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Quadriceps Tendon Rupture, Repair and Rehab - Page 215

post #6421 of 10802
Originally Posted by Tuckwell View Post

I will get the hang of it pretty quick. I rarely get involved in any forums but this one is truly a life and death forum for people like us. This double quad injury has done such a head trip on me, but it also has changed my life for the better in many respects. I don't take anything or anyone for granted. Yes we are close in age and I turn 69 in July. As per the injury, they tell me I am actually a little ahead of schedule. But full recovery is not expect until February of 2015 at the earliest. By full recovery, the surgeon was referring to the ability to kneel down, full squats, full mobility as previous to the accident. My suspicion is that I can come out of this stronger than I was before the injury. That is my goal, but I will plug along slowly and carefully,.
Again, I am so deeply thankful for finding this forum. You all give me great hope, and for that I am eternally thankful.
post #6422 of 10802
I am in week11 of single QTR & my OS wanted brace & crutches for 6 wks after surgery 2/14. Recently threw away crutches & braces & now doing PT every day of the week--3 days at PT shop. Just given permission to pitch. & putt plus flat biking after doing 120 degrees on stationary bike.
To/from CA for my son's wedding with cane only. Still respect going down stairs & uneven surfaces.
post #6423 of 10802
Originally Posted by getting there View Post

Thanks Bruce, probably good advice that is hard to do. I never did get anywhere near back to pre TQR shape and had to give up most of the sports I have loved all of my life. I don't expect a third quad operation to improve things much, there is only so much satisfaction one can take at being able to make it through a shopping trip to the grocery store successfully. I busted my arse at PT and performed all my home exercises yet saw very limited mobility regained.

Getting there - good work but keep up the stretching at home. I bought the belt they use at PT for $10 from them and it helped. Mobility is not easy so keep it up and it will come back. Patience is needed with this injury since you will have amny ups and downs. The leg does not give back mobility or quad growth easily. Expect 1 to 1 1/2 years and you can see how long it takes to get back to normal. Keep busting at home too and you will see progress in a few weeks. Then celebrate the little things it really helps.

post #6424 of 10802

I had my 9-month appointment with O.S. yesterday. He said that it is incredible that I am already running (albeit slowly) nine months after bilateral surgery. I think the main reason he still wants to see me is what he calls a very mild extension lag. For example, I can sit on a chair and straighten my knees out in front of me, but I can't actively extend them to minus 10 degrees. If I straighten my knees out and put my feet on another chair of equal height, he can press down on my knees and cause them to passively extend to minus 10 degrees. He thinks I should be able to actively extend them the same amount as I can passively extend them so that him pressing down has no effect. Can others do that? I'm not sure if I could do that pre-injury.


I read some posts expressing concern about rogue exercise behavior. My O.S. gave only seven words of instruction to my P.T. after the leg shackles came off: PUSH HIM AS HARD AS YOU CAN. Since then, I have been totally in charge of my recovery. I let my P.T. push me as hard as I could reasonably withstand without incurring unusual pain. I have been pushing myself as hard as I reasonably can in my independent exercises. As long as I do not push myself to the point if injury, I can be as aggressive as I want to without breaching the seven-work instruction from my O.S. If I did anything less than what I am able to do, I would be non-compliant.


So folks, if you are blessed with this injury, you ought to consider taking a little walk on the wild side. Once the leg shackles come off, PUSH YOURSELF AS HARD AS YOU CAN without incurring unusual pain (beyond normal exercise pain) or re-injury. Good luck!

post #6425 of 10802

@RUNNERMX ...Extensor lag.  I had (may still have a bit) that condition as well.  NJ Pete gave me some good info in an earlier post.  There are a many reasons but I think nerve damage and VMO weakness seem to be the main culprits.  Strengthening the VMO is something we can do but nerves take a long time to regenerate....sometimes years if at all.  My left quad does not fire as well as my right one.  I use backwards elliptical and uphill backwards treadmill to target my VMO.  If you get any better exercises please share.   Mt PT did a hip flexor stretch which immediately improved my extensor lag.

