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Quadriceps Tendon Rupture, Repair and Rehab - Page 21

post #601 of 10804


Originally Posted by Helmut2468 View Post
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?
Helmut - Hi
I know EXACTLY what you are talking about. I swear, your and my doctor must have gone to the same school!
  • I too am stuck with the immobilizer for 8 weeks AND I also have the "slide down" problem you describe....and it sure does make a difference where the straps lay in respect to your knee. I'm 5'9" and weigh 126 pounds and my legs are thin anyways.
  • To best describe what it is like for me is this...You know those little novelty items that has all the colored-thick-liquidy stuff in them that flows so slowly and you turn these items upside down and the gunky stuff starts draining down to the bottom of the plastic container..(supposed to be entertaining, I guess.)..well, that is what it is like for me....I stand up and it feels as though all the fluid in my leg just starts flowing ever so slowly to the bottom of my foot. You can actually feel it just draining down. My foot and then my leg gets bigger and bigger until I am racing for my chair to sit down and get my leg up....(that really stinks by the way)....Sometimes, I think my foot is going to split open.
Now with respect to the immobilizer problem here is what I do...

First, I have the velcro monster with the area directly over my knee covered but there are no straps that tighten directly on top of my knee. Just above and below and for several inches. 3 on the bottom and 3 on the thigh.
I have found that , when I stand, the first strap just below my knee seems to press on the bottom part of my knee just enough to cause a lot of pain there. (Near the tibial tendon-the tendon that comes off the bottom of the knee cap). So......

I cinch my immobilizer like this...The first 2 straps on my thigh gets cinched gently snug. The bottom 2 as well. Gently Snug with the straps going behind my leg.....BUT, the strap just below my knee I cinch it just a bit less than snug and then I take the strap and lead towards the bottom of my splint and stick it there. That way, it sort of pulls the "buckle" at an angle, away from that tendon. My incision is right there too and it helps to keep the strap off of that....simply put, I can't have anything on that area anyway, it just hurts too much.
Now, the first strap just above my knee gets done the same way...not as snug and not wrapped behind my knee , but gets taken towards the very top of my immobizer and anchored there. It doesn't make my splint any less looser as we have those 2 metal side bars, which, I stick my finger inside of those and run it along both sides to sort of loosen the splint some, just a little helps a lot. By cinching the top 2 straps and the bottom 2 straps gently tighter, I don't have the slide down problem as much as I did in the beginning.

I would like to know, when was everyone able to pick up their own leg and how do you guys do this. I have to have somebody actually lift my leg for me...seriously, I can't do it yet.....Hubby, as gentle as he tries to be sometimes tweaks my knee and that smarts! Doesn't last too long, but still.......

Hope this helps...!! - Talk Soon - Connie
post #602 of 10804
Connie thanks I will try the strap sequence you mentioned.

As far as leg lifts go-- I have been able to lift my leg easily after week 4. My OS specifically said to start lifting it and do quad flexes several times per day and put full weight on it as long as the immobilizer is on.

Try lifting straight in front of as you are standing. Lift it as high as you can comfortably. I do 3 sets of 10. Lift and hold for 3-4 seconds then rest 3-4 seconds. This works very well.

I also do some lifting while laying on the bed but, not very high it is a big strain on the leg.

Lifting while i sit on the bed is much more difficult because your leg is already at 90 degrees to your body so you can't go more than a couple of inches up. I find it somewhat painful but know that the real problem is the immobilizer. Once it is off the pain should be less.

The swelling in my foot acted the same as yours. However, as soon as i started putting weight on the foot within 24hours that went away. I also removed the tensor bandages and use a hand towel for padding inside the immobilizer. That seemed to help a bit as well.


Mine happened as a result of a motorcycle crash. All my OS said was that after 40 there is a natural degradation of tendons. If you played contact sports like hockey(which I have for 35 years)that degradation would be increased.
My repair was tendon to tendon so I escaped the extra pain of having bones drilled into. However, the first 2 or 3 days was pretty bad. My doc kept me well doped up. Toradol ever 6 hours and morphine as requested in between.
After i left the hospital he gave me a script for Tramadol this contains parcetamol and acetaminphin. Stuff works well but made me feel sick and left a real bad hang over feeling.
post #603 of 10804

PT progress, see doctor Sept 9

There has been no measure of rom since my last post. Maybe it it will be measured tomorrow at PT. I guess they figure I'm past 105 rom and they see me go way down on the Total Gym so they probably don't see a problem with me being stuck. It just takes time. If I go by how far I squat down on Total Gym and the way my leg feels, I probably just have a little ways to go for total rom for my leg (whatever that may be).

In general, I feel more strength and stability in the leg. Of course there is a long way to go, but it is feeling better.

I do not have the strength to jog yet (nor have I tried). We haven't worked on walking down and incline. I still do not have strength to always try walking up stairs pulling my body weight up with my injured leg. Sure I can do 10 reps x 3 on the Fonda step with one riser at PT (going up and 10x 3 going side to side) but I grab on the stair rail at home and always go slowly up the stairs. Sometimes leading with injured leg, sometimes not. I'm not going to stumble on the stairs late at night or early in the morning when I'm not quite awake.


Illinois Tie Tripper - I started with 2 crutches, then I started using 1 crutch. I ditched all crutches 2 weeks ago when going out in public (injury was 5/28/08). I wear my jointed knee brace out in public but not at home. I might bring a crutch outside if I know I'm going to be in a crowded public place or walking in an area that is hilly. I did not use a crutch inside the house since about over a month or two ago.

don jp - using the leg machine with the padding behind my leg - PT added more weight from 12.5 to 15 pounds and 4 sets x 10 reps. I still get swelling around the knee when I do too much activity. I'm good for a few hours of standing, walking, exercising, and then I need to elevate and ice the leg to decrease the swelling. I dont' know how long that it going to go on? How about those that are further along? When does this swelling finally go away? I don't have any pain around the knee (but then I don't have holes drilled in my kneecap). Once I broke through scar tissue, there has been no problem bending my knee as far as I can get it doing my heel slides on the bed. In fact, I don't even have to use a towel or anything to help get the leg bent. I sit there and do 20 raises and by the last one, without straining, the leg is bent as far as I can get it.

