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Quadriceps Tendon Rupture, Repair and Rehab - Page 195

post #5821 of 10803
Originally Posted by Shoonka View Post

@Keithus and @NJ Pete, I'm also a Vermonter! I still live in the Norwich area.


I'm at the 4 week post-surgery for my biquad rupture - going in to meet with surgeon and ortho specialist tomorrow. Fingers crossed they lets me start bending and putting weight on the legs. I've been locked in Bledsoe braces at zero since this happened.

I'm firing the quad muscles really well with no pain and the incisions are healing very well (staples out two weeks ago).



@Shoonka, welcome to the club. I went to high school across the bridge in Hanover. I know the area a little. Your OS may or may not want you doing ANY movement. That is typical. Some do and some don't. If he does not let you until 6 weeks, stick with what you are doing. Follow the UW guide and it will get you where you need to be...with the exception of the ROM exercises. The quad setting is teh best possible thing you can do to maintain your quad strength. You are going to lose a little, but those exercises are VERY helpful.

post #5822 of 10803

Thanks @NJ Pete! I'm going to print out that UW guide - looks very helpful. I had my surgery at DHMC, and I'm told the Ortho and PT department is very good there.


It's scary, my legs have already lost so much muscle! - I was really active outside and trained in the gym 4 days a week prior to this.

My only hope is the ability to start walking sometime in the next 10 weeks. Before my fall, I had bought a trip to Maui for my wife and I at the end of March. The departure date would be 14 weeks post-surgery. I'm not going to rush recovery, I just don't want to still be in a wheelchair!

post #5823 of 10803
My mom worked as a surgical nurse in that hospital for a long time. You are in great hands. The second you get the go ahead for PT go 3 times/week. By 14 weeks, you should be full ROM and with a near normal gait in your walk. Remember, there is nothing more important than protection. If you compound PT and at home PT from the guide with some rest and great nutrition you will be in a good place.

Check out http://www.quadtendon.com for some patient profiles and stories. I am adding as I go.

Check my other posts on getting your ROM with gravity.
post #5824 of 10803

I am 15 weeks post op with bilateral tear repairs.  Have been going to Physiotherapy (Private Clinic) 3-5 times weekly for past 5 weeks.  The only area I am lagging (or legging) in is to be able to contract the muscle to completely lock the knee(s) straight.  The last 5 degrees seem to be "droopy".  Physiotherapist is using the "taser patches" for electronic stimulation as well as a stretched elastic band just below the knee pulling while contracting the muscle.    Is there another specific exercise that I can do to get this last 5 degrees of straightening?  Or is it something that will just happen over time?  This maybe seems to be the muscle that has to perform to get rid of the going downhill anxiety?  

post #5825 of 10803

@skicarver, the condition you have is extensor lag. Not sure of the underlying cause though. Extensor lag is quite common on QTR patients. I can tell you there are common and uncommon causes. Please view this link for both. My guess is that you still have a strength issue. Are you doing strengthening exercises in your PT sessions now? If so, what kind are you doing?


Follow the link above as there are some good closed chain exercises that will assist with strengthening the quad.

post #5826 of 10803

Thanks N J Pete

He has me riding the bike.  I was doing leg curls with 60 lbs each leg but once my Physiotherapist noticed the extensor lag he had me stop it.  He has me doing a form of the press outs but do not look nearly as effective as the demo you provided looks to be.  I will send Physio the link to show him what others are doing.   I think the leg press at the gym may be helpful.  Maybe do reps of 25 degrees to extension lock. Bilateral cases are very rare here and seems I am being treated a bit more cautiously by Physio.  

Once again...we have to be an advocate fro ourselves

post #5827 of 10803

Sjkicarver, I had extension lags of 5 degrees on both sides at 15 weeks, which have since diminished but are not completely gone. The extension lags were not at the zero position but from minus 10 to minus 5 degrees, and I wondered why they mattered. I was told that mild extension lags are a strength issue that diminishes over time. When I was in P.T., she had me do an exercise where I faced the wall with bands extending from the wall to around my knees. I would bend the knees forward and straighten them against the resistance of the bands. Other exercises that help are the elliptical machine (alternating forward and reverse if you are comfortable with that), and the "strider" that resembles an elliptical except that it goes forward and up, then backward and down without following an elliptical path. The multiple step-downs also help if you completely straighten each leg each time you step back and up. The leg press and stationary bike didn't seem to affect my extension lags, although logic implies that they would help.

post #5828 of 10803
Hi all

Brief update, now approaching 7 weeks post surgery for right rupture. Pleased to say I can perform leg raises now off the bed with and without brace.