I still say the bicycle is doing as much for me as the gym.  70 km (42 miles) since Saturday plus a 2 hr+ gym session.  More biking tomorrow PM for me after work.   I am also one of the deviants who has turned into an exercise fanatic.  The proof is in the improvement in everyday life.  Climbing stairs, stepping off curbs, walking posture.   If only I could get the going down stair thing back to somewhat normal!!  

post #6426 of 10802

Skicarver, I agree that cycling is one of the better exercises. When you are outside, you get the benefit of leaning forward slightly off the seat going up hills. That forward-leaning vertical movement isolates the quads much the same as the stairmaster, except that cycling is infinitely more enjoyable. The problem here is the weather hasn't been very good most of the time; one would have to take an indoor spinning class to get the same benefit.


I attribute the mild extension lag to the same strength deficit that makes it harder to run, harder to descend stairs, harder to jump, etc. All of these movements require strength in the final few degrees of extension. Descending stairs involves the eccentric phase of the movement where the weakness occurs in the first few degrees of flexion. Running or jumping requires strength in the final few degrees of extension, as does the stairmaster (where most people only bend the knees a little). The leg press is easier because you bend the knees a lot; by the time you reach the last few degrees the momentum carries you. The recumbent bike doesn't require full extension and is easier. Bicycling outside and uphill requires less knee bend and more strength in the final degrees of extension, which is where you are seeing a lot of benefit.


My P.T. instructed me to push as hard as I can. As long as I don't slack off, it is impossible for me to violate his protocol. I was fortunate to find a P.T. like that here in Illinois, where the trend seems to be medical marijuana, sit on the couch and watch the world go by.

post #6427 of 10802

The last 2 sentences were meant to refer to my O.S., not my P.T. who  followed his instruction.

post #6428 of 10802

Almost 10 months since the surgery.  Doing well, but I have a goofy question.


Does anyone else's incision feel odd when they kneel?   I'm not in pain or anything like that, it just feels...different.


I noticed it when I started to plank again.  When kneeling afterwards and stretching.   The harder the surface the more I notice it.


Oh, and when stretching I can sit back as well as before the injury.  Maybe a little better.

post #6429 of 10802

llipgh, I have no issues kneeling on a carpet or rubber exercise mat, but hard floors are uncomfortable. You still have the scar tissue, the incision, the elastic strands tugging on the patella, and the knees have been through hell.

post #6430 of 10802
Hi all,
I haven't been on in a while but wanted to get caught up on everyone's progress. Looks like there are a lot of new folks here and to you all, sorry about your injury. I can tell all of you that you will get better if you listen to your OS and PT. I had my second QTR in December, with surgery on January 3rd. I had my first QTR five years ago and first found this forum at that time. I am happy to say that I have been done with PT about a month now and work out in the gym occasionally, not as often as I would like. I am doing great though, stiffness is all but gone unless I have been in the car for a couple hours, I do have to be very careful on any uneven ground and make sure I always keep an eye out for any obstacles in my path. I also still struggle with steps, quad just isn't strong enough, and I know it will take some time and more effort on my part in the gym. I am thankful for all of the support I received from folks here, it was integral in helping me to maintain my sanity (both times I had this injury,). Good luck to everyone, work hard, be patient and you will get better.
post #6431 of 10802

Just checking in. Had my 9 week post-op appt. today with PA. He said to wear immobilizer 4 more weeks but I can start PT next week. I am excited because on Easter Sunday I was able to lift my foot off the floor when sitting for the first time since the injury on Feb. 13, 2014! I Yelled for my husband to come "look what I can do"!! LOL 


SkiCarver...glad your son is doing well. Hope his next surgery is smooth. It has to be difficult being so far away. 


"Gettingthere":sorry to hear you are having difficulty. Must be so discouraging.


"Graceella": doing this again is one of my biggest fears! Bless your heart for going through it twice! I can't imagine. 



