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Quadriceps Tendon Rupture, Repair and Rehab - Page 20

post #571 of 10804

Full Cast!!!

Illinois - The full cast was my OSs plan 2 weeks ago. I think he wanted to make sure I wouldn't be able to put myself in the kind of high risk situation that resulted in my falling and damaging the original repair. Since I felt I'd learned my lesson (anyone else wanna do this a 3rd time?) I opted for the immobilizer brace and the "no fall zone" attitude Sinrider used to write about.

Just got back from a 2.7 mile flat hike. Took a little over an hour so I'm not setting any speed records. Felt pretty good, just a little tightness.

CQP - I've been meaning to thank you for all of the research you've been doing and reporting on this site. I think I speak for all of us when I say we'll probably miss that when you go back to work.

You asked about the 8 week delay on the MRI. That was really my fault, just not wanting to go through another surgery and start all over again.
post #572 of 10804

Fellow Quadripods

Ok, I found this thread a week ago and feel the need to share.

On vacation July 31, slipped while walking down the steps of a lake front cottage was the cause of my Quad going. The OS diagnosed it as a complete rupture. The following Wednesday, August 6 was the surgery. After a few days of regulating the pain meds I was able to feel comfortable enough to start the CPM regiem.

Bit of history: I'm an avid cyclist and triathlete. I've been instructing Spinning for 10 years so I'm hoping the base I have might help speed things up a bit.

I am amazed though how quickly the quad leaves you when it's not being used at all.

I'm now two weeks out of surgery with 60 degrees of bend with CPM assistance. Saw the doc on Monday the 18th and he's quite happy with the progress. His plan is to keep me in the immobilizer for 8 weeks. After that a hinged brace and more PT...

I'll try to track my progress as thing move along. It's just nice to know (although I wouldn't wish this on anyone) there are quite a few others that have shared this injury.

post #573 of 10804
Hi Everyone!

Thought I'd share an update. Went to my OS on Monday. They did a couple of xrays while seated in my wheelchair (thank God I didn't have to climb onto their HARD table)-I just had to hold the film cassettes for them. Then they removed my staples. That part of my knee feels better anyway. Then I saw my xrays and my knee cap was up where it is supposed to be and everything looked good, except that my knee cap wasn't nice and smooth looking on top like it should. It just sort of looked more rough and choppy...but that's ok.

I was told I can begin to bear a little weight and certainly no bending the knee yet. Immobilizer back on and see him again in 2 more weeks. Not much else really.......

I am quickly learning that what works one day might not work the next (as far as pillows and sitting places are concerned). Hubby came upon a couple of old foam couch cushions and he sliced and diced them up to create for me a big foam wedgie that I can put both of my feet onto for sleeping. He cut out semi-circles on the top of one side so my heal NO LONGER has to rest against anything but air. He made another one for my wheelchair and one for my stool that I use near the desk computer. These have been a lifesaver for me as my heel was really getting SORE. They aren't real pretty, but they hide nicely in a pillowcase and besides that......who cares as long as they work!

Has anyone seen Helmut lately??

Welcome Buford....You and I are real close in injury and surgery times...Except that I'm stuck in the immobilizer. I have no ROM right now. Anyways.....Welcome!

Talk soon-Connie
post #574 of 10804

New exercise for going downstairs - treadmill incline set to 5

I thought I'd list new things that have been added to my PT. If I get a rom measurement tomorrow, I'll list it.

Everything is the same as previously posted, except for:

Balance exercise with ball (It has little knobby things sticking out all around it--I guess so when you smack it against the wall it doesn't always come straight back to you--sometimes a little off to the side) - I'm going to do this exercise before I do my treadmill at 5 incline, high step marching, and stair exercises. I had trouble keeping my balance with this one! The one PT came by and told me to put my uninjured leg behind me with only my toes touching the floor--just to help me. He said to do that a few more times and then gradually pick up the leg when my balance improves. Sure it was no problem for me to do a static balance on the injured leg for 15 seconds x 5 sets, but this is a challenge. And just think, until you master this one and other strength and stability exercises, you aren't even close to going down stairs with the injured leg!

Quad sets - they put a 5 pound ankle weight on top of my thigh. This adds just a little more weight to help get the knee down. No, it isn't close to being like the other leg. It is going to be a slow process. The knee is going down more, but not even close to hyperflexion like the non-injured leg can do.

Stationary Bike - I was pedaling about 85-90 rpm--quite fast from last week. It isn't straining, but feels good. I "listen to the knee". If it tells me to slow down, then I do, if I feel I can do more, then I do.