Brace is still set at 50degs and not quite reached it yet but I feel bit more confident in pushing it bit more, thousand elastic bands round the joint now feel like 750 so progress is there but bloody slow!

post #5829 of 10803

@ Skicarver. My PT spent weeks / months working on the lag I had. Personally, I agree with Runnermax in that I think it would correct itself over time. But he was quite concerned with function. Interestingly he had very little focus, or concern, about ROM. In fact, he never did any ROM stretching, and zero scar tissue massage ( much to my relief ). Those were the primary focus of the PT I had when I did my left QT 10 years ago.

My current PT explained that the lag was as much neurological as it was muscle wastage. Nerves severed and damaged when the injury took place have to regrow / repair and connect to the brain. Makes sense.

The one exercise that helped me most was where he had me sit on a firm surface, placed a bar bell below my knee, and had me try and lift the heel off the surface I was sitting on. At first I couldn’t do it. But after lots of practices, I could get it to lift up momentarily – then after 2 to 3 weeks – I could hold it up. It is important that you don’t use your hips to hoist the heel up. You have to keep your hips / butt firmly planted in one place. Use your good leg as a bench mark for comparing and estimating lag. I often used to do the reps rather quickly and alternate the legs. Seemed to coach the nerves into copying the good leg.

In the early days, when I first arrived at PT, the first thing he would have me do was a straight leg lift and measure the lag. Then he would have me do this exercise for 10 minutes, and have me do it again. Low and behold… no lag. He said the exercise “got the nerves firing”. Don’t know if he was correct – but it definitely worked. I wasn’t released from PT until I could do a leg lift with no lag at the beginning of the session.

Other exercises included the one outlined by runnermax. Only mine was done on a slant board on the decline.

My PT focused on the control in the 5 degree range. Making me do countless exercises where I wasn't allowed to let my leg flick back into the locked position. He seemed to think that control in this range will help catch you when slipping / stumbling and protect from future reinjury


post #5830 of 10803

Here's a glimmer of hope for runners in the bilateral tear club. I'm now 5 months, 3 weeks (almost 6 months) post-surgery. Yesterday I went through the motions of jogging a mile, 9 laps around an indoor track. Very slow, reluctant to look at the clock. Today I doubled down, went two miles and it felt better. Still slow, 35 minutes for two miles. I  noticed that some of the runners with one injured leg started  around this pace and  worked their way forward. You really  have to start at ground zero, and get past ground zero before you can get to square one. I see this as reason for I optimism because a month ago I could not have done this.

post #5831 of 10803

Yesterday I met with the surgeon and ortho specialist - it was exactly 4 weeks since my fall (today is 4 weeks post-surgery for the bi-quad rupture)


I was hoping for good news, and got it! Things are healing very well, and I was given the go-ahead to start 'walking' with the aid of a walker. The best part was actually standing up for the first time in a month! What an experience! My legs felt like rubber - very shaky and weak. They had me 'walk' and it was a slow shuffle. I gripped the walker for dear life. A good portion of my leg muscles have wasted away. I look like the bulldog cartoon character from the old Warner Bros. cartoon - big upper body, tiny stick legs! I was up and standing 3 times yesterday for short periods.


Bledsoe braces are locked at zero and will be adjusted by the in-home PT. The ortho dept. gave them an outline for the next 4 weeks. It includes a 10 degree increase every week (starting at 30 in the next week) - this depends on progress and pain level. I'm slated for 3 in-home PT visits a week. After that, I will be going to the PT dept. at the hospital for the remainder.


