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Quadriceps Tendon Rupture, Repair and Rehab - Page 202

post #6031 of 10801

I have been reading the posts here, dont know if anyone is still reading however i thought Id share my story. On May 8, 2013 i was at work and just simply walking down a few front steps (I was wearing work boots with 1 inch heels to climb ladders and poles) when my right foot slipped forward, with the heel catching the lip of the step. Now my right foot is pointing straight down and Im standing, I tried to put my left foot down (on the same step) to brace myself, unfortunately it did the same exact thing. Now Im standing up but both feet are pointing straight down. Don't know why but instead of falling forward or back I felt like someone jumped on my shoulders making me go into a fast power squat, that's when I heard the two pops one after another. I was laying face down on the ground, and remember trying to get up, and that's when i realized something wasn't rite. I felt like i broke both my knees.


I have never been sick (outside normal things flu, cold, sprained ankle) and never had any health issues before so this was shocking to me. I have to inform you also I just moved to this state (NH) a week before and my wife wasnt moved up yet, she was still in NJ. I knew NO ONE. Either way I was taken to the hospital and they took an MRI and sent me to a orthopedic surgeon. He diagnosed the bilateral quad tendons had snapped of of my knee caps (BOTH). I had to wait a week before my surgery which went well.


I was in two immobilizer braces and in a wheel chair for 4 months before I started PT. I did PT for 5 months, the right leg responded well and is getting better, the left never got off the ground, I still cant climb stairs if I use the left leg to lift, I have to go right leg first, still have pain when extending and no power in the lower quad. This resulted in a 2nd surgery 2 weeks ago today (today being Feb 17, 2014) on my left knee. The doc cleaned it up saw a couple things and now he said there is no guarantee it would help but it was worth a shot. I am now going to resume PT this week.


I will add that I was put on blood thinners to prevent clots, however I did end up with a clot in my lung which I have to say was just as if not MORE painful than my knees ever were. I am looking to see if anyone with this injury has fully recovered with no looming issues. I have resigned myself to the fact that this may be the best its going to be, but IM going to push hard in PT with hope I can get it as good at least as the right one.

post #6032 of 10801

Blimey Kruker, you have really been through it!

I'm a Simultaneous Biquad from 11 july last year, that's about 31 weeks now. To be in a wheelchair and braces for that long is quite unusual compared to all of the other stories that I have read. Considering that you get about 1% ATRIFY per day I'm surprised that you have any legs left!.

I must confess that I'm not one for regular excercising but I did do the Phisio for the first few months and now have full Range Of Movement and can walk OK but not run. I can walk up stairs without a handrail but not down.

The wasting in my muscles has shocked me and I intend to start working soon as I hope that all day excercise will have a beneficial effect.

There is a wealth of information on this site and some woeful stories as well but if you have the patience to read the threads you will be able to find some inspiration to help you through this terrible injury.

I really feel for you and hope that your last surgery is successful and you can get a good phisio regime going. Chin up and keep posting, I've a feeling that you are going to be here for quite a while.


All the best from a very wet and miserable Yorkshire in England.

post #6033 of 10801

Hi all,


I saw my OS today and heard what I was hoping to hear.  He told me that I could take my brace off now when I am in my house or anywhere else that I am comfortable.  He said I should wear the brace when outside of my home but the brace is to be unlocked to 70 degrees rom, gave me a script for PT 3x per week and lifted restrictions regarding driving.  I set up my first PT session for this Thursday, I have been assigned to work with a  PT that is not a DPT and he is only out of school for three years so I am going to reach out to another practice to try to get someone more experienced. 

All in all, things are going well, just now dealing with a bit of anxiety about not wearing brace and/or having it unlocked.  Ironic how I finally got what I wanted and now I am anxious about it... Really hoping this damn snow/ice in the northeast would go away so I could walk outside with some confidence.  Thanks for all the guidance and support you have all given to me.

post #6034 of 10801

Kruker, I had bilateral surgery July 23 following a hard fall June 30. I've had a moderately decent recovery thus far, but I had to work my tail off to get here. The thing that strikes me about your posts is the exclusive reliance on PT. It would have been impossible for me to rely solely on PT. I've worked on my recovery every day since the leg shackles came off September 1. I've also browsed through this entire thread and noticed that the people with the most successful recoveries are the ones who work on it almost every day.