Treadmill - I had my setting on "2" and no incline. The head PT came by and amped it up to "5" on incline. Head PT is always watching everyone and evaluating them, so he could see I was doing so well, he decided to make it a little more challenging. I slowed the thing down to "1.5" because that incline made it quite a workout.

Going Down Stairs exercise - a new one to do at facility and at home. No, it isn't even close to going down real stairs, but it is a beginning exercise for training to do that. I'll see if I can explain it. You put the uninjured leg out about 12 inches in front of you with the toe up, so only your heel is touching the ground, this causes your injured leg to bend a little at the knee. You have to do this between the balance bars (and hold onto them). You then go up and down on the injured leg 10 times and repeat for 3 sets. You are only going up and down about an inch or so. My PT said this was good for me to do at home to build strength in that leg for going downstairs on the injured leg.

I have to do these exercises holding onto those balance bars. I would never attempt to do this without the bars. I can tell that going downstairs using the non-injured leg is going to be an advanced exercise that will take a while to master.

Do not try any of these things unless your therapists tells you. I asked them when we were going to do exercises to practice going down with the noninjured leg on steps (which of course puts all your weight on the injured leg as you bend the injured leg). I already do the exercise going up with the injured leg.

Future PT - I asked my PT what the plan is for the next few weeks. She said we will be increasing the sets for most exercises, probably adding another level under the Fonda step also. So, this is mostly endurance and strength the next few weeks.

They were so busy at the PT facility, I wasn't able to ask about an exercise plan outside of PT. However, I will look for my chance to ask if they could help me work out an exercise plan I can take to the junior college gym (it is my old stomping grounds so I'm familiar with the people and equipment).
I did ask about any exercises I should never do - the same one everyone else has listed here. The leg extension with weight in front of your leg--too hard on the tendon. No loss for me. Better safe than sorry.

The increased incline and "down stairs" exercise really wiped me out yesterday and today! See, it is always a few little things that can make PT challenging and make you realize you still have a long way to go. Also, I had some cramping in the calf of my non injured leg! What a difference a little incline makes.

Will - your luck just has to get better. I really can understand why you wouldn't want to get any more bad news. Denial sure sets in quick! However, I guess it would have been best to get the bad news as soon as possible so you would have had that surgery again 8 weeks ago!

I remember the worst day I ever had wasn't the quad rip - it was when the doctor told my Dad and I in the exam room with my Mom that she had terminal cancer (in 1997). I could have gone into denial, but I did a lot of research for what she had online. Unfortunately, there was no good news. But, at least we knew what she had and the whole family went into crisis mode because we didn't know if we had 6 days or 6 months. It was terrible news but we just had to face it head on. We had to get wills, living trusts, burial plans, treatments, paperwork, etc. The doctor showed me her chest Xray and pointed out all the cancer spots and explained everything to me (spread to brain, etc.) Her doctor was about my age and I thanked him for being so upfront. He asked if we wanted him to do the paperwork for Hospice. My Dad didn't even know what that was, but I did and told him to please do the paperwork.

My first boyfriend's Dad went into a hospital with pancreatitis back in 1979 and was gone in two weeks at the age of 42.

No one wants bad news, and it is hard to comprehend what the doctor is saying when it is bad. But, I've learned I just want to know the bad news right away so I can take action.
Can someone explain what LAG measurement is? I guess they haven't measured that on me in PT so I don't know what it is.
Will - if I was your doctor I'd probably do the cast just to protect my butt! Or, as he said, have you sign something saying he recommended a cast but you refused it. You know he is just afraid of you messing up his handiwork again.

Sometimes we have to put ourselves in the doctor's place. He doesn't want to see you in surgery again either!

So far at PT I've met people in worse shape than us and younger!! One guy in his late 20's tore up his knee at a job site. He was an engineer, I guess hands on. I don't remember what all he tore up in his knee, but he is going to have to go to PT for about a year and he is going to be doing something less physical for a job. He has to get around on crutches and a jointed leg brace and he has been there for over a month.

We all have Idaho Guy to thank for starting this forum. When I go back to work, I will still be checking in here to see the progress everyone is making and to report progress I'm making.

ConnieP - maybe we should all meet someday at Connie's for the steak fry. I like mine well done

buford - welcome and sorry you had to join us.

How are all the bi-lateral quad people doing?

Hopefully everyone is doing well.
post #575 of 10804
LAG Question

They have been referring to the lag as the degree to which I can not straighten my leg. ie my good leg goes to zero degrees. My bad one won't straighten to that (under my own muscle control). It is at a 20 defree lag.

CQP-are you off of crutches already?

Will- Am I ready you correctly in that you walked for 2.7 miles?