This injury is crazy and unexpected but I am thankful to learn from you all and I thank you for listening when I am whiny! :)

post #6432 of 10802
12 week post surgery observations:
Recovery going well
Range of motion was identical in both legs at 8.5 weeks
Spending 2-4 hours a day on rehab
Routine includes exercise biking, weight training, water walking, regular walking and the stretching/exercises the PT gave me. Strength seems to be increasing---quickly at first, now more slowly.
Walking: after a mile gait becomes an issue. Should correct as knee gets stronger.
Pain in body. I take Imuran for an unrelated platelet problem and Imuran causes me body pain. This pain has increased with weight training. Just a suck it up issue as Imuran was about the tenth attempt to get the platelet problem solved and I need the weights to build up the leg.

All in all
I am doing way better than I expected. The top of my charts are the hour a day on the exercise bike, the weight training and the water walking, plus the encouragement and advice from this forum.
post #6433 of 10802

Well,I tell you what.....RUNNERMAX and me (my idol, BTW)..thinks that there needs to be some SPIRIT and EXCITEMENT instilled here. So, GET EXCITED! You all are doing great...I feel so fortunate to have whipped this nasty injury. For incentive, take a look at my daughter climbing a rock face in Spain. Best to all and keep up the good fight!

post #6434 of 10802

That picture is unreal ! I can't begin to imagine doing that. Ever. Your daughter is amazing, and I'm sure she gets the attitude from you !

I like the positive vibe here. Ten weeks, doing well, start rehab next week ( anxious, happy, yet apprehensive ! ), swam in pool first time today and it was awesome ! Also walked 1 1/2 miles. Not anywhere near Old Bruce and others but good progress for me.

Capped it off by grilling some steaks, a little red wine, and now some NBA and NHL playoffs.

A great day ! No way we will let these knees stop us from having fun !
post #6435 of 10802

Eric308....that picture is amazing! Your daughter must be fearless :)

post #6436 of 10802
Breckbill: You're doing great. Also like the way you describe the mix of emotions. Hope you enjoyed the steaks.

Eric: Great photo. Takes your breath away.
post #6437 of 10802

Thanks guys/gals...yeah, she's a trip for sure. You nailed it with my influence...I'm flattered. I just want to thank you all for your POWERFUL influence on my/OUR recovery. You have all inspired me beyond belief. Thank you...I'm still here.Thumbs Up

post #6438 of 10802

Eric308, thanks for the accolades and great picture of your daughter. My climbing event this weekend was to get up on a ladder and change some high ceiling lights. I've been putting this off. I've had this aversion to falling ever since the hard fall that took out both of my quads. I've never gotten depressed about this injury but I can only slowly overcome this aversion to falling.


When this injury happened, I just figured that it was my turn to spend some time in the cellar. Looking around, some of my friends and relatives have endured heart attacks, cancer, broken bones, etc., and this was the first major thing that ever happened to me. Every one gets a turn in the cellar sooner or later. What defines us is not the fact of being in the cellar, but how we handle our time down there.


I've read some controversial posts on the use of the elliptical machine. For comparison, I did 100 minutes going forward on the elliptical on Saturday (level 14/20), and 100 minutes in reverse on Sunday (level 15/20). As far as I can tell. both are good exercises, and both directions work the quads. Going forward works the shoulders and back a little harder. Going in reverse works the glutes and hamstrings a little harder. The best approach to any exercise is listen to your body. Your body will tell you if something is too uncomfortable to continue.


Also, the best way to avoid depression is to be proactive and get o the gym. Whatever is bothering you, you will always feel 1000% better if you are doing something about it. Good luck!

post #6439 of 10802

A fall from that height would take out more than quads!!  I had a fall on Saturday.  Something I feared but turned out to be quite funny.  I was chatting to a neighbor and had only one shoe unclipped from from my bicycle pedals.  I pulled up on the attached pedal and my body weight shifted to the attached side.  TIMBER....down to the pavement.  All I could do was laugh!  Did not get a scratch.  I had to explain to my neighbor I was still clipped in and there was nothing I could do.  I think he originally thought I was crazy!!  Quite funny.  Fear conquered!!  Lesson learned...Unclip both shoes when stopped for an extended period of time.