I saw a person in PT on table on stomach, using a strap to pull his foot way up to his behind. I said to the PT "I guess that is one exercise a quad patient should never do." She said that is right, it puts too much stress on the quad. So for those of you thinking of doing that--it isn't recommended. Just do those heel slides.

bulldog - treadmill, I'm only doing 10 minutes on treadmill 3 times a week at PT going up to 5 incline (I would guess that it takes me about 2 minutes of slowly getting the incline up to 5 and then towards the end going down slowly, so I'm probably only doing 5 for 6 minutes straight.) Anyway, the PT felt I could do it and I haven't had any problems.
in2falling - Your workout schedule made me tired just reading it. We all have certain energy levels. I'm just wondering how I'm going to manage an exercise schedule when I go back to work (won't know when I go back until I see doctor Sept 9). I have to wake up at 5am which only give me 45 minutes to get ready and walk one block to the corner for the local bus at 5:45am (I may have to get up at 4:45am because I can't run like I used to if I was running late.) The bus takes us to the local train station, train arrives 6:20am, arrive in L.A. by 7:00am. Once again, I can't run to the bus so I don't know how I will make it from the platform to bus and get to work by 7:15am! Then when I'm at work, I work a 9/80 schedule so I'm at work until 4:45pm. I'll probably never make the 5pm train, so I'll have to settle for the 5:20pm train and by the time I get back home it will be 6:15pm. That is about a total of 13 hours gone all day. I only have 30 minutes for lunch, some of that time I have to use just getting my lunch. I guess while I'm at work I can make trips to the fridge to get a bag of crushed ice and elevate my leg. I have two 15 minute breaks so I could ice on breaks and lunch.

I was thinking about waking up earlier to do some stretching or riding the statinary bike. However, by the time I get home, have dinner, read mail, there isn't going to be a lot of time. I used to go to bed by 11pm, but I'm going to need more sleep so I'll have to get to sleep by 9pm at the latest or I'll never make it through the week. So, I'll have to do my work out at home when I get home.

How did you more advanced people get through the day at work? I'm thinking if I don't ice and elevate at work I'm going to have a terribly swollen knee and won't be able to do much exercise when I get home. I can't elevate the leg on the train (you can't put your feet on the seats and it is always crowded).

Helmut - Sometimes I would loosen up the strap that was at the knee cap or just undo it completely. With the rest of the straps and metal rods, the knee isn't going to bend.

Weights vs reps - My PT people said they would rather have me increase sets instead of weight. So I know go from 3 sets to 4 sets on most of my exercises with a slight increase on weight for the machine where I bend my leg back.

Jobo Pooks - Thanks for the link with your story. I don't think most of our doctors spent much time wondering why the quad rupture happened. I don't think there is any one reason for all of us, except being over 40. In my case, I didn't even fall or slip--freak accident.

ConnieP - it takes quite a while to be able to lift your leg up. In the meantime, I would have to just lift the bottom strap of the immobilizer and get my leg to where I wanted it to go.

It is too bad your doctor does not let you put weight on the leg. I could do so right after surgery and it made all the different. Ten days after surgery when the staples were removed, the next day I was on a table at PT doing quad sets, heel raises, and side-to-side slides. The following week we added assisted leg lifts. I would do all these 3 times a day. I used a towel as a sling at home to assist my leg up and after 2 weeks of 3 times a day and 3 times at PT facility, by the end of those 2 weeks I was able to lift my leg up barely an inch off the bed. It was one of the happiest days for my recovery. Before that, things were really depressing.

One that leg started moving on its own power, I quickly was able to lift the leg with a shoe on, then a small weight, and I worked up to a 10 pound weight in a few weeks. I asked my PT if I should do any more than 10, but she said 10 was the max. She said she couldn't even do 10 pounds on a leg lift. She has no injuries, she just said she has weak quads (maybe this means she will never have to worry about a quad rupture).

So, everyone is different in what they can do.

When I went to PT 10 days after surgery, I was still wearing the immobilizer. That thing only came off for PT at the facility and at home and went right back on and I had it on for 6 weeks. However, by week 5 I noticed when it slipped down my leg, I was standing and walking on my own (keeping the leg straight) and the immobilizer wasn't helping me do that.

Good luck to everyone on their recovery. Right now I'm more concerned about if the doctor will release me on Sept 9. I wouldn't mind being off another 4 weeks to increase strength and endurance for going up and down stairs, up and down inclines, and even attempting a slow jog.

I'm really concerned my PT will suffer if I go back to work. I'm still doing my 3 times a day exercises at home and that will not happen when I go back to work, along with being able to elevate and ice when I need to.
post #604 of 10804
Helmut-At my last visit my OS did say I could bear "light weight" -which I do just standing...otherwise I don't know what light weight bearing is. It wasn't until after I got home that I began to think ok....now just exactly what does that mean? Either I am standing or sitting...as I can't bear full weight yet. Maybe at my 4 week check this Wednesday, I get the "Go" on the full weight bearing. If I can just get past the foot swelling, as I now try to stay up even when it is swollen (feels like I am standing on two balls. I did try to swing my leg forward yesterday...and it just would not go. It's like there just wasn't a way to get it to move forward....???

However, I am so happy to announce that yesterday was my first day since my surgery that I was 100%-totally pain free!!!
Even when adjusting the splint up or down...pulling the bar on the splint to bring my leg closer to midline or pushing it, to adjust farther away from midline...PLUS, I didn't take any noon'ish meds yesterday-forgot'em and was still pain free!!!!! Also, with the first mornings stretch, the quad had taken some passive contracting for sure....in the beginning it hurt a lot and now, I just let her go....

I know, "Pride goeth before a fall" so please know I'm not bragg'in....I am however, just very THANKFUL!

CalPop-If I were you and I wish I was, as far as your recovery goes, I would sincerly tell your OS your concerns. And how fast everything has come along doing what you've been doing and that you'd really-really appreciate another 4 weeks before going back to work....Explain to him your work environment and perhaps he'll give you more time..!!