Connie-Don't you love the improvisions we make in the recovery process?
post #576 of 10804

12 weeks post op


Illinois T.T- I am also in my 40"s(47 to be exact)I was going for my 4th set of squats when the rupture happen,I had 495 lbs.I was going up very easy, for only one rep like I have done many times before when I heard the pop,and the rest is history.and yes I go very low with the squats,or, I should say,I use to go low.About 20 yrs ago I had a partial rupture of the same tendon,the doct put me in a cast for 6 weeks and the tendon heal by itself(no surgery)
About the lag ,I am able to full extend my leg(0 lag) with some pain.I ask my ortho. and he said that lag should come as the quad muscles get stronger,same for the rom.\
CPQ-the pt routine you have is very similar to mine. bike, treadmill, steps up and down stairs,They also gave leg press machine,and leg extensions only with a 5 lbs ankle wts.My knee still swells and my rom is between 96 and 102 in a good day. Hopefully the rom will get better.Leg extensions hurt some around the patella.
Wyopapa-you were at 94 rom by week 12.At week 18 you were at 136. How did you do it? maybe I still have some hope to get there myself.
in2falling-you had 95 rom at week 9.You said that maybe you were goig to have surgery to clean out scar tissue,did you have the surgery?

good luck to everyone
post #577 of 10804
Hi all I'm back. Small glitch in the matrix kept me out for a little while.
Looks like everyone is progressing nicely.

My update; Last Monday I went for my 4 week check up. Doc took immobilizer off and bent leg a little and did a lot off feeling around. He also had me do some quad flexes. Said all was very good and put the immobilizer back on. I was expecting to get it off but he said no. Due to the fact that I had began this journey with a small tear then increased it to a 80% tear he said I will have to stay in it for 2 more weeks.
After that I can remove it for PT only until the PT feels I'm safe not to.

Some good news though. He has told me to start putting full weight on the leg when I walk with the crutches. Also gave me some ISO flexs to do.

The foot swelling disappeared in 1 day after I was told to put full weight on the leg.

The repair feels great no pain at all and flexs very well. My issue is I have very severe arthritis in that knee and it is causing me lots of pain. I cannot take my regular meds for it because of the blood thinners I am on. So the OS has put me on a drug called Tamacet which helps a bit but is not the same as Celebrex.
I am hoping that when the immobilizer comes off that will help with some of that type of pain or my recovery will take much longer than it should.
post #578 of 10804
Hi All!
Buford: "welcome". i too slid down a few stairs that created the injury.

Will: my OS told me he usually has done 2-3 QTR a year but between my surgery (11/12) and my 2nd OS visit (12/27) he did 5! I suspect the aging baby boomers may be the cause.

CQP: I was doing 45 min on the treadmill/day prior to the injury. When I asked him about TM on my December visit he said as you can tolerate but no incline until I release you. So I did none until March.

Keep Pluggin'!

post #579 of 10804

Post op - 5/6 and 7/24

Welcome Buford, you’ve found a great site for info on QTRs. By the way, what does CPM stand for? Reading your post reminds me how athletic the average QTR patient is. I’ve been on a similar site and it seems to me that close to 80% of us are involved in some form of cycling, stationary or other. After 30 years of pick-up basketball and tennis, I started spending about 1 hour a day on a recumbent bike 6 months prior to my injury. Ironically, I had hoped cycling would help my aching knees enough to get back to my the tennis and basketball courts.

Connie – Your husband’s foam device is enough to make the rest of us jealous. Sounds like he put a lot of thought into your comfort.

CQP – Your 100% right, I shouldn’t have waited 8 weeks, but my luck is getting better. I don’t know what my OS did different this time but it feels nothing like the first surgery. Stronger, tighter, no pain and no lag. It’s everything I can do to keep from trying something really risky (jogging, jumping, etc.).

Illinois – Yes, 2.7 miles and yesterday the same. I’ve been using a ski type aerobic machine at the gym almost daily for 40-60 minutes. Started 13 days after surgery and no, did not ask my OS or PT if it was a good idea. It’s seems to be a great way to get my heart rate up (136+) without risk of re-injury. The machine I use could be used even with the brace locked almost straight. I set my brace at about 30-40 degrees as the gentle bending seems to be therapeutic and breaking up the scar tissue.

NYBB – Where are you? We need an update! Just thinking the other day that symmetry being as important as it is in your sport, matching knees could be a plus.

Don jp – 495 deep? What % of your body weight is that? I once put 315 on the bar and it felt like it was going to crush my spine. You guys are animals!
post #580 of 10804

Week 18

Well still struggling with the battle against scar tissue that is jammed up under my repair/quad tendon and on the top medial side of the my knee. ROM has been stuck at 110 for the last 3 weeks but good news is that 0 to 105 is fairly loose and my quad strength is good also.