post #6440 of 10802
I tried to catalog my 12-week observations the other day but there was one more elusive or complicated thing going on. Dealing with qtr takes a focus, determination that is kind of fanatical. I think it is critical to go all in and make healing your #1 priority. But there is a dark side to that: self-centeredness and self-absorption. I am trying to bring balance back into my life, including returning to my part time work ( consulting/training) and volunteer (hospice) duties. It is a strange balance, because it takes incredible focus to bring the leg back, but I found I needed to connect to others in ways where it isn't about me. Don't know, maybe three months is a normal time for this to come up, especially for semi retirees.
post #6441 of 10802
Originally Posted by old bruce View Post

I tried to catalog my 12-week observations the other day but there was one more elusive or complicated thing going on. Dealing with qtr takes a focus, determination that is kind of fanatical. I think it is critical to go all in and make healing your #1 priority. But there is a dark side to that: self-centeredness and self-absorption. I am trying to bring balance back into my life, including returning to my part time work ( consulting/training) and volunteer (hospice) duties. It is a strange balance, because it takes incredible focus to bring the leg back, but I found I needed to connect to others in ways where it isn't about me. Don't know, maybe three months is a normal time for this to come up, especially for semi retirees.

@old bruce.....great observation. I've recently  become a "Big Brother", started volunteering at a local St. Vincent de Paul Food Pantry, and am serving on a local humane society board. All but the food pantry post surgery. My wife still says I need to do more! I told her she should follow me around the gym sometime. All in all, I feel quite satisfied with my recovery...I look back to way beyond where I was prior to the injury and did it in relatively quick time. Just a bit more than a year ago I was heading out on a cross country train trip at barely three months post surgery. Thanks for bringing up some aspects that aren't typically discussed. Best to you and your recovery and all you other troupers!

post #6442 of 10802

Just wanted to say Happy Mothers day to all the mothers out there. Also, I want to personally thank my wife for having to deal with my knee issues through the past almost two years since my initial injury.


Yes, this injury sucks. I can tell you I am far from where I WANT/NEED to be. I am making progress. There is no doubt about that. The important thing I have done in my life is realize the importance of diet(consuming healthy calories) and activity are both important to the recovery as well as life.


Numbness in the knees - Yes, this sucks. Especially if you have been cut twice in the same place on both knees. The infrapatella branch of the saphenous nerve is what causes numbness. Surgeons slice right down the center of your knee not caring about cutting this nerve. Some people have two branches, some have 3 or 4 or more. The more they cut, the worse the outcome. It heals in rare cases. It gets a little better overall but will never be like it was before they cut...unless your surgeon took the time to find this nerve and cut around it. This means, 99% of the QTR's will have a form of numbness for life. Thanks again to the technology of orthopedics. OS's do this more and more during total knee replacements....WHY NOT QTR's?


TGIF Folks

post #6443 of 10802
[IMG]http://www.epicski.com/content/type/61/id/148718/width/200/height/400[/IM First post-surgery walk on a dirt/gravel type up and down trail at Ken Caryl/South Valley Park in the Denver area. Lots of deer, sunshine and a feeling of one more thing moving in the direction of normal.
post #6444 of 10802

First week of PT down, feeling more hopeful. Started at 40 degrees on Tues and hit 55 degrees today. Realizing it's the baby steps that are going to get me well. Interesting that the PT stressed the importance of pushing my knee back to straighten it...I have been so wrapped up in bending my leg, that I forgot about straightening it! Learning a lot through all of this. The PTs just want me focusing on motion and moving/bending my knee right now and they said the strength will come later. (I'm only 10 weeks post op). 


Sounds like everyone is doing well. :)

post #6445 of 10802

Doing PT manipulation 3x week for single right leg QTR and now have range of motion of 115 degrees in 12th week after surgery. Maximum ROM at age 62 is about 125-130.  I started PT in week 7.5 (Dr. did not allow any PT except bending leg up to 30 degrees while on stomach 1st 6 weeks to facilitate healing).