Ank-I owe you a message....haven't forgot you...
post #605 of 10804

4 Weeks 3 days Post Surgery

Hey Guys! I hope everyone is enjoying their Labor Day Weekend.

I'm starting to "feel" a lot of progress. I'm a week pain free. No meds for an entire week. I feel a little soreness or pain, but it's short and bearable. I have iced a couple of times at night. I try to stay off of it as much as possible. But thats really hard to do when you aren't having any pain at all. It makes you feel like you should be up doing something. But my doctor was pretty specific about staying off of it until the 15th of Sept. So ConnieP, I truly understand what you mean about being confused about stay off the leg. So I move around the house and up and down the stairs, with the immobilizer and crutches. I haven't tried to move about with out those aids ...yet.

Last Monday I was sooooo tired of sitting in the house, my wife and I went out to dinner. The ride in the car was kind of uncomfortable not being able to bend the knee at all. About halfway thru dinner I started feeling a little soreness. Probably because i wasn't used to having the leg on the floor that long

As for the straps, my sequence is exactly as ConnieP. Tighten the bottom and top and leave the middle a little loose.

My swelling has gone down and the tenderness is easing. When did you guys start sleeping without the immobilizer. Now thats annoying for me. I can't stand it. The area around my knee(especially above) shakes like jelly. When I stand in the shower, it feels like there is no support around that area. Now thats scary. My doctor doesn't communicate information very well. When he says just stay off of it until 9/15, I wondering if I can do any flexing of my quad or walk without crutches or anything. hmmmmmm. No pain at all and I can lift my leg off of the couch and bed when getting up. Not sure when it happened. Just realized I was doing it one day this week.

Thanks for all of the information guys and keep up the rehabilitation efforts. Every post is encouraging.
post #606 of 10804
Dudinmd-In the car I find it very help to fold an old pillow in half and jam it under my heel of the bum leg with my good foot That seems to really cushion the leg well.

In restaurants we request booth seating that way I can slide in one side with my leg up across the bench seat.

I now keep my immobilizer very tight on the bottom 2 straps and the top 2 straps. The 2 middle ones are very loose. This has helped decrease the pain in the knee joint. Funny thing is this morning I woke up and the immobilizer was turned almost 90 degrees from normal. Must be sleeping better not to notice the twisting that must have gone on in the night.

Connie- Doc told me to weight bare at the 4 week appointment. I asked how much and he said full. I can tell you for sure that I am not putting all the weight on the knee though. I just tried really hard to put full weight on the leg and could not do it. The immobilizer is the problem I think. I feel like the leg is bent ever so slightly this is causing me not to be able to lock the knee to take full weight. I'm sure that once it is off I will be fine. Until then I load it up the best I can. Some is better than none.

I did not start trying to lift the leg forward until week 4 1/2 so I'm sure you will be able to do it better at that time. The quad flexes really help make it feel better too.

As soon as I was told to start full weight baring the swelling in my foot disappeared. Seems like it took about 24 hours for that to happen. It was amazing how fast it went down.
post #607 of 10804
Duncan: I'm getting my sleep, normally in bed before 9pm and sometimes hit the sack when I put my two little girls to bed at 8pm. Weekends I sleep in and normally get 10 hours of sleep. My wife is a stay at home mom and has not worked for the last 2 years which has been wonderful throughout my rehab, she does almost everything around the house during the week allowing me to focus on work and rehabbing this knee.

CaliforniaQuadPop: I crutched back to work about 2 weeks after surgery and it sucked, I did not have much of a choice since I am a IT contractor/consultant and If I do not work I do not get paid.
I suffered the first few weeks back at work with no real access to ice, but we moved to a new building couple of weeks after I came back to work with a very nice break room with a ice machine 50 feet away from me. So I just brought in a bunch of ziplock baggies and a big ace bandage for my icing.

I have no real choice but to continue my aggressive rehab, I am suffering from quite a bit of scar tissue that I need to get broken down. I am trying to figure out why I have so much scar tissue from this injury. Along with spraining my MCL, I thinking I may have bruised the bones inside my knees from my violent landing which caused bleeding which developed extra scar tissue.

I just started doing my own Graston Technique (http://www.grastontechnique.com/) massage therapy on my scar tissue last week. I use my SnapOn socket wrench and or a long thin screw driver, grab both ends and work the side of the knee and the quad tendon. Do it right after ultrasounding using the ultrasound gel too lube it. Oh man the fun of grinding away at your own scar tissue!! It feels like I am rubbing against a ruff tree, but seem much more effective than using just my fingers.
post #608 of 10804
Edited by Jobo Pooks - 9/26/09 at 4:19am
post #609 of 10804
I just looked at a slide show on grastontechnique.com. Doesn't look like a difficult thing to do yourself. i'm sure we could all find tools around the house to use.
post #610 of 10804

5+ months

Hello friends, both old and new -

I see a lot of new members since the last time that I logged on a few weeks ago.

My QTR happened on February 20 and I had surgery the next day. I was in a brace for about seven weeks before starting PT. I would have started PT at five weeks, but I developed blood clotting in the injured leg due to its prolonged immobility. [A reminder to all of you to take aspirin regularly, at the very least, to help thin the blood during the initial weeks when you spend a lot of time in bed.]

I now have gained almost complete recovery of flexibility in my injured leg, with ROM of about 136 degrees. Getting to that level was the most physically painful thing that I've ever been through, but worth it.

I had PT sessions 3x week from the first of April to the end of July. During August, I reduced PT to 2x week. During all of this time, however, I did PT exercises on my own at home or at the gym. I have a routine that I go through at least 5x week, which takes 1-1/2 to 2 hours per day.

I overdid the PT, pushing too hard during my unsupervised sessions at the gym, not realizing how atrophied my entire leg had become. In late June, I suffered a tear in the gastroncenemius (calf muscle), which put me back in bed and then back on crutches.

I stopped using a cane in early August. I am now walking unassisted. The leg is still weak and wobbly. I walk rather slowly. It will still be several months, I suspect, before I return to jogging, let alone running. My PT tells me that I am on my own now to do the exercise sets daily, remembering to do ALL of them because the ENTIRE leg is atrophied. In five months of PT, I still have not recovered the strength that I lost in seven weeks of immobilization.