Rehab is pretty much a all day everyday process for me I am trying my hardest to avoid a dreaded second surgery for scar tissue removal surgery. My day consist of following.

4:30am Make big cup coffee
4:30am Ultrasound knee scar tissue (just started this 2 days ago)
5:00am Gym
15 minutes elliptical to get knee loosened up
20 minutes using leg ext, squat machine, leg press/curl
machine and lots of stretching to get ROM as loose as
possible. Use weight machines to stretch everything out
and work through ROM.
20 minutes on upright bike seat as low as possible
20 minutes on treadmill either walking forward step incline
or walking backwards
20 minutes on upright bike again.
8:30am Leave for work after shower with ice pack on knee if
9:00am Work
10:30am Heat and Ice flex ROM. Heat pack the knee with
max flex (not too painful) under office chair for
30 minutes, switch to ice holding same max flex
for 20 minutes (This feels f__king GREAT after I
am done!! Knee almost feels normal)
12:30pm More heat/ice flex ROM after ultrasounding scar tissue
4:00pm More heat/ice flex ROM
6:00pm Go home
7:00pm Ultrasound and massage (also massage throughout the day
and drive home from work)
7:30-8:00pm Ride recumbent bike for 30 minutes (if i am not too

Weekend are pretty much the same thing but spend more time in the gym.

Two days out of the week I do the same routine at the gym but instead of the doing bike and treadmill I focus completely on strength building single leg press, squat machine, light leg ext (i know there bad for you but going light weights), leg curls, wall squats, and step up's.

Also doing stretching and working it through the ROM under my desk and doing quad flexes all day long.

I purchase a portable ultrasound unit off of Amazon for $140, and so far this seems to be making a bit of a difference the last few days. I am being very careful with it, don't want to fry my soft tissue so did a bunch of web research on proper usage and the power setting.

Also getting a 30 minute too 1 hour very deep tissue massage on my quads once a week. This is great because you are not fighting both a stiff knee and tight quads. I tried letting her massage the quad tendon but she just made things worse , so I just do that my self.

I see the doc in 3 1/2 more weeks so I will see where I am at at that point. This by far has been the most frustrating physical injury I have ever dealt with !

Don_jp: No did not have the surgery and hopefully can avoid it. 495 squats? That scares me every time I watch someone squatting that much !! I was up to 6x20 with 230lb before my injury and hopefully be there again some day. I love high rep strict form squats, no better exercise for your legs.
post #581 of 10804
Hello Everyone,

September 5th will be the 5 month mark since my injury. I was officially released from PT about 2 weeks ago, but am still going 3 times a week on my own just to use the equipment and keep things loosened up and still trying to strengthen the quad. I have a popping sensation on the outside of my knee that occurs about 50% of the time when I walk. It may be scar tissue getting caught, I don't know, but I don't like it. I sometimes still walk with a stiff gait and sometimes I walk almost normal. Going up and down stairs is still not completely stable and have some pain in the knee cap when I do that. Also, have some pain in the knee when I go to get up after sitting in a chair.

Donjp - ROM will come back for you. I was stuck at around 90 or 92 for a couple of weeks. I just kept working at it and being persistent both at PT and at home. The bending and stretching exercises and the PT really pushing on my leg in a bent position really helped. This is a severe injury and it takes a lot of hard work to get back the ROM. Once I broke 100 things really moved fast and I was able to get to 136 shortly after that. There were times when I really got discouraged, but I kept at it because I knew it would come if I stayed focused and kept working hard. There is no secret, just hard work and keep doing the bending and stretching exercises. Right now my main concern is the popping I have in the knee when I walk. Hopefully, OS will have me get an MRI when I go back to see him on Sept. 8.

Don, what is your current ROM and how long ago did you have surgery? My best advice is to keep working at your PT, don't give up and be positive. I know sometimes it seems like ROM will never return, but it does and it will for you also. It just takes a long time. Hang in there buddy.
post #582 of 10804
Hi Everyone!

Welcome to the new QTRs. Coming up on 7 months post surg and it is probably a good thing that I have forgotten my password for posting! Things progress for all of us. To the new QTRs, this is a life changing injury but the light at the end of the tunnel is not a locomotive coming at you.

Surgery was 4 Feb 08. Some of you may know that my OS never wrote an order for PT. I think that I have had no ill affect for that. My rehab consists of getting out there and doing it, as uncomfortable as that was. I am currently riding 4X per week appox 150 miles in an ok week. I run 2 miles 2-3 times per week and hiking is a new venue for quad training. Nothing extreme, just consistent.