There are two aspects of recovery, knee bending and leg strength. Good exercises for knee bending include wall sits (per Texas Diesel), static holds (per NJ Pete), Nu-Step or similar cross-fit machine, stationary bicycle, rowing machine, and deep knee squats in shallow water. For the wall sits, you lie on your back on a carpeted floor and place your feet against the wall, allowing gravity to bend your knees. For the static holds, you sit on any piece of furniture and hold your knees in a bent position for 5 minutes, then relax and repeat. You need to work on knee bending every day until you achieve full range of motion.


For leg strength, start out on a leg press machine. Pick a weight that you can comfortably do 15-20 times for 2-3 sets. Do this both for two-legged  presses and single-legged presses (one leg at a time). As you get stronger, you can graduate to elliptical striders (hey follow a back and forth path), true ellipticals (they follow an elliptical path and are harder), freestyle squats followed by squats with weights, deadlifts, etc. Also, do no underestimate the benefits of sitting on a stationary recumbent bike for up to an hour, gradually increasing the speed and resistance. In fact, the leg press and the stationary bike should be your staples in the early stages of strength recovery. Once you are strong enough, make step-ups and step-downs a regular part of your routine.


I think it's unfortunate that you were locked in leg shackles for 4 months (I wore them for 40 days/nights), but you can't change the past. it's like my 23-day delay to surgery that resulted from misdiagnosis. The only thing we can do is look forward, stay positive, and play the cards that were dealt to us to the best of our abilities.

post #6035 of 10801

@kruker...be sure to read RUNNERMX's post above. It is EXACTLY the right advice and if you follow suit, you will be ahead of the game. I also had a relatively quick recovery time and agree that PT is secondary, but a strict regimen of exercise is necessary to achieve the best possible recovery.

@Graceella...very happy to see you making great progress. It's all down hill from here.;) Man, I agree with you about all the snow and ice. I'm heading to SC on Sunday and the way I figure there will be a

60+ degree temperature increase when I get off the plane. Continued good luck! PS...you might consider wearing a neoprene knee sleeve for awhile. I did and it really helped my confidence right after I ditched the brace.


post #6036 of 10801
Originally Posted by MickyD View Post

Looks like I have connected with the other "ripped dudes". And by that I do not mean muscular. I suppose that recovery time depends on whether the tear is partial or full. Since mine is a full tear (rupture /separation) I am hearing 4 weeks of absolute calm before even starting rehab, and then based on the doc's words and reading some historical accounts here, 4 to 6 months before doing sports to any degree that we would probably all consider full enjoyment. I also understand that this is an easy one to muck up by not being patient. 90% recovery is the prediction by my doc. I can't accept that since I don't have 10% to spare.

So what I am hearing here and elsewhere is 1. Do your research. 2. Shop hard for the the right doc 3. Be patient in recovery.

@MickyD, you hit the nail on the head. 4. Remember to listen to your body. A little resting is good. A lot of resting during your recovery period will create a recovery setback. I also think you can get greater than 90% recovery. It is just a matter of nutrition and persistence.


@RUNNERMX, I can't wait to get back to dead lifting. I have been working day and night on a current project. It is slowly coming to an end though. I have friends who have run marathons. They NEVER deadlift. It makes sense the way you explain it. Thanks


@poodiesmom, I am glad to hear you are doing better. I suppose you are going to need to start at ground zero again. You can do it. Set your goals and keep focused.