All in all, it was a great day yesterday. Literally the first steps to recovery!

post #5832 of 10803


  7 weeks post surgery today.Have had two great PT secessions with specific

goals each time.Walking outside (flat and dry) with crutches 2x 35 minutes each

time.Working on leg lifts, calf raises and upper body strength work etc.Started driving

3 days ago with no problem,other than getting in and out of the car. Brace set at 60 degrees.

Did you start PT yet?

                      All The Best,


post #5833 of 10803

@RUNNERMX: Great news! When I started my first very slow jogging after 5 month after right knee QTR, I did it in intervalls, e.g. 500m run - 100m walk, this help me a lot.

Just be carefull not to overact which I did it in this phase of recovery (my surgeon who is a marathon runner friend pushed me).  Good news from me: my next challenge was to have the courage to run downhill again. Last Saturday I did it:  a 2 hours run 600m uphill and back downhill (snow and ice disappeared last week thanks to the mild climate here in the german/austrian/swiss corner I'm living). And : no negative impacts the following days, I was so glad!

It shows: you could think that recovery is in a stagnant phase but suddenly, sometimes unexpected, you achieve the next target.

All the best for you and all others in this club!

Cheers Richie

post #5834 of 10803

Thanks Richie1, and congratulations on your continued progress. It seems that the muscles that make running challenging are the same ones that make it a challenge to a) descend stairs, b) remain suspended on the Stairmaster for a long period of time, and c) perform vertical squats with weights on the back. For the past few weeks, I've been working on b) and c) intermittently, and on a) every day by performing up to 300 step-downs with each leg. All of these movements have been improving in tandem. Prior to January, I wasn't doing any of these movements regularly because they were too difficult for an ongoing routine. For now, I will probably stick with running 1-2 miles per day until my speed and comfort levels increase. That will leave enough time for the other quad exercises and the overall conditioning exercises that I do. I haven't hit any stagnant phases yet. This has been a "steady Eddy" recovery, not very speedy, but no stalls or setbacks.

post #5835 of 10803

Great news Shoonka!!  Every little piece of this injury you earn back is a victory!!  You'll be doing the "Frankenstein Walk"  before you know it!! 

post #5836 of 10803

Hi Calliker


I like the fact we are both on the same timeline, like in the right sense of course!


I see my PT once a fortnight at present and that is just to adjust the brace, she said the real therapy will start in 2 weeks time as she wanted to make sure the tendon had healed.


I dont use my crutches at all now and the leg is slowly getting stronger, not quite at 50 degrees yet but I hope to before next Tuesday when she sets it to 70.


I still cant drive though which is a right pain in the jacksey but again I hope next week will see me start.


All the best

post #5837 of 10803

Hi everyone.,

                      Just an update on my progress I went to work for three half days (6 hour shifts) and walking or on my feet for at least 5 hours and boy what a challenge I can do my normal work but the leg just becomes so rigid and makes me limp and tire so much. I still have a problem with swelling of the whole leg. This makes me both mentally and physically tired at the end of the day but alas going to try a 10 hour shift on Monday. I cant think of who said it but they were right its the toughest rehab you will ever do.




post #5838 of 10803

I have returned back to work on a full time basis.  I ruptured the quadriceps in both legs on July 22, 2013 and had surgery a few days later.  In August I acquired an infection in my right knee and had surgery to clean out the infection.  I nearly died from that.  I was in-patient from July 22 to October 28.  I had home health from October 29 to December 31.  The home health included physical therapy. I went back to work on January 2, 2014. 


I have ditched the wheel chair and am using a walker.  I am finally able to go from a sitting position to a standing position if the chair has arms (or there are bars in the bathroom). 


I am still seeing my orthopedic surgeon.  My right knee looks like it may be infection.  My right knee was totally healed and then I started getting these very strange bumps on the incision.  My doctor said it was granulation.  The granulation thingies are full of blood vessels and the dang thingies bleed a lot.  My surgeon wants to do surgery and remove them.  He says it will be an outpatient surgery with only a week of down time from work.  The surgery would be done under general anesthesia.  I am scared to death of another surgery.  I had such a bad time from the last surgery that was done for infection.  I was out of it for 8 days and nearly died.  All I remember about those 8 days is that I felt terribly alone/scared and could not communicate with anyone in the room.  I think I have PTSD from that experience.  Anyway, I will be seeing the surgeon next week and will probably have to have the surgery.  I am also supposed to see the infectious disease doctor but he has not called back with the appointment time. I would be happy if he would just prescribe me an antibiotic to clear all this up and skip the surgery. 