At this point, my injured quad is not were I want it to be in terms of strength but it is a strong muscle group and is still a work in progress.

I have adapted a perspective that I look at push my recovery timelines out to the one year point for complete recovery to pre injury status. Work hard daily to make it happen. We are not 20 yo Olympiads as much as we would like to be!

The Best of days to all! VS
post #583 of 10804
WyoPapa: Think that maybe the popping sensation could be a patella tracking issue due to maybe one side of your quad being stronger than the other?
Guy at work was explaining some issue he was having with his patella tracking wrong due to his inner quad being weak and was able to correct the problem by building more strength on the particular quad muscle to correct his tracking issue. Just a thought.
post #584 of 10804

1 Month since injury/3.5 weeks since surgery

Hey guys!

I have a question. At this point, 3.5 weeks since surgery, did you guys still have tenderness and swelling around your knee? For the most part, I'm not in any pain. Maybe one pain pill when I start feeling pain. Yesterday was the first 24 hour period when I had no pain meds and I haven't so far today either.

My doctor didn't get any xrays when I got my staples removed. So I was wondering if the swelling and tenderness around my knee was normal. It also feels kinda hard around that area as well.

I'm just starting to notice how small my thigh and leg look. Even though, my knee still doesn't look like "a knee" yet, the swelling has gone down significantly.

Thanks to your posts, I've tried so many things to help me get comfy to go to sleep. Thats been crazy in itself. Thank You Olympics!

The hard part now is that I'm not feeling much pain, I want to move around more. My wife has been doing a lot for me which has been great. But now that I'm not feeling much pain, I want to do more in general. It would help the day go by easier. But my doctor was pretty specific when he said to stay off of it until 9/15.

I'm so jealous of all of your PT posts. I know it's going to be hard, but I'd rather be at that phase trying to strengthen and get better.

Congrats to everyone on their progress and Hang in there to all of us frustrated patients.
post #585 of 10804
Vermont Soldier - Good to hear from you again. My quad is not quite where I would like it to be in terms of strenght either, but I guess it just takes a long time to get it back. Going up and down stairs is scary sometimes depending on the height of the stair and pushing off with the bad knee to go up a stair is usually painful. Am walking a couple of miles a few times a week now. Knee still buckles once in awhile, but not as bad or as much as it did two months ago.

DudeinMd - I had pretty good swelling in the knee for a long time after my surgery, especially after working it out in PT. PT guy told me it was just trama from the surgery and it would go away. For the most part now my knee looks pretty normal now. Just make sure you ice it down after workouts - it should help with the swelling issue. The hardness around the knee that you speak of sounds like the tight band feeling that I have heard others talk about and that I have also had. I think that is where they tied the quad back into the knee and it is probably a shorter tendon now then it was before, hence the tight feeling. Although mine is not is tight as it was (it tends to loosen up with time and stretching), it still is not like the good knee. Don't know if it ever will be either. Time will tell.

in2falling - Thanks for the thought on the patella tracking. I never thought of that, but when I see the OS again on Sept. 8 I'll ask him about that. Hopefully, he is going to do an MRI to see what is going on. I'll let you know.
post #586 of 10804
Dude-Swelling is pretty normal. Mine swells more when I am on it or sitting up for longer periods of time (at 11 weeks post surgery), although the swelling is subsiding as time goes on. I elevate and ice after being on it for a while (and also after PT). This helps bunch. I do have 1 spot that seems to be pooling fluid on the outside bottom of the knee. Also, the muscle starting swelling a bit in the last few weeks, as I've been starting the strengthening phase of PT.
post #587 of 10804
Hello everybody:
I hope everyone is ok and improving.
WILL-I weight 275 lbs and I use to compete in power lifting .My knee was bothering me for couple of weeks but because my knees are always hurting at some level I went for the lift anyway.Big mistake! live and learn,well, I did it the hard way,not too smart.
Is like calif.quad.pop.said"we are not in our 20 anymore".
I hope your knee feels better
INFALLING-quite a routine schedule you have there! that's the way it should be if we want to let this behind us,I guess.
Is the ultrasound helping with the scar tissue problem?quad massage,that sounds very good,maybe I'll try that.Is the area around your patella still sensitive to the touch?