@walterrob, I thought you meant a marathon. I think you can be ready for that event. Like Eric said...gimping around is just as good.

post #6037 of 10801
Originally Posted by kcarp1 View Post

walterRob - Be very careful. Partial Tear may speed the recovery but long wieght on surgury might slow it doen. I was in the brace out of the house for 4 months. It was not locked but I still had to wear it out of the house. I think my OS is very concerned at protesting me. PT is great for all the stretching the tendon needs. After 4 months it is all me at the gym. Alittle over 5 months and I can see why it takes a year to get over this. Stay positive stretch as much as you can. I did mine 2 times a day. I just wish the quad muscle did not just melt away.

My ortho told me to expect my recovery period to be similar to what I've been reading here so not sure if it made much of a difference that it was a partial tear. He is pretty cautious but my schedule for PT begins at week three and wearing the brace until the end of May. Just looking forward to getting back into my crossfit workouts when I can
post #6038 of 10801

Hi Gang

Just a quick update on my Bilateral progress.  First to all the new forum members.  Any progress is progress!  Everything gets easier.  Operated on in late Sept 2013 so 4 1/2 months into recovery.  No set backs yet.  I did dial my 2hr+ gym workout schedule down to alternating days.  I feel much better.  On my non-gym days I will walk when the weather permits and do quad strength exercises.  My cardio is now great.  After 2 hrs at the gym I still feel great but moderate stiffness sets in the knees later in the day.  I can go up stairs without handrails but going down I can do one at a time or regular rate using the handrails.  Got out skeet shooting and the 12 gauge therapy was great!!  My Herman Munster knees are stiff on the swing so there was alot of misses.   My anticipated for return to work is April on modified duties and May for full.  Winter in the Northeast has been brutal.  So much snow and ice.  I am still nervous to do some things.  I am using 180 lbs on the leg press but it still feels very light but scared to death to increase too much as I never want to hear the tendon snap noise again!!  I know I am capable of maxing out the machine at 300 lbs but increasing 20 lbs a week as a caution.  I forced myself to jump today.  It took 2 tries! LOL  Landed OK though.   So Happy to see poodiesmom is "kickin' it".   Everybody keep up the good work.  The finish line gets closer every day!!

post #6039 of 10801

Hi everyone, started PT today.  I ended up going to another facility so I could work with a more experienced PT and in the end decided to work with the person my OS had recommended the last time around.  We had a good talk about my concerns up front and I liked his answers and think it will be a good fit.  I am currently at 90 degrees ROM and will be going to PT three times per week.  Today was a relatively easy day, more talking and evaluation then anything else.  I did work on the recumbent bike going half way forward and and half way backward, got a little electrical stim. and that was it.  It feels so good to drive and since we are expecting a heat wave (55 degrees in Philly) this weekend I am hoping some snow/ice will melt and I can get around with a bit more confidence this weekend. 

Eric 308, so jealous that you are going to feel some real warmth this weekend, ENJOY!!

Poodies Mom, glad to hear that you are making some gains!  Having been through this before I can definitely attest to the fact that it will take a while but one day you will just realize that you are feeling great, it just kind of sneaks up on you.  Congrats on all of the weight loss as well!  That is hard work but the benefits will definitely be worth all of your hard work!

post #6040 of 10801

Ali Mason,

  12 weeks post-op. How are you doing?

                All The Best,


post #6041 of 10801
Had posted in the past. Had bilateral QTR in Oct of 12. Ten weeks non WB. Extensive home and outpatient PT. Up to hour on elliptical and spin bike. Range continues to improve even now. One disappointed is that running is not comfortable. That might be a no go. Interested, some folks gave suggested my cause, besides years of running and basketball , was going in a statin. Others hear that ?
post #6042 of 10801
Yes, Statins are one cause. There is a study on high cholesterol and tendon weakness as well.
post #6043 of 10801

Tomorrow AM is the big day for me. Early AM surgery for the ruptured quad tendon. I'm really glad to have found this forum. Seems to be quite the range of experiences and recovery timeframes represented here. It is interesting that the post-surgery immobility also varies so much.