My knees are still quite sore.  When I first get up after sitting or sleeping, I can hardly walk because I am so stiff.  Must be the arthritis that the doc talked about.  Once I walk a little bit, I am doing fine.  No way can I do stairs.  I can finally step up and off a curb with a lot of help.  My recovery is sooooooooooo slow.

post #5839 of 10803


 Sounds like you are doing great. Let's keep track of each other.

Where do you live and can you get outside for a walk,it really helps

me to get out of the house.Start back ,in a very limited way,to the

gym next week.

                           All The Best,


post #5840 of 10803

Terence, being tired at the end of the day is normal for the next few months, but standing up until your leg swells means your body is telling you something. If you have to stand up that long, and have no other choice, remember that it is always easier to walk than to stand in one place. If you have to stand in one place, shift your weight back and forth from one leg to the other, as if you were walking in place. You will feel better.

post #5841 of 10803

I live in England and it's mostly hammering down at the moment, I manage to get out walking most days but leg tends to stiffen up after a while.

I have been back in the gym for 2 weeks now, doing 20 mins on upper body ergometer and then circuit of dips, press ups, pull ups and some light weights. Just feels awesome to sweat and the blood pumping round seems to make leg feel better!!

Good luck
post #5842 of 10803

Poodiesmom, you might want to get  second opinion because (from your previous posts) I'm not convinced that these people know what they are doing. I've had bumps, scabbing and scaling on my knees (especially one knee) for the past two months, and I've seen other posts from people with similar issues. I used creams to try to treat them and they got worse. Then, my O.S. said I should only clean the areas with soap and water and otherwise ignore them, and the scaling will eventually go away. So far he has been right; the scaling diminishes gradually. 

post #5843 of 10803


                            thanks for the words of support and encouragement its really helps. I like the support from this forum as when you have a bad time you only have to look to the forum for words of advice and support. Again many thanks.




post #5844 of 10803

@poodiesmom, Not sure if you are able to get a second opinion, but it might be worth it. Also, if you get your immune system WAY up, you will not have to worry so much post surgery. There is only ONE way to do it. Extreme living enzymes in and waste out. That is why I tried to push the juices on you. The cold pressed juices are great. If you drink enough throughout the day, you will flush the MAXIMUM nutrition through your body. My heart stopped while I was in a coma on a respirator. My heart stopped again while I had sepsis after my bilateral surgery. I know PTSD. I know some other strange stuff that maybe is not meant for this forum. I am glad to hear of your progress. Keep the positive thinking. You can do it!!! You have come a LONG way so far.

post #5845 of 10803

I am definitely going to do the juicing.  I need to buy a juicer.  I would love to get all vegetables and fruits in my system by using juice.  Thanks.

post #5846 of 10803

I am so happy to have found this group.  I really felt alone without anyone to talk to.  You just don't find that many people with quadricep ruptures and you really don't find many people with bilateral quadricep ruptures.  Good advice and good support on this site.  Thanks!

post #5847 of 10803

Hi 'poodiesmom', sounds like you are having a bad time of the injury.

I'm also 'Bilateral' from 11th July last year. My surgery has healed very well and I've been up on my feet for some time now. Just cannot discipline myself to do serious excercises!

I've just 'found' a rugby ground near to where I live which has a running track around the perimeter and a couple of decent excercise 'units' at the side . There is a set of concrete steps from one level to another and I've had a go at running up and down them. I can run up two steps at a time but coming down is still a challenge. BUT I still cannot even jog on the flat!!!!!!!

I have my own building business, renovating primarily bathrooms and kitchens. Getting tools and materials up to a bathroom will be a no - no at the moment, but I'm gonna have a go at a kitchen in the next couple of weeks (which is on the ground level.) I've maintained upper body strength and have some leg strength but my Quads are still quite pathetic and that's at nearly 7 months.

I used to be a Technology teacher and have visited an agency to see if I could get back to teaching. They said that under Health and Safety grounds I would not be allowed into a school, so that counts that option out.