Recovery time depends on the individual. The most important variable besides attitude and discipline is perhaps body type. I have always been fit and active, but I am thin and, by nature, do not have a great deal of muscle mass. According to my PT, those of you who have genetically inherited more muscle mass have the capacity for somewhat quicker recovery. This has nothing to do with weight, i.e., merely being thin or heavy, but with muscle mass.

Only in the past week have I been able to get out of bed in the morning with much less stiffness and soreness.

When I first had the accident, the OS told me that it would take about six months for me to walk again without a limp. I still have a mild limp, but I also had a few setbacks during the recovery.

I would like to encourage all of you new friends to keep up your spirits and maintain the discipline that you need to get through this. I had a hard time believing that I would ever get to where I am now, but here I am. You will do it too!

As for you old-timers in the forum, I would like to hear how you are doing five or six months post-operation.


post #611 of 10804

4 Weeks Since Surgery

All, it's been four weeks now and here's where I'm at....

I've been strolling around a bit without the immobilizer, only around the house though. I've gone to the club mainly working on upper body, it seems to help me through my endorphin withdrawals. I've been in the therapy pool 3 times now. It's a great feeling being mobile without constraints.

I have a question regarding the immobilizer for anyone out there.

At what point in the recovery did your OS let you go to an adjustable one? I'm sure it's too soon for me but would like to know when I can look forward to loosing the Frankenstein walk.

I see the OS on the 8th. I'll post my progress according to him then.

Take care
post #612 of 10804
Buford your doing well i see. I still cannot put full weight on the leg at 6 weeks. The immobilizer cause me to have pain in the joint due to arthritic conditions. That pain would not be there if the immobilizer was not on. OS said immobilizer stays on till 6th week then only comes off for physio until they are sure I will not buckle and fall. there will be no adjustable brace for me.
when I see him Thursday I plan on whinning until he lets me take it off completely.
post #613 of 10804

$64,000 queston: Why did my quad tendon rupture?

Hi all,

I'm 15 weeks out at this point and doing most everything I was before I got injured, although not as fast or as long. I ran about 15 miles last week (maybe some mile per week conversion?) and that's the one activity where my knee does tighten up afterwards. I'm going to the gym and doing some quad specific exercises -- squats, leg extensions -- and am starting to get a tiny bit of muscle definition back in the injured quad. My right leg is weaker but feels stable.

As far as the "what did I do to deserve this" question, the best expression I've heard is the "it was your turn to get hit by lightning, pal." On the x-ray they say a tiny bit of calcification which might have been on the tendon which might have made it slightly weaker, but I'd had no weakness or soreness at all before I got injured. Just old age -- at 37 I'm sure this would not have happened, but at 47 it turned out my number was up.

I'm hustling to return to my normal level of activity as soon as I can. One positive thing is that unlike some other injuries, such as a blown ACL, a QTR does not seem to have a high re-injury rate. For folks who are farther out (say 6+ months) and still checking this board, how is the continued recovery? Does the tightness gradually diminish or is that going to be there forever? How much strength have you gotten back?

post #614 of 10804
PhillyBuster and Paulsenw: I was 9 months post-surgery Aug 12. I can do anything I want in terms of activities, however I still feel the tight band on the top of the knee. I am wondering if it has to do with numbness in the tendon. When i last saw my OS (Feb 18) he said it will be a year, although he said he really didnt know because noone has ever come back for a 12 month visit. I plan to go back at 11/12 months if still have the "band", just to see what he says and to give him an update for his benefit and tell him about this thread. I went to the U Minnesota football game last saturday and it was tough sitting in those tight quarters with my knee, otherwise I feel great.

post #615 of 10804
Hello, fellow QTR survivors. I'm 3 weeks/3 days post accident; surgery was the next day. I Stumbled and fell down the steps of my deck. At first, I thought I wouldn't be able to straighten my leg. When my wife (a non-practicing MD) assessed that I wasn't in shock and went in to get her phone, I forced my leg to straighten. It was clear from the start what I did.

I'm a 65-year-old, a distance runner for 50 years -- although I've been confined to my elliptical and weight training for most of the year due to a neuromuscular problem in the calf of my "other" leg. I've also had both knees scoped, and still had discomfort in the knee that I damaged.

I'm in an immobilizer that does adjust, although it's on at "full strength." I see the OS on 9/15. In the meantime, I have a sense -- probably false -- that I'm doing relatively well. At the 14-day mark, I started back with light upper body weight exercises. I do these alone in my basement gym so I'm working at half my pre-accident weight levels to be sure I don't have another freak accident.

Pre-accident, I was doing heavy gastroc/peroneus/tibialis anterior exercises in my leg w/ the neuromuscular problem in an effort to get it back to normal. I don't want to lose all of that, so I'm doing isometrics and easy resistance exercises for the calf muscles, with the bottom half of the brace unstrapped to unconstrict the muscles and blood vessels.

I began a few days ago to do straight leg lifts of my damaged leg. In the A.M., I do six lifts, holding each for 6 secs. In the P.M., I just go up/down 25 times (in the pre-accident, I'd do this 25 times w/ a 10 lb. ankle weight).

I haven't had time to read this entire thread, but thanks, all. I'm glad I found it and will return often. What I've learned to date is that this is a bad injury that takes a lot of time to heal. At my age, I'm not too optimistic that I'll ever be able to run again. If I can get back to thrashing myself for an hour every night on the elliptical, I'll be very happy. In addition, we'r all different, and receiving a wide array of advice/directives from MDs and therapists. But I think I now have better questions for my OS after reading about your experiences. Talk to y'all soon!
post #616 of 10804

QTR fellowship

Greetings fellow QTR survivors. I joined the club 3 weeks/3 days ago, w/ surgery the next day. Fell down the steps of my deck. It was clear from the moment I realized I couldn't straighten my leg that I'd torn a tendon at the least. Had to wait until my wife (a non-practicing MD) went inside to get her phone after determining that I wasn't in shock/wasn't in imminent danger to force my leg to straighten.