My surgeon, who I met for 5 minutes was pretty glib about the whole thing saying that I could use the same marginal soft brace I was given the day of the accident and that I could get up and around the house whenever I felt I could. "Just don't bend your knee". Heck I can bend my knee inside this brace.  That lack of detailed instruction rattles me a bit. Really he had little advice or instruction except that when PT time comes to follow it.  All I know is from reading here and at the Orthopedic Association website.


In the long run I don't care about his bedside manner it he does a good job and everything works, but I'd be in the dark without all the reading up. I would be interested to here others experiences with their surgeons. 

post #6044 of 10801
Thanks to everyone for such helpful information and encouragement.
To MickyD- I would definitely get a full leg brace as you don't want to bend that knee and very easy to do. Also, you'll need it to slowly open up later for ROM
Asked for a femoral pain block from anesth.
Before surgery ad very helpful
Good luck
post #6045 of 10801


My surgeon changed my brace from the soft brace I was given. Had my surgery on 2/10 and am in a hard brace that locks my knee/. That's surprising to hear that your surgeon is so cavalier about your surgery. eventually your surgeon unlocks the brace to increase your range of motion in the knee. Good luck.

post #6046 of 10801

@MickyD...from all of my past experience with this injury EVERYONE is given a locked brace (with a dial flexion capability) either pre-surgery or post-surgery. It is imperative that the knee stays straight for the tendon to reconnect to the patella. I was partial weight bearing a couple of days after surgery and gimping around without crutches, BUT if I had not had a locked brace I would have taken a huge risk. Rather late for this, but I would insist on talking to the OS again. How many of these procedures has he done? As mentioned above you are eventually allowed to adjust the brace for increased ROM. I was locked straight for six weeks before they gave me 40 degrees flexion. During early PT sessions the therapist would remove the brace for PASSIVE/ASSISTED exercises, then immediately locked back to straight and zero degrees. Also, ask for steri-strip closures and below skin sutures. Much more comfortable and less scarring than those staples. Made a huge improvement in gaining initial ROM, too. Keep us posted and best of luck. Please read this link...maybe even share it with the OS!  Re: OS.. I had a team of 3 surgeons and had detailed consultations a day or so before surgery, while I was in the OR just prior, in the recovery room, and just prior to release. Then follow-up visits starting at two weeks post for suture removal, etc. Final visit was at 16 weeks post when they released me.

Guide to Quadricep Tendon Recovery



post #6047 of 10801



The doc said that we could probably use the brace I have which is a soft wrap, with metal bars inside the back, with lots of velcro straps. It slips and is a bit sloppy in my opinion which I told him. I asked about the locked brace and he said. You don't want that yet because it is really uncomfortable. You will get one when you start PT.  He said this in a fairly dismissive, off the cuff manner. So I told his PA that this brace is already falling apart (velcro tear). The PA said we'll see what we can do about getting another.Also in a non-commital way.


This doc is a general Orthopod so he does knees, shoulders, what have you. I'm told that while he only does a couple of these a year, I am the third this month. He is having "a run" of them. I was searching for alternative docs but I will soon be approaching two weeks after my fall, and everything I read says do not wait any longer.


Thanks for the note. I am going to call the PA today.  

post #6048 of 10801
Originally Posted by MickyD View Post



The doc said that we could probably use the brace I have which is a soft wrap, with metal bars inside the back, with lots of velcro straps. It slips and is a bit sloppy in my opinion which I told him. I asked about the locked brace and he said. You don't want that yet because it is really uncomfortable. You will get one when you start PT.  He said this in a fairly dismissive, off the cuff manner. So I told his PA that this brace is already falling apart (velcro tear). The PA said we'll see what we can do about getting another.Also in a non-commital way.


This doc is a general Orthopod so he does knees, shoulders, what have you. I'm told that while he only does a couple of these a year, I am the third this month. He is having "a run" of them. I was searching for alternative docs but I will soon be approaching two weeks after my fall, and everything I read says do not wait any longer.


Thanks for the note. I am going to call the PA today.  