I have been on benefits here in the UK for the period and I really do need to get back to making real money. In the UK we have a system where after a period of time you are assessed for your suitability to work. I have an appointment for the 23rd this month so I shall see what they have to say. Must confess I'm gonna get as much as I can out of the system as i've paid my taxes for the last 40 odd years and now I want something back!


I'm really surprised that you have gone back to work so early. Occasionally I still feel as though my legs are going to collapse forwards, especially if I catch my toe on something. You are really brave to do what you are doing considering that you are also having problems with your surgery. I do not post on the forum very often but I do read the new posts every day.

I hope that your progress does not have any more 'hiccups' and wish you a better new year from a pretty miserable YORKSHIRE in ENGLAND.:) 

post #5848 of 10803

I decided to go back to work because staying home was just driving me crazy.  Plus, I have been without a paycheck since last September.  My law firm does have disability insurance but I have not filed for it yet.  It only pays 50% of my gross salary.  I am still walking with a walker and riding the handicapped bus to work. The handicapped bus has a lift so I don't have to worry about the steps into the bus.  Any kind of step is a no no for me. I work on the 6th floor of my building and I do worry about a fire drill or a real fire.  I would have to somehow get down the 6 flights of stairs.  I think if there was a fire, I could probably make it down the stairs.  I would have to go down walking backwards and holding on for dear life.Biquad,  I'm impressed by all that you can do.  My quads don't hurt at all. It is my knees that are really really really painful.  I also have arthritis so it may be the arthritis that is causing the pain.  I also think that I need a lot more strength in my legs.  I have not been really good about doing my exercises, but I have started back doing them. 


As far as going back to work, I find that I am making a lot more progress than if I stayed at home.  My secretary reminds me hourly to get up and walk.  I am also the organist at my church.  Last night was the first time for me to play for the choir rehearsal. The chair to the piano is too short for me to get up from.  So, I stacked three of the plastic chairs on top of each other and I had the right height.  I have to make adjustments all the time.  I can't really go to a restaraunt because the chairs are too low and don't have arms for me to push up from.  I have to plan every trip in advance.  For example, I can't go visit people in their homes because their toilets are too low.  So, I either have to not eat or drink anything for a while before visiting or I have to leave and go home. 


I am improving each day.  It may not be a lot of improvement each day but the little improvements do add up. I really rejoice over each small improvement. Like the best thing all week for me has been finding out that I can use the handicapped toilet at work.  There are bars on the left side of the toilet and I am able to pull myself up.  I have never had to pull myself up with bars on the right side.  That will be a little scary for me because any time I do something that I have not attempted before, I am a little scared.  I am terrified of falling again.


Good to be able to rant to all of you.  Thanks.

post #5849 of 10803


You are definitely not alone in being afraid of falling again.  That is my biggest fear!  Keep up the hard work, glad to see you are making some progress... even if it is slow.

post #5850 of 10803

Well I rupured my quad tendon Labor day slipping while playing golf. Surgery Sept 5, 2013. I started PT at 4 weeks after surgery. I went 3 times a week and did home PT everday of the week 2 times a day. It was all stretching for the first 2 months of PT. The PT started stregnth exercises at about 3 months and I was still in a full brace. In Dec at 3 months I could take the brace off in the house only and I started to try going upstairs which was scary but I can do it holding the raling but down is still a no go. My PT has ended and I am on my own. In January 2014 I saw the Dr for my 4 month visit the doctor told me no more brace. Yippee so tired of that full leg brace. I have a neoprene brace that I can use as needed and have not had it on much. I joined a gym to work out the quad which is still very weak. I do cardio 4 times a week and work the quad hard 3 times a week. I see the DR next in March for my 6 month vist right before my first golf trip sicne Sept. I have a great PT who I can email questions any time. It still feels like all my exercise is hitting the tendon and not the muscle since it gets tight. This injury really stinks and your really need patients big time. My Dr keeps telling me at least a year to get my quad back. I am going to keep pushing. Good luck everyone. My ROM was complete after about 4 months and I never really had tendon pain. Now sometimes I feel a sharp pain like something is tearing so I just rub it.

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