I'm in an adjustable immobilizer that's still set to keep me at 0 degrees. My OS visit is set for 9/15. Hopefully, he'll give me some flexibility. In the meantime, I restarted light upper body weights about 10 days ago. I'm keeping this at about half my regular level because I do it alone in my basement gym and don't want to risk any other accidents for now.

I'm a 65-year-old who's been a distance runner for 50 years. But I've been confined to my elliptical for a few months due to a neuromuscular problem in my "other" leg. And, I've also had both knees scoped. The knee I just damaged was arthritic to begin with; the scoping never helped.

I'd been doing heavy calf exercises for the neuromuscular problem for almost 2 months and didn't want to lose all that, so I also returned to these about 10 days ago on a limited basis. I hang onto a piece of furniture in my home gym, loosen the bottom half of the brace, and go to it.

Last week I began doing straight leg lifts w/ both legs while in a semi-recllining position. Until the accident, I had been doing these on a daily basis w/ 10 lb. ankle weights. I don't feel any pain, or risk, doing these. In the A.M., I lift 6 times and hold for 6 secs. In the P.M., I go up/down 25 times.

I'm grateful to have found this forum/thread. There's not that much info out there. I haven't had time to read more than aboout 10% of your posts. What I've learned is that we've had a range of experiences and been guided by a range of opinions from our OS's and phys. therapists. Thanks to you, however, I now have more and better questions I'll be asking the folks who are/will be treating me.

Talk to y'all soon!
post #617 of 10804

Type O blood can be a condition for quad rupture? see link

I found this article on emedicine, just passing along. Not sure what O blood would have to do to contribute to a quadricep rupture or any tendon rupture. Maybe you all can quiz your doctor or PTs about that theory.


(so now I can add over 40 and type O blood for possible conditions in my case, but I like the theory "it was just time for lightening to strike")
Ruptured Tendon Overview

A tendon is the fibrous tissue that attaches muscle to bone in the human body. The forces applied to a tendon may be more than 5 times your body weight. In some rare instances, tendons can snap or rupture. Conditions that make a rupture more likely include the injection of steroids into a tendon, certain diseases (such as gout or hyperparathyroidism), and having type O blood.

later in the article, it specifies under Achilles rupture
"Having group O blood type (This is a controversial cause-and-effect relationship.)"

Of course they left out the newer one:
- use of Fluoroquinolones antibiotics (Cipro, Levaquin, etc.)


As Bulldog mentioned, I would plan on going for a 12-month checkup if my doctor recommends it. Since it does take 6 months to a year for recovery, should let these doctors see what kind of progress there is for your benefit and theirs.

Helmut & Buford - After 6 weeks I didn't have to whine about the immobilizer coming off. The doctor said it was ok to ditch it and then he didn't even recommend a knee brace! But I asked for one to use while out in public as I would feel safer. Mine was not adjustable, but has metal hinges on the sides (you can't see them as they as they are inside special pockets within the neoprene material). I guess I was lucky that my doctor wanted me to go to therapy 10 days after surgery (when staples were out). My immobilizer came off for that, but was on all day and night other than PT.

Seating at restaurants - I did not like booth seating. I would always get a table with 4 chairs (the chairs can't have arms) with my Dad. That way I could put my immobilized leg straight out in front of me on one chair and have it scooted in and put my crutches on that chair. Oh, my legs are short, so I could never sit at a booth and have my leg straight out on the other side, the leg would not reach! And scooting into a booth and having my leg out to the side was not comfortable at all! So, my Dad and I learned where to go eat after therapy. I know all the best places in town that have the right tables and chairs!

PhillyBuster - I am going to learn from your post and stay on the conservative path in regards to my unsupervised PT. I ask them at PT what I should be doing at home and what we are going to be doing at PT. It is hard to be so patient, but doing what I'm told, I have just about reached full range of motion and no pain. Some stiffness still in morning and when being in one position too long. Also swelling if up too long or too much activity, so I control that with ice and elevation throughout the day.

in2falling - your do-it-yourself Graston technique sounds like a good idea. I also watched the slideshow at that site. It might take more work to dig deep into the tissues.

I guess I'm really fortunate in that I have had almost enough sick and vacation time to cover my time off from work. I wish everyone was able to fully recover and have access to good PT before having to go back to work. I have a little emergency funds carrying me through. I pay for enhanced short-term disability. They paid out for 2 weeks, but it has been 3 weeks since they have approved the continuation of the claim and I'm not happy about that.

Fun with Disability Insurance
Does it pay to have "enhanced" disability insurance? Maybe not. I'm starting to think when I get back to work I may discontinue paying for the enhanced short-term disability. Reason? Because I pay about $800 per year for it (bi-weekly payroll deductions)and times 8 years that is $6,400 I could have had in my savings account (plus interest) and not have to fill out forms and such to have access to some of that money. There is a basic short-term disability benefit at work that pays out 50% of your pay and it costs nothing extra. This one is supposed to pay out at 66 2/3% of pay.

I've been calling the disability insurance place every other day. (The initial claim was approved rather quickly and I received two weekly checks, but nothing since 8/11/08.) They have the continuation claim my doctor filled out, it was examined by a nurse (I ask you all, how does a nurse qualify to look at these claims? Doesn't my specialized Ortho MD have more qualifications than a nurse?) And then today I received a call from a claims rep that they "had some questions for me". Well, they called while I was in the bathroom where I can't hear a phone and I had to hurry to PT. So I called and got an answering machine (figures). I said "I don't know what I possibly could tell you that you didn't already receive in writing from my doctor. I'm on my way to PT and I won't be back until 5pm. Please call my doctor at (phone number). This is a continuation of the same claim and I don't know what is taking so long to process. I did not make a miracle recovery since 8/11/08."
(I hope I didn't sound too pissy.)
(Besides, is this some kind of a trick to see if the doctor's information and my information match? Today I got a copy of what my doctor sent out to the insurance company so I could stay on the same page.)

Maybe if someone at the insurance company had a quad rupture, they would better understand just how long recovery is for this!

Then I called my doctor's office and left a message for the person that handles claims to please call my disability insurance person because they need some more information and I haven't received a check for 3 weeks.