WYOPAPA-I am 3 month post surg. and 96-98 rom,that's why when I read your post and saw that now you are at 135, gave me some hope.It's very frustrating when you are working your leg very hard and finish the day with almost 100 rom and the next morning when you wake up you are like 20 degrees less and seems like you have to start all over again. Sometimes feels like this never is going to end.Do you use to have the felling like having a very tight rubber band around your knee cap specially in the morning?.My injured leg is 2" smaller than the good one,how long it suppose to take to reach the same size?Anyway, let me stop complaining and,thank you very much for your words . keep improving.
post #588 of 10804

4 1/2 weeks post surgery

Paul - I need more details on your 1 mile run at the 12 week point. (how fast and compared to pre-injury) I was re-reading your 1st post and I am also planning on doing some hiking at the 6 week point. I had planned and paid for a trip to Yellowstone Nat. Park with one of my kids before the injury, and I can’t bear the disappointment of not doing some of the planned hikes. I’ll start with the flattest and see how it goes. I’ll keep the hinged brace set to lock at 60-70 degrees.

I know what everyone is thinking and no, I don’t plan on getting OS or PT approval. It’s like asking if it’s ok to drive. If your OS says no, you don’t have disability, and you can’t afford to be out of work, you might just have to get in your car anyway, put the seat all the way back, test the pedals and decide for yourself if it can be done without risking life or limb. At some point, you gotta do, what you gotta do.

I did more testing of my knee this weekend and can do flat walks of 3 miles easily and I’m sure I could go a lot further. I’ve eliminated the hitch in my step almost completely, and am testing some steeper downgrades. I can go upstairs without trouble, down if I take it slow.

I believe I’ve had almost all the nuisance injuries over the years, and what I like about this one is the improvements I see almost every day. My OS said he felt the repair would be at 80% at the 6 week point. I won’t be doing any running or jumping and I can’t really see how I’d need 80% of the strength of a healthy knee. I’m going to PT twice this week and would like to see ROM go from current 90 degrees to 110. That’s it. I don’t think I’m asking too much.

post #589 of 10804

6 months down - 6 months to go

Originally Posted by Duncan_CalgaryAB View Post

One thing I notice when I do squat exercises is I feel a "click" or "pop" part-way through the range of motion. It's not painful but it is definitely noticeable. I wonder if this is muscle, tendon, or scar tissue moving across the repair location sutures or drill-holes. Hopefully this will go away when I build additional muscle mass.
Yup, same thing happened to me when I started using an exercise bike regularly. It was really evident when resistance increased while pedaling. It went away after a month. No explanation other that while the muscles are not up to full strength, there's more play in the joint. Plus, I have a torn meniscus in that knee which may have contributed.

Saw the OS last week. He was really happy at the progress. I got the green light to get back into golfing. After an incident a couple months ago that put me briefly back on crutches (caused by the torn menicus), I've been cautious about getting too aggresive. But he said the muscles are in good enough shape to keep the joint in place when swinging and on the follow-through.

He did say there's still another 6 months before things are truly back in shape. There's really nothing you can do about that tight feeling . . . like a rubber band still in your knee. And that brief moment of stiffness when standing up after sitting a while.

post #590 of 10804
Will all the best of luck with your hike. It is remarkable that you are so far ahead. I am at the 5 week mark and the OS said no way are you getting out of the immobilizer until at least the 6-8 week mark.
He said the repair is not fully healed until at least 6 weeks.

The one issue I do have is now that i can put full weight on the leg the darn immobilizer keeps falling down. The pressure from the straps on the knee cap causes enough pain to prevent me doing and weight bearing. Does anyone have suggestions to prevent that?
post #591 of 10804

13+ weeks post surgery -- ran 3 miles uphill on fire road

Hi all,

It's been a busy August that involved a lot of travel that I didn't think would have a chance of happening when I blew out my right quad on May 16 (surgery was May 21).

Last week we flew cross country and spent a week at Cape May NJ at a family reunion for my wife's family. When I first got hurt I thought there was no way I'd be able to make the trip but it ended up not being a problem at all -- trekking through airports, carrying bags, it was all fine. I would highly recommend water therapy if you have it available. I spent a lot of time in the water with my kids, body surfing and also splashing around, and it helped my leg. I'd balance on my right (injured leg), then jump up and do a motion like I was punting a football. The water acted as a cushion and resistance, similar to the resistance bands they have at PT, but a much better workout. Was also able to walk up and down the 199 stairs in the Cape May Lighthouse without a problem.

The leg is definitely still not 100% (maybe ~ 75-80%), and gets stiff if I have to stand in one place for a long period of time, but otherwise it's reasonably functional, and I don't have any problems with it collapsing or feeling unsteady.

Yesterday I ventured out early to one of my favorite running trails and was able to run the 3 mile uphill. It was tough but the leg held together. I walked most of the downhill -- I suspect downhill will be harder than uphill for some time -- but it was still a nice feeling to get back to my sport in some fashion.