Just started personal trainer session today at my FC to rebuild core and overall body flexibility.


Did some yard work Mon & Wed including pushing a drop spreader. And allowed to pitch & putt golf.

Making great strides but it is a long slog.


Still uncomfortable with knee strength on down stairs & slopes.


I believe attitude is also a great healing force, as well.


Hang in there all of you.

post #6446 of 10802

Hi everyone

Just a quick reminder that you have to grab this injury "by the throat" once given the OK by the OS and PT.   This dam injury will give you NOTHING.  The usual approach of staying off an injury until it heals or feels better will not work.  Turn into a "Gym Junkie".   Exercising is the ONLY way back to normal!!  PUSH PUSH PUSH!!   You will find yourself being able to do more than pre-injury.  There is a crazy hill that used to play me out after cycling it once pre injury.    Yesterday I pushed myself to to do it SIX TIMES in a row.   It was a full hour of steep hill climbing.  My neighbors just shook their heads and said "You are insane."  To that I replied "I have an extra bicycle if you want to try to keep up!"  No takers so far.....  Everybody keep pushing your present limits.  Before you know it you won't have any limits!!  

post #6447 of 10802
Skicarver, you, Eric 308 and Runnermx are our qtr alpha dogs. Your hill repeats post got me to bring today's workout up a notch. Thanks, guys, for the consistent message.
post #6448 of 10802
I've been quietly lurking through this thread for about a month now, and it's helped me keep my spirits up through my journey so far.

I'm a 29 year old, female with 18+ years of knee pain. In an attempt to be more active and competitive (athletically and in dog sports) I underwent Lateral Release surgery on March 14th. That surgery went well and my recovery was going great, until April 2nd, when I tripped getting out of a shower at a hotel when I was working out of town....Yep, I got bitch slapped by the universe. I was hoping it was just a quad strain, and I told my PT about it the next day, checked it out real quick, looked scared and then told me I HAD to tell my OS when I saw him the following week.

I saw my OS the following week, and at first he seemed mildly concerned about a quad tendon tear, and told me he'd see me back in two weeks. The next morning I got a call from my OS's office telling me that he was VERY concerned about a quad tendon tear and he wanted to schedule and MRI as soon as possible. I had my MRI the following week and saw my OS to get the terrible news the next day. Luckily it was only a partial tear.

I had surgery on May 2nd, so I'm 8 days post-op and the first few days were brutally painful. My OS instructed me not to remove my immobilization brace for 7 days (this is probably his version of the plastic safety bubble he thinks I should live in). I finally got to remove it for a shower yesterday and I must say I'm impressed with how the incision looks it's only about 3.5 inches, but there will barely be a scar when I'm finished healing.

I'll be immobilized at 0 for three more weeks and then I'll get to resume PT. My OS thinks that my lateral rentinaculum was so tight over the years it didn't allow for my quad tendon to work properly, so when I tripped there was just a really bad combination of a weak quad tendon that was still tight from surgery.
post #6449 of 10802

Thanks old bruce but you deserve the credit.  You had the Amped -up workout in you....just had to pull it out.  


CFFF  Slips seem to be the main cause of this injury.  I wish I had a better story for my 2 but same old boring "Oh Crap!" story.  Recovery from this Bast@rd Injury goes in phases I've found.  The first is the be patient and keep your spirits up.  Focus on what you CAN do.  The second phase is the Physiotherapy-begin exercise phase.  We know we have to earn our freedom back but are cautious not to re-injure.  The final and longest phase, for me, is the "I got this one".  It is intense training and a total body transformation which allows us to become better and stronger individuals if we so choose.  For now be patient and do all the passive exercises you were given.  Recovery is 95% you and 5% Medical Professionals.  Keep yourself locked in to the great mind frame you have yourself and enjoy the ride!!   Anything you need advice on "how to do things" just put it out there on the forum because we are all here to help and encourage each other.

post #6450 of 10802

Waiting for the first post from Derek Jacobi- wonder if he will find this site? 





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