When I got home, there were no messages from anyone. So, I guess I'll call my doctor's office in the morning and ask if they got hold of my insurance person. If not, I will beg them to call and answer any questions because they are holding up my claim (I'm sure this is standard procedure.)
My PT thinks my doctor will put me out for another 4 weeks of PT. I know I need it as we are just starting to build up some strength, endurance, better balance, and stair and incline work. We may add another riser to the step on Friday. Of course this means I may have to wait yet another 3-4 weeks for disability to approve yet another continuation. However, I'm more concerned about getting the leg in as good a shape as I can before going back to work. So I may suffer financially for a short while, but I can't really put a price on getting my leg to function normally. Guess I will just have to hound the disability insurance.

Maybe the last card I play with them is asking to talk to a supervisor and telling them I'm questioning my continuation of this plan when I go back to work because I don't seem to be getting what was promised in the plan--peace of mind of continuation of a part of my salary so I don't have to worry about my bills while trying to recover from a major surgery and trying to get normal use of my leg back!
post #618 of 10804

QTR conqueror

Hi, I am on the way to being a QTR conqueror and find this thread to be great. But I also tried unsuccessfully (as far as I can determine) to post my story last night. If this post is accepted, I'll happily return later today and join in at greater length.
post #619 of 10804
I'm not sure your initial post posted....But am very interested in your QTR...tell us about it please!

Anxious to learn more.
post #620 of 10804
Hello Folks...
Well, I had my 4 week post op visit yesterday. And here is what he said.....
Keep the immobilizer on 24 x 7
Bear Full Weight
Walk, but never without the immobilizer.
Begin to bend my leg - but to not more than 30 degrees.
And see him again in 2 1/2 weeks.

OK, so I did try to bear more than light weight....and really, I was surprised, this did not cause any pain in my knee at all! I can't do absolute full weight yet, but I'd say at least a good 70% with no pain in the knee. And I can bring my leg forward actually though, I have to kind of use my hip to do it. I can't do it all the time, nor do I capture a full stride, but I try to get up and "walk" every 4 hours on CARPET-ketchin floor (tiled) is too hard and hurts my heal.

I have no problem with leaving my immobilizer on...now I'm kinda scared to take it off...even later!!

But, I am having a BIG issue with the leg bending.....I am so scared to do this....How do I do it and what do I do if it gets stuck? Does this hurt?? He didn't tell me how to do it other than stick something under my knee and kind of raise my foot...I honestly, shudder just thinking about it. So, I haven't done it yet...He also said that if I didn't it would get stiff and I would have to get a job being a German soldier like in the old WW2 Movies....He thought it was funny, I just felt nauseated.

He wants me off the meds too, he said, I'd feel better just being off of them - He doesn't know I take only one vicodine a day now, just at bedtime. I do take 3 Ibuprofen (200mg each) twice a day and it seems to hold me just fine.

HELP with the bending...

Please and Thanks in advance!
post #621 of 10804
Cali, Go back to work, it is good good for the soul! You will be astounded at how well you will adapt. Pain, Yes and you will figure out your own routine for getting your execises done.

Connie, Lay on the couch, bend your leg, stand up, bear weight and practice walking. Get comfy with and without the adaptive device and get off the meds. Push the risk envolope. It hurts but you will amaze yourself.

The best of days to all. VS
post #622 of 10804

QTR conqueror

Hi, Connie P et al. I'm a 65-year-old who's been a runner for 50 years. For several months, however, I've been confined to the elliptical trainer in my basement gym, and weightlifting, due to an odd neuromuscular condition in my left calf that has so far defied physiotherapy.

On Aug. 11, I stumbled down the steps of my deck. My wife (a non-practicing MD) assessed the situation and, after determining that I wasn't bleeding or in shock, went in to get her phone. I already knew it was bad because I couldn't straighten my right leg. While she was inside, I forced my leg to straighten, which wasn't fun. By that point, I knew I'd torn something.

We called my New York (we live in North Jersey) surgeon right away (he's already scoped both my knees) and he said to come in the next day. Upon examination, he determined that no pictures were necessary; it was definitely a quad tendon tear. The immediate surgery revealed that the tear was complete, but he said the procedure went well.

I came home 2 days later in an immobilizer. By day 4, I no longer needed pain killers; the PT who was sent to do a home assessment decided that I was getting around quite well.

About 2 weeks ago, I began upper body workouts with light weights (I do this alone and don't want to risk any new accidents, so I'm lifting about half what I normally do), and calf strengtheners, with the lower half of the brace loosened, holding on at all times. Ten days ago, I started doing straight leg lifts with both legs. I feel no pain when I do this, only a tightness in the damaged area.

As long as my immobilizer is securely (i.e., uncomfortably!) strapped on, my knee feels totally asymptomatic. I've been mowing the lawn, grocery shopping, just about everything except driving and, of course, pedaling my elliptical. In fact, my left leg, with the strange neuromuscular problem, bothers me more than my right - again, as long as I wear the brace.

I see my OS on 9/15. It's so hard to get good info on QTR's. This thread is the best source. Thank you all. I now have more and better questions for both the OS and whoever I hire for PT.

I'll be back soon. Best wishes to all of you in the meantime.
post #623 of 10804


Connie P et al: I must be toxic. I tried another lengthy post (my third) and got the same message, that it won't appear until approved by an administrator. But nothing ever appears. I enjoy and benefit from this thread and would like to contribute. But so far no go.
post #624 of 10804

Help with bending knee safely

Connie - I can't believe your doctor didn't even give you any therapy exercises to do at home yet wants you to start bending your leg and putting weight on it.

I'll give you the same exercises approved by my doctor and PT.
The safest way to get your leg to bend. First, you need to get on a nice surface. The bed will do fine. Just remove the top covers and fold them all down.

Here are supplies you will need on the bed:
- top of a metal TV tray or a large cookie sheet
- an old thin towel
- a hand towel
- a large moist heating pad
- egg timer
- at least two large pillows to put behind your back while sitting up in the bed doing these exercises.