@MickyD...WTF! It NEEDS to be uncomfortable and you will grow to hate it, BUT it is what you should have. I had the same locked brace they gave me in the ER for the duration. It is damn near as important prior to surgery because of the possibility of compounding the rupture or creating further damage. I think I would demand one. True that it's important to get it done ASAP, but at what risk? Man, just wait until NJPete sees this...he'll be on the next flight to Boise.:D Seriously, do talk to the PA and tell him you are uncomfortable with the situation and "please help me"! It is your right to have confidence in your Doc and you are surely not displaying that. Get to work on resolving this...at this point a day or two for a new Doc may be worth the wait. Also, obviously I'm not a medical professional, but my past experience and everybody else on here has given me some degree of what is right or wrong treatment. Best of luck...I'm pulling for you.

post #6049 of 10801

Thanks man, that is my plan. I even found a locking brace for sale which I may just show up with. If it were a day or two I would surely shop docs, but I expect a longer process to surgery if I switch now. I did talk to the medical director at the big insurer here (employee of friend) and he checked on this doc for me and did not get any bad feedback and actually some good feedback, so yeah WTF? So I will be calling adamantly today. Thanks for the support in doing so. I'll be back here once I come out the other side of the major post op pain.

post #6050 of 10801

Mickey D,


I agree with everyone else that you should have a locked brace immediately after surgery.  I have had this injury twice now and both times my treatment has required my leg to be locked for six weeks in this brace.  I couldn't bend the knee if I tried.  After each surgery I was permitted to unlock the brace to bend the knee to a predetermined degree.  In the end the soft brace is dangerous in my mind.  My soft brace that I had prior to surgery was lousy, my knee buckled while wearing it and I fell, and I fell hard!  Above all costs you need to protect the repair.  You should demand the locked brace!  Good luck with things, keep us posted.

post #6051 of 10801

@MickyD, MAKE SURE THIS OS DOES NOT SCREW YOUR LIFE.  The first OS I had screwed me. He was shoulder, knee and whatever ortho. This is the MOST IMPORTANT decision you can make.


Tap Online Resources

A number of online databases provide a way to identify board certified knee replacement surgeons and check their credentials. The American Academy of Orthopedic Surgeons, the American Association of Hip and Knee Surgeons and the American Medical Association provide lists of qualified surgeons. BoneSmart.org offers a database of joint replacement clinics that specialize in knee replacements and other procedures.

post #6052 of 10801

Pete I'm doing a lot of soul searching today to come to a decision. 

post #6053 of 10801
Originally Posted by MickyD View Post

Pete I'm doing a lot of soul searching today to come to a decision. 

@MickyD....See? I knew others would jump on board in agreement. Be sure to keep us posted on any developments. This place is a brotherhood/sisterhood and we are with you every step of the way. Oh, and possibly a good omen....I had my surgery on 2/20/13 and was pretty much up and at 'em within four months...weird coincidence.

post #6054 of 10801

Let me tell you what could happen if this OS is NOT capable enough.


1. If the OS does not cut your ruptured tendon in the perfect place eliminating all micro tears from the replacable tendon - This could lead to a non 100% tendon reattachment. Scar tissue will form in the place where the attachment and you will most likely ALWAYS have a high degree of extensor lag


2. If your OS does not use the right sutures and technique to suture - You tendon could be too flexible or not flexible enough. This could lead to several complications including but not limiting to:  Tendon tear, Patellar placement (which leads to Chondromalacia) and many others.


Choosing the right OS is the MOST important thing you need to do here.


Two things that work for me:


1. Make sure your OS is an established OS that works on KNEE/HIP as MOST of their profession. DO NOT LET SOME GENERAL ORTHO WHO DOES SHOULDERS, FINGERS, AND EVERYTHING ELSE. They are NOT experienced or trained good enough to operate on you.


2. Board Certified is another VERY important point - This means they pass an exam with some other professionsl to evaluate them they are capable to practice in that area


3. Make sure they are experienced in repairing Quad or Patella tendons.


If you can get these qualifications from your OS, you are 75% there. The other 25% is you. That includes diet, PT, rest and protection.