I did PT from about 3 weeks post-op through 8 weeks, 2X per week. Since then I just walk and use it as much as I can, but I pay close attention to not doing too much.

Buford, I'm 47 and also "elder" athlete, it seems to be a decent sized group, at least here.

Will the Thrill, I don't think I could have handled hiking at 6 weeks, I was still on crutches at that point. I was doing some light weight bearing with a brace on for protection, but didn't do my mountain hiking until 9 1/2 weeks post surgery. I did my first running on a track about then. It's been another 3 weeks and I'm going to venture out to wherever I want to go, with the exception that I'll take it easy on the downhills, and probably walk the steep downhills for awhile longer. But whereas I could comfortably run 10 miles on trails before surgery, at this point 3 is a big effort. Still have a long way to go.

I keep reminding myself that I was on crutches for 8 weeks, and to give it time to come back. I've read some articles about lingering quad muscle weakness, so I'm doing different exercises -- holding myself with my back up against the wall with my legs bend at 90 degrees, squats with a light weight (about 130 lbs), biking, swimming, basically whatever I can do to move it around like a normal leg.

I have good ROM but still not the same as my uninjured leg. They tell me that will come back, so I'm just letting my leg guide me as to how far it wants to bend. It does get all the way straight, which was something they were worried about early on.

I do have that leg bump around my scar, an oval about 3 1/2 inches long, 2 inches wide, and maybe 1/4" high, but it's a distinct new feature of my leg. It's not really noticeable except when I lock my legs straight next to each other.

My OS was good, he kept me in check the first 8 weeks, and since then I've paid close attention to how my legs looks and feels. One thing to note, I had not had any knee or legs injuries prior to this, and have a very "neutral" stride, so those things may be helping my recovery. While my QTR was definitely a catastrophic injury, the baseline condition was healthy, so is probably helping my recovery.

When I had surgery on May 21 I was originally hoping to be able to run an easy 5K by Thanksgiving, and that looks like no problem. For people earlier in the cycle, my advice is to stick with the knee brace and crutches for 7-8 weeks, then bring back motion as much as you feel your leg will bear. I have little pain since about 2 weeks, but I've been patient about not doing anything my leg was telling me it couldn't do, especially ROM. As you're able, just move it, move it, and move it some more, in or out of PT.

I'll post again with activity milestones, so that people who are following can track their progress against what I'm doing. I was fit to start and had a good OS, but I think that's true for most of the people here. Give it time, and the motion will come.
post #592 of 10804

I reread your note and if you're already walking 3 miles at 1/3 weeks you're way ahead of me. My leg brace was locked straight for 4 weeks, so I couldn't even have tried what you're attempting. You might want to get some hiking sticks (or use old ski poles) as a safety net for steep downhills. Every recovery is different but yours seems exceptionally fast. I could not have done the hiking at 6 1/2 weeks -- I really made a lot of progress from weeks 6 to 9. Good luck!
post #593 of 10804
Good to see that everyone is progressing well.

Connie, yes the pain does go away and I do recall, although not fondly, those nights when I just could not get comfortable. Your husband sounds like he has done a great job of creating some support for your leg. I agree that you should give up on the weeding idea for a while. You're experiencing what we all went through of wanting to get back too soon. This is a major injury. So take the time now to let it heal, get the swelling down and rest the leg. Investing time now to get better will pay off later. And I too recall the purple feet and ankles. But this too shall pass.

I found it helpful sleeping at night (I am a side sleeper) to have pillows between my knees and resting the leg on the pillows. This avoided the twisting motion on the knee too. I will never forget the agony of the **** at the hospital putting a right leg splint on my left leg by mistake. The pain I had from the knee being bent in the wrong direction was incredible. It took a day for me to figure it out. So be careful and don't twist the knee. You will surely regret it.

I agree with paulson above. The 6-9 week period was a period of much progress. I also agree with the pain and stiffness of keeping the leg in the same position for long periods. I'm really looking forward to my 13 hour flight in November. :-)

Connie, maybe ask your Dr re standing and putting weight on the leg. My Dr had me start this the day after surgery. I had crutches vs a wheel chair. I sure felt unstable, but I also believe it helped speed up the recover. I had a fixed brace for a week, and then a flex brace after that for 6 weeks. Each week the brace was adjusted for another 15 degree ROM. When I saw the Dr after the 6 weeks he told be to throw the brace and crutches away. Now that was an experience and boy did I feel unstable. But I never fell.

I have taken a break from PT. I am 6 months post surgery and still progressing well. Even stairs are easy now, and ramps are no longer a problem. I walk all day on concrete floors though and that can hurt towards the end of the day.