Get up on the bed (keep crutched nearby) and put some pillows behind your back. Have the TV tray/cookie sheet and thin towel, and heating pad on the bed before you unstrap your immobilizer (if you have the moist heat pad, first run the thin foam under water and stick in back inside the pad--turn to high and let it warm up for 5 minutes or so).

Before you unstrap the immobilizer, put the towel over the tray/sheet, now get the leg over that and unstrap the immobilizer. Keep your leg straight and carefully remove the immobilizer (you may have to roll off to the side to get it off and keep your leg on that towel which is on the tray.) Set the immobilizer off to the side.

Now put that heating pad under and over your leg (should cover the scar area and upper thigh). Keep it there for 10 minutes (oh, might want to have an egg timer handy, or watch the clock, and might as well have some reading material handy.)

After the heating pad has warmed up your muscles, turn it off and set it aside.

Now you are ready for table exercises:

Heel Slides - Your leg (mostly the heel area) should be on the towel which is on the metal tray. This will allow your leg to easily glide on the surface. You slowly raise your knee up hold for 10 counts, then leg it straighten out and count for 10. Do this a total of 20 times. Don't worry, your leg probably isn't going to go past 30 degrees. Do not force the leg in any way. Do not use a strap or towel to help it up. Just go as far as you can, hold, and relax.

As long as you are at it, here are other things you can do on the bed before strapping the immobilizer back on.

After you finish your heel slides, take a rest.
Quad Sets - get a small foam ball (maybe your husband can cut a little chunk of foam from an old cushion as he is handy at that) or take a small hand towel and make a small roll, put that small roll under your knee of injured leg. Now squeeze your knee down on the roll/ball and count to 10, then let the knee relax for 10, then do that 19 mores times. Rest a bit.

Side-to-side leg slides - Keep your leg straight and slide your leg back and forth for 10 counts, rest for 10 (repeat for a total of 10 x 10 = 100 slides).

Assisted leg lift - Keep your leg straight, have your husband put his hand under your heel and slowly lift your leg up about 12 inches while you try to lift it and count to 10, then slowly down and rest for 10, then repeat 9 more times. (The leg isn't going to lift on its own for a while, but this will build the muscle up.)
If hubby is too busy, pick up the ends of the towel so your leg is like in a sling (this may not work because you have long legs). Now slowly lift your leg in the towel, counting to 10, then let it down and count to 10. This exercise will wipe you out, but this is the important one.

Now get your immobilizer next to your leg and roll your leg back onto the immobilizer (or ask hubby to help or use your crutch to help lift your leg onto the immobilizer). See if hubby can bring a Ziploc bag of crushed ice and that handy foam thing to elevate your leg. Now put the ice pack on your knee and leave it there for 15 minutes.

That complete one PT session at home. Do this 2 more times a day. Do all the above exercises 3 times a day (try to space them out 5 or 6 hours apart).
These are safe and I believe just about everyone here did these exercises. My doctor had me doing these at home and at the PT facility just 10 days after surgery (when the staples were out). Sure it seemed scary at first, but when I was able to actually slide my leg across the bed instead of dragging it, and got more muscle tone, and the exciting day I could lift my own leg up without the sling (that happened in 2 weeks, after doing therapy 3 times a day as above), things seemed to get a whole lot better. I stopped the heavy drugs 5 days after surgery. The only thing I would recommend is possibly taking 2 extra strength Tylenol (or similar) one hour before your PT sessions. That will reduce swelling and pain. Check with your doctor though if you are taking other medications. My doctor told me not to take Tylenol and the heavy duty pain meds, I could only take one or the other.

These exercises should not be painful. Sure they seem hard at first, and you will feel stiff, but they will get easier as time goes by. They might get boring, but have a TV or radio on hand while you do them or a window to look out of and it will make the time go by better.

These are the same exercises I did. I am happy to report I no longer have to do heel slides! At PT after they give me my heating pad, I head straight to the stationary bike to warm up. However, at home, I still have my trusty TV tray and towel near the bed and I do about 20 bends in the morning like above to warm the leg up after using a heating pad. And I do my side-to-side slides with a 10 pound weight, and leg raises with a 10 pound weight.

When walking around, have a comfy pair of slipper you can slip on. Then if you are sitting, your heel will be on the cushioned bottom of the slippers. If you are able to get socks on (use that dresser thing or ask for hubby's help, and get some tennis shoes on tied loosely) during part of the day, I found that helped reduce swelling in the feet, provided cushion for my foot, and helped a lot.

Finally, my disability insurance was approved today.

I'm doing what my doctor tells me. I can't wait to see him next Tuesday. I'm pretty sure it will be another 4 weeks of PT but I am working like crazy doing my PT at home and at the facility and seeing results. I have now added 10 pounds (two 5-pound weights) to my wall slides. I'll try 16 pounds tomorrow (if PT approves). We are going to add another level to the step. And my small knee dips that I do to get ready for walking down stairs are making my knee stronger. I have not had any "buckling" feeling. My walking is getting better. I'm almost able to do 10 complete bounces of the ball against the wall while standing on my injured leg. When I can do those for 3 sets, then I will have to do the same exercise standing on a 3 inch foam pad. This really helps with stability and balance and strengthens the knee.

No, I've been out this long and as long as I'm covered I'm going to do my PT and be really strong. Then when I do go back to work, I'm not just going to barely make it through the day, but I will have the stamina to get through the whole day and get through the whole week. Also, my job has a lot of strict legal deadlines so I have to be able to handle everything I'm assigned and not go home in the middle of the day and dump the work on someone else's desk. Also, I have to be able to get across the street with lots of paperwork to deliver and pick up.

Anyway, when I'm finished with my PT at the end of 4 more weeks, my plan is to actually walk to work from the train station (used to take me 15 minutes). I used to walk to the station at the end of the day. I'll have to see how I feel. Anyway, if I can walk to and from the station to work, and then do some walking at breaks and then at lunch go down all those stairs (there are about 45 small steps) to lunch (but take the elevator back up), that will be a way to put a workout in my day. Then when I get home I can do the stationary bike for a while and my wall slides and balance exercises. Then I'll work up to going back to the gym (but I'm getting a workout program from PT before I leave.)

