it showed in their results.  Once that tendon is healed it can handle a heavy workload provided perfect form is used.

post #4306 of 10802
Thanks Teekay - sorry to hear about your ACL!

Cdn Wrestler - wow! That's great to hear. You touch on something I've been thinking a lot about and would love to hear more on. That is, once the tendon reattachment has healed and becomes stronger, how much load can it handle? Is it the same as pre-rupture loads? Does the risk of a re-rupture become less over time and is this risk correlated to strength? Love to hear thoughts on those Qs.

Tomorrow I'm 6 weeks post op and I get to open the brace to 60 degrees. Great to feel strength coming back in to the leg with straight leg raises and no pain. Walking much easier without crutches now, though still use one if I'm out of the house. Hope everyone's rehab is progressing well. Cheers
post #4307 of 10802

Interesting read. I broke my ankle & tore my meniscus/acl about a week & a 1/2 ago while skiing. I'll be in a hard cast from my toes to just below the knee for a few more weeks. Fortunately my doctor feels I won't need surgery just therapy. Do you think it's realistic for me to hope to be back on skis in April or is my season done?

post #4308 of 10802

Hello all! I'm now 96 hours post surgery and am up and around. Just walked downstairs with no crutches (have dual hand railings) and have weaned myself off the 5mg oxycodone (2-3 every three hours). That stuff really helped for the first couple of days, though. I have used hydrocodone (vicodin) in the past with poor results. Changed the dressing yesterday and it was very dry and clean with no drainage. The doc used those steri-closures in lieu of staples. Much more comfortable and will leave a minimal scar, although that is a very low priority at this point. I have used my raised toilet seat with handles to great advantage. Saved that from my total knee in '06. I'd say at this point the rehab is easier and is less painful than the TKR. I've decided to not go to Spain and risk blood clots and just being uncomfortable. My daughter has plans for us to be touring all over Barcelona, and I'd surely not be 100% mobility by then....my wife is still going so I'll wait until 2014. My first follow-up visit with the doc is on 3/5 and I have my first PT session on 3/11. I have a feeling I'll be in a high percentile when it comes to recovery times. I'd like to thank all of you for your invaluable feedback and information. It has really made a huge difference. Two additional thoughts....I had the general anesthesia and was in the recovery room in 90 minutes...they used hydromorphone (dilaudid) by injection until they switched me to oral oxycodone that evening. I also got solid food the first day and they did in fact keep me over night. It would have been really tough for me to have done that as "day surgery".mad.gif In case you missed my previous posts I had a total rupture of the quadriceps tendon and also damaged the patellar capsule which was also repaired.

Edited by Eric308 - 2/24/13 at 2:35pm
post #4309 of 10802

In a few weeks you will know the answer, had a complete quad tear in 4/12, I did not ski this season maybe next year. 

post #4310 of 10802

Some very interesting recent posts


Cdn wrestler -- That is an amazing and inspirational recovery!  Have you tried running and had issues?  Just curious.  I'm 3 weeks, 2 days post surgery for a partial quad tendon tear and am thinking of setting a goal of doing a sprint triathlon, partly to help push me in the recovery.  Prior to the injury, the running would have been the easy part, but it seems like this thread has a lot of reports of very fit people having a tough time with running.


Steamboat -- Your cast is a lot shorter than the full length brace I've got, which doesn't allow me to bend my knee, so your results may be different, but I've been amazed at how much my quads have atrophied in 3 weeks.  I can't imagine hitting the slopes this season, but maybe it will be different for you.  It sounds like it would be your calf muscle that would be most affected.



Eric -- Glad to hear you made it through the first step.  The pain the day or two after surgery was pretty bad, but it got much better very quickly.  Hope your recovery goes well.


For anyone facing the surgery, I'll mention that the anesthesiologist gave me some anti-nausea meds intravenously (not sure what it was) and an anti-nausea patch that I wore for the first three days.  The patch seemed to help a lot, although it made my vision blurry.

post #4311 of 10802

I am now 7 weeks, 3 days post op.  I still wear the brace, but it is open with a lock-out at 90 degrees.  My flexion is approaching 100 degrees, and my OS has now told me to slow on that work a bit, and just go for a few degrees more per week.  I find walking normally has been the best mental relief, as my opposite hip was paying the price.  Today, I have been cleared to return to the gym and do upper body work and limit leg work to that which I do in PT.  Bruce, you mention how much the quads have disappeared in just 3 weeks, so wait until 7....it's disgusting to see the size difference in my legs now, even the calf size as all those muscles have paid a price too.  Anyway, things do move along, my PT has me doing alot with proprioception, concentric and eccentric muscle work, and now just beginning to work on extension exercise (non-hip) to begin the lower leg rehab.  It's alot of work from multiple angles, but I remain encouraged and like to share my experiences as well as read those of others.

post #4312 of 10802

Dear Eric

I think a parenteral narcotic is absolutely essential for the first few hours post op- once you have reasonable pain control then you can switch to oral meds. The problem is if the pain is not under good control initially it can increase the risk of vomiting and dehydration as well as being very, very, very unpleasant.