If you choose the wrong OS, you are playing roulette betting a 50% chance they could do a good enough job.


TRUST ME WHEN I TELL YOU - I have been through a BAD OS. I lost over a year of my life in a wheel chair due to incompetencies.

post #6055 of 10801



I'm glad to hear that you are a success story. I'm 61 so I'm not having any expectations, but 4 months would be fabulous. I will tell the doc that by this time next year I expect to be able to ski down what I want and ride up what I can now.




Despite my reservations this doc has been doing it for 35 years, and gets an OK from the medical director of the state's largest insurance company who I called. I know his boss personally so I don't think he would BS me. He is a general ortho though, and is board certified.  He has had a spate of quads recently, 3 this month but beyond that he says 2 or 3 quads a year. He has hospital privileges at both major hospitals here. I think that he is just a horrible communicator. Maybe these guys just get glib after a while


I called his office today and told them that I am still unclear on post-op and that I like things spelled out, not just glossed over. Also they will have now be using a different brace. Maybe they are humoring me I don't know. I talked to my friend in Vermont (who was on the lift at Mad River -sheesh!) He is a GP and he said an ortho would have to be pretty inept to screw up a quad repair and that my friends atients who have had them have all done well. Then again, this is the guy who when he tore his ACL went to an olympic ski team surgeon.


So that's my day so far. Thank you guys a lot for the support and input. I am going in tomorrow, so here's hoping. Once I get over the first couple? few? days of post surgery trauma, I will come back to share my story as it develops

post #6056 of 10801

Alrighty then!  We have some new folks on board (I'm sorry you have to go through this) so I'll share my progress.  I'm 24 weeks post-op on a complete QTR on my right leg.  I'm able to walk at a brisk pace and average about 5 miles a day.  I'm working my legs on Wednesday (regular workout for both legs) and Saturday (focus on right leg and beginning impact drills).  I started doing squats with just the bar (45lbs.) and have added ten pounds per week for sets of 20 reps.  Today I will attempt 175lbs for a new post surgery record. Considering that I used to squat over 600lbs this is a very humbling injury.  However, one can either wallow in self-pity or rise to the challenge.  I've done the self-pity thing and it gets zero results.  Therefore,  I challenge all of you in recovery to rise up, keep your head up, and keep moving forward.


Arigato out!!

post #6057 of 10801
Ask your anesthesiologist about doing a femoral pain block before surgery- I got Markaine injected into the leg
I had no pain post op and very little that week
I realize this may not be the case with everyone but really worked well with me
Keep a firm wrap on and RICE is important
Get all your stuff together and easily accessible where you'll be hanging out the
next couple weeks
Take care
I realize this is not always the case
post #6058 of 10801

@MickyD, you gotta do what you gotta do. I am sure you will be in good hands. Good luck and let us know your outcome.

post #6059 of 10801

Mickyd.  I did not get to pick my surgeon and he turned out to be excellent.  He was an ex-chief of surgery.  My surgeon said it takes 12 weeks for that tendon to attach strong.  I was "lucky" enough to tear both legs.  Make sure your operated leg is immobilized.  Mine was for 6 weeks at 0 degrees and then had to wear the adjustable braces for the next 6 weeks.  I have lots of used braces/immobilizers if anybody can't afford one.   This injury sucks but I'm recovering from 2 so 1 should be a walk in the park.   

Best wishes for a speedy recovery.

post #6060 of 10801

MickyD, good luck for tomorrow and keep us informed as to how things are going. It's a shame we don't know where we all are as I've got a pair of good braces here, surplus to requirements now!

As the others have said NO bending for at least six weeks, I did 8 weeks but then I am Bilateral.

In fact I'm undecided whether it's better to have both go or just one. My reasoning is that whatever the reason for this injury, if only one tendon 'goes', is the other one 'nearly' there? Just a thought.

Again, all the best.



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