Anyway, we are all different and there are other things that affect my energy levels so we all have to do what is best for our situations.

Good luck to all on your progress.
post #625 of 10804
Well I finally got my orders for PT and removed the immobilizer after almost 7 weeks. It was very nice to spend the evening without it.

The night however, was horrible. The pain in the joint was very bad. Every time i moved It woke me up. Not sure if it is because of weakness in the joint or the arthritic condition guess time will tell.

Doc said repair looked very good. No extensor lag at all. this was due to all the ISO flexes I was doing in the immobilizer. ROM was 38 degrees. Would have been better if swelling was a bit less so I do not anticipate any issues with regaining ROM quickly.

Cali- good to see that you finally got paid. Hard enough dealing with recovery let alone dealing with pencil pushers who could care less.

Connie- definitley need to get away from the drugs. 1200mg of ibuprofen and a vicodin is still quite a bit of pain killer. Can't imagine why you would still need that.

Bending you knee should not hurt too much yet. You will not be able to go very far. At week 4 I was trying to bend it without permission and did not get far at all. To do it I just sat on the edge of my lazyboy with my exposed leg straight out and tried to slide my heel back as far as comfortable under my own power. I would hold this for a minute the slide it back straight.

In the past i have used Cali's methods and they work just fine. But for some reason I am much more cautious with this repair. Probably due to the misdiagnosis origionally.

Being able to swing the leg forward from the hip is important. You must keep that hip strong and flexible. Your ankle too must be kept moving.

Don't worry you will be fine. You will look back on this in a few weeks and wonder what all the worry was about. I can say this for sure as I have been through a few knee surgeries now and it has always been the same. Worry about the future progress then next thing you know all is well.
post #626 of 10804

Regarding the pain meds.

Connie P., in regards to the pain meds. I too agree with Helmut that you need to get away from them. My experience with them wasn't too thrilling. I was prescribe Oxicotyn and Dilaudin for the spikes in pain. After 4 days of this I was feeling a bit closed in and anxious so that was it, dropped them cold turkey. I think another couple days of the med regime and I'd have become a raving mad man.

Whether you know it or not you can become very dependent on the pain meds. If I need something to take the edge off, which is not that often, I take 600 mg of Ibuprofin with a two Benadryl to aid with sleep. A friend of mine is a pharmacist and he's basically said that it becomes an Ibuprofin PM with the Bendryl.

Our injuries occured only days apart so I'm using our stories as comparisons of treatment.

5 weeks since surgery on the 6th of August.

- ROM 64% with CPM assistance.
- I do walk around a bit without the immobilizer in the house.
- Very little pain. I think you'll get used to it without the meds.

I'm hoping after my OS visit on Monday I'll have a better understanding of when PT will start.

I'll keep you all posted as time permits.

post #627 of 10804

QTR conqueror

Hello, fellow conquerors – I’m trying yet again to post at length. My first three efforts were not successful. I’m 65-yrs.-old, a distance runner since 9th grade – although I’ve been confined to my (commercial grade) elliptical and weights in my basement gym for several months due to a neuromuscular condition in my left calf that has defied rehab to date.

On 8/11, I stumbled down the steps of our deck and did the QTR thing to my right leg. I realized it was bad when I tried unsuccessfully to straighten my leg. After my wife (a nonpracticing MD) determined I wasn’t bleeding or in shock and went in to get her phone, I forced my leg straight – what fun! Immediately called my OS, who’d already scoped both my arthritic knees. We went into NYC the next day; he didn’t need pictures to make the Dx; had surgery a couple of hrs. later for what turned out to be a total tear.

I went home 2 days later w/ instructions that I could put full weight on my leg as long as it’s in the immobilizer, locked in a straight position. I’ve never had to use crutches. By day 4, I was off pain meds. I’ve also been showering since that time. I walk to the bathroom & back w/ a walker but no brace. My wife is always lurking.

I had the staples out by week 2; will see the OS for the first time on 9/15, 34 days post-surgery.

By week 2, I started back on light upper body exercises. I’m using dumb- instead of barbells, less than half the weight I normally lift, just to be sure I don’t stumble or have another accident, as I do this alone. I also am back to the calf exercises (gastrocs, peroneus, tib. anterior) I was doing for my neuromuscular condition, but w/out weights, just body resistance. To do these, I loosen the lower half of the brace but always hold on to something. Finally, I’m doing straight leg lifts, w/out brace, while sitting in a semi-recumbent position. I feel tightness but no pain during these.

So it seems as if I sort of fit the pattern I see in this most helpful thread: From the start, I’ve been more advanced than some of you in terms of freedom from pain and not needing crutches; but I still haven’t tried to bend my knee at all, much less try to figure out how to adjust the flex brace. I’ll wait 10 more days and see what the OS says.

I hope this posts and look forward to reading more of this thread (I’m up to p. 4). Best wishes to all of you. And, “Go Gators, whup “Mia-muh” tomorrow night!
post #628 of 10804
GatorJersey, your other posts got nailed by a spam filter. Not your fault and it should be fixed now. The names of some medicines is in the filter and causes the posts to be moderated. All are back now.
post #629 of 10804
Thanks, Cirque. Can you please delete all but my first post? The others are, essentially, retellings. Thanks.
post #630 of 10804
Hey all. Been following all of the posts just not contributing too much. (catching up with work will do that). Here's my update. Injury on the 15th of July, surgery the next day. Imobilizer came off the 28th of August and OS told me to keep the crutches handy but to start PT and put some weight on the leg. I had a 100% rupture. Started PT on Sept 2 and was at %50 ROM with pressure. Worked up to 70% on Friday then all hell broke loose.
Was crutching outside to a restaurant and my crutches caught a steel grate and slipped. I jammed the bad leg really bad (hyperextended it backwards with full pressure on my heel) and it inflated like a balloon instantaneously. Iced it immediately and advil and ice every 4 hours for the past 3 days. I now have a large very dark bruise on the outside left side of the knee cap which is actually a depression now. PT said to wait until all of the inflamation is out before calling the OS but he fears the worst. I have absolutely no ROM at this time.

Anyone else have an accident with their knee after the fact?
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