Good luck everyone. Keep improving.
post #594 of 10804
Don_JP: Yes the ultrasounding I have been doing seems too be helping, I don't think its a cure all but feels good and seems like good way to get things warmed up deep down in the tendon and around the knee to loosen things up. Its kind of weird because when I get done it actually feels like I iced the knee when its actually warming thing up. I use it right before I go to the gym and right before I do overpressure stretching and seems to make it eaiser to get things streched out.

The morning stiffness started getting better for me about 2 weeks ago once the scar tissue adhesions released around the quad heads, now I just need to get the crap under and around the quad tendon broken up. Its really frustrating but it does get better. Just keep working at it everyday, recovery from this injury is a marathon and not a sprint.

I highly recommend going in and getting a deep tissue massage on the quad muscles, remember they have not been strectched out in months and a massage feels great and helps loosen them up.
post #595 of 10804
Don jp - I was on crutches and in a full leg brace for the first 2 months after surgery. I did not start PT until the beginning of my third month. At the first measurement, before I started any PT, ROM was only 50. It then went to 78, 82, 85 and 90, where it stayed between 90 and 92 for about a week. Finally, after two months of PT I got it up to 135. Haven't measured it lately, but probably will have PT guy do that in a couple of weeks. If your ROM is at 98 after only 3 months post surgery, you are further along then I was at that time. Keep up the good work!!

Ah, the dreaded tight rubber band feeling around the knee. Yep, I still have it, although it is not as bad as it was. It used to be very, very tight and I still don't know if it will ever completely go away, although I think it will in time. It is not nearly as bad as it was and right at this moment, it doesn't even feel tight as I sit here typing this. The pain in the knee when I go up or down stairs is what is getting me right now, but its not bad all the time.

My bad leg still looks atrophyed compared to my good leg. Man, it takes a long time to build that quad back to what it was. Got to keep working at it.

Well, gotta run and get dinner going. Talk to you guys later.
post #596 of 10804
Hey again, three weeks post op and seeing some real progress.

Willthethrill: CPM is Continual Passive Motion.. I guess it's as close to PT as I'm allowed per my OS.

What I've done on my own: I'm venturing around a bit out of the immobilizer. Not something I'd do outside the house but it sure feels great to move without strapping in all the time.

My OS did inform me his plan is to wait the full 8 weeks before PT is allowed. I'm going to take a bit of a flyer myself tonight though. The club I work at has a tremendous current pool. I'm planning on getting in there for a bit today. Again, I'm going right up to the pool in the immobilizer so I'm not breaking the rules too much. I'll post everyone on how it goes.

I've never wished for time to pass as I am now. I'm hoping the next 5 weeks would be here and passed. I'm sure all of you have had the same thoughts.

Anyway, take care.

post #597 of 10804

Edited by Jobo Pooks - 9/26/09 at 4:17am
post #598 of 10804

21 Weeks

21 weeks since surgery. I decided a couple of weeks ago to go with self-directed PT from now on. I generally do cardio 3 or 4 days a week, bike riding if the weather is good, and elliptical trainer on the weekends. My routine is something like this:

Friday: 30 - 60 minutes elliptical trainer (warm-up for back workout)
Saturday: 1 - 4 hour bike ride, length depends on weather and other plans.
Sunday 30 - 60 minutes elliptical trainer (warm-up for chest workout)
Monday: Day off
Tuesday: Day off or light cardio workout
Wednesday: Light leg strengthening exercises
Thursday: Day off

For today's leg workout I did 3x15 weightless squats, then 1x10 with each of 20lbs, 40lbs, and 45lbs barbells. I am tempted to go heavier but I think I will wait until October as per my OS' recommendation. I wish I knew what the safe maximum weight limit was. Even this fall I will probably be second-guessing whether the weight is too heavy/risky.

in2falling: I admire your perseverence with that daily routine. However I am a bit concerned that you may be short-changing yourself for rest and recovery. I recommend a minimum of eight hours of sleep per day, and preferably one or two days per week with 9-10 hours.

Jobo Pooks: Thanks for posting that link. I see there is quite a bit of information on that site as well.
post #599 of 10804
Duncan looks like you are doing a great job of rehab on your own. I agree with going solo after you are able to move freely around with risk.
If I may suggest; instead of increasing weight perhaps an increase in reps is the way to go.
I have found in my gym activites before injury that if I increased my reps by 25% before going to a heavier weight I did not suffer the effects of increasing the weight that my partner did by going straight to heavier weight.
I also seemed to get better muscle building results than he did.
post #600 of 10804
Edited by Jobo Pooks - 9/26/09 at 4:18am
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