Dear StevieP

I have just seen your post from 10 days ago- sounds like the manipulation and arthroscopy was helpful- hope things are still improving.

post #4313 of 10802
Dear catinthehat,
It seemed to go quite well, on the evening after the op, they had me on a machine flexing my leg to 126 degrees for three hours on and off without any real pain to speak of, however since leaving hospital it has tightened up again. I had a physio assessment last week, my ROM was measured at 100 at the start and 112 degrees at the end of the session, so it does seem as though it will improve with time and hard work, and hard work it is, since the op it has been a lot more painful than before and even with strong painkillers stretching is very painful.
The one thing I wasn't happy about is that the physio told me the fact that it took so long to get to where I was after the first op and the fact that the surgeon could only bend my leg to 125 degrees during surgery is indicative that my leg may never get back to normal, which for my good leg is 150 degrees, that said I'm determined to work it hard and see where it goes!

All the best Steve.
post #4314 of 10802

Well, one week post surgery tomorrow, 2/27. When did you all get rid of the crutches? I'm also anxious to drive and get back to the gym for at least upper body exercise. I now sleep with a 25 pound dumbbell instead of my wife! (Careful there) wink.gif My first PT session is 3/11. Hoping to hear some good news that day. I wish it was my left leg...I'd be driving today. Totally off pain meds except for an Advil from time to time. Lost about 12 pounds since day of injury, 2/14. Don't mind that so much, but I was not overweight. Just don't have much appetite.

post #4315 of 10802

I had no apetite for the 5 days waiting for surgery and for the 3 weeks post-op.  Perhaps it was the analgesics I was on, don't know, but I dropped 16 pounds.  I was able to ditche both crutches after about 10 days, but remained with 1 crutch into the 4th week.  You need it for when you encounter uneven ground, uphill or downhill walks, etc.  I was just more confident with it.  I was able to drive after 2 weeks, when I could get about 30 degrees of flexion, in order to get into the drivers seat, and out.

post #4316 of 10802

Forget Weight Watchers or Atkins, I think we've discovered a much faster way to slim down.  I've lost about 14 pounds on the Quad Tendon Rupture Diet in the last month.  It's painful but effective!  

post #4317 of 10802
Originally Posted by PatB View Post

I had no apetite for the 5 days waiting for surgery and for the 3 weeks post-op.  Perhaps it was the analgesics I was on, don't know, but I dropped 16 pounds.  I was able to ditche both crutches after about 10 days, but remained with 1 crutch into the 4th week.  You need it for when you encounter uneven ground, uphill or downhill walks, etc.  I was just more confident with it.  I was able to drive after 2 weeks, when I could get about 30 degrees of flexion, in order to get into the drivers seat, and out.

Hey Pat...sounds as if I'm on the same recovery timetable. Totally agree about having the one crutch for what you described. Just did some triceps extensions with my dumbbell and also curls. Hard to believe how much strength and tone I've lost in two short weeks. Bummer. Hopefully, they'll give me some flexion at the PT session. Thanks for the input! Were you able to shower after the post-op check and suture removal?

post #4318 of 10802

I was able to shower on post-op day 5.  I had a cheesy splint made of foam and velcro that the ED gave me upon initial injury.  I put a 4x4 over the wound with a large tegaderm over that, then the foam splint.  My wife helped into the shower and I took my shower, then she helped me out.  I took the foam splint off, re-did the dressing, and put my brace back on.  This worled well forme, as the foam splint would dry by the next day if I hung it over the shower rod.

post #4319 of 10802

10 months on! 69 yr old and used to be active!

Nearly back to normal.

Cycling OK  except standing on pedals not easy, but improving. If desperate I do a one legged pedal as my good leg has a lot of power, but don't want to get out of balance!

50km easy, first 100km planned for next weekend.

Body generally still a bit weak so got back ache after shovelling a bit of snow. Having to do back exercises but that's OK maybe I should have done them sooner.

Strength returning. Need to stretch more. Doing careful squats whilst holding on to a chair, and similar slow stretches.

Haven't run since it happened, but I never did anyway. Maybe I'll start running for the first time in my life.

post #4320 of 10802
Eric - I was given a couple of 'leg bags' when I left the hospital that taped to my leg above the brace. PT gave me a shower stool as well, so I showered the day after surgery and every other day when I got home. I had my stitches out two weeks post op so ditched the bag at that point. Great feeling

I opened my brace to 60 degrees this week. Walking without crutches much more easily now, doing leg raises and calf raises too. Leg strength is good at 6 weeks post op. Muscle mass isn't too bad so I'm hoping the early weight bearing helped. I'm still thinking the protein shakes, BCAAs and other supps have helped this on the inside. Feels good to have my leg back doing what I want it to do. Driving and that sense of freedom is brilliant. Getting back in to the winery is good for the spirit! Best to everyone.
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