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Quadriceps Tendon Rupture, Repair and Rehab - Page 249

post #7441 of 10860


Want to encourage posters to add photos as they get out and about as part of the qtr rehab. Here's the sunrise as I did my morning shuffle/run with the dogs in the Denver area. John, any shots from your ski adventures?
post #7442 of 10860

*

 

OK Bruce!  I'll take you up on your suggestion to post a pic as we continue our QTR recovery.  On March 10th I slipped while walking in ski boots.  Surgery on March 27th, and after 7 months of PT and much work, I'm back to skiing.  

post #7443 of 10860
Great photo, John. Can pictures of @Eric308 on his rower and @skicarver on his bike (with socks) be far behind?
post #7444 of 10860
Quote:
Originally Posted by old bruce View Post

Great photo, John. Can pictures of @Eric308 on his rower and @skicarver on his bike (with socks) be far behind?


@old bruce...you got it. My camera is going to the gym tomorrow! Wow, Red Nighthawk...that really is a great photo.

post #7445 of 10860

Have been a follower of this forum for a year and as today is the 1 year anniversary of my left quad tendon repair surgery he is my story:

 

Bio:

56 year old male, avid runner (have completed 1/2 marathons), cyclist and golfer (...always prefer to walk).

I am in technical sales which involves working in factories in the USA and China...a lot of walking and a lot of stairs at some accounts.

 

Accident:

Slipped on and icy street 10 yards from a customers doorsteps on 13-JAN-2014.  Could not raise my left leg to right myself and knew something was wrong and after gathering myself to an upright position (thanks to some assistance from incoming workers) I surmised my best option was to get to an emergency room ASAP.  I felt no pain at this point and because it was my left leg I pleaded with my helpers to load me into my vehicle as I decided it best to drive the 1 hour back to my hometown hospital. I was met in the hospital parking lot by my wife who wheelchaired me into the emergency room.  After X-rays it was determined I had a completely torn left quadriceps tendon and would need surgery to repair.  14-JAN-2014 was historic in my life in that I had to use the first "sick day" of my 34 years of employment. Surgery was done on 16-JAN, 2.5 hours, but was home by 1:30pm.  Took the prescribed pain pills for 1 day then an Advil PM at night for a week to help sleep.  Staples out in 2 weeks and carefully balanced on 1 leg to shower with the help of a chair to get over the shower edge.  Was allowed to start PT at 4 weeks though followed a regime at home 3X a day to keep accelerating the recovery. Got ROM to 130 degrees. Finally was fitted with a hinged knee brace at 7 weeks and returned to work at 8 weeks.  Probably could have returned much earlier if I had a desk job but as this was a workmen's comp case I had to follow orders.  I was back on the golf course by mid-May...albeit in a golf cart, but was walking again with the knee brace by early June.  Did mostly cycling and a lot of walking during the summer and graduated from PT in early June.  Started a running routine on a treadmill at the local YMCA that I belong to in October but have not pushed that too much as am happy with my 1 mile at a 8 min pace.  It usually takes about a 1/2 mile for the knee to feel somewhat normal.  Ran 1.5 mile last weekend and knee was sore for an extra day so will continue to ramp it up at a slower pace.  Given all that's happen I know I am not as invincible as I once thought I was and maybe I will never be able to run another 1/2 marathon again but I am grateful for where I am after 1 year post op... as I have read many a story on this site that have struggled much more than I. 

 

Mike Golfrunner

post #7446 of 10860
Quote:
Originally Posted by Mike Golfrunner View Post

Have been a follower of this forum for a year and as today is the 1 year anniversary of my left quad tendon repair surgery he is my story:

Bio:
56 year old male, avid runner (have completed 1/2 marathons), cyclist and golfer (...always prefer to walk).
I am in technical sales which involves working in factories in the USA and China...a lot of walking and a lot of stairs at some accounts.

Accident:
Slipped on and icy street 10 yards from a customers doorsteps on 13-JAN-2014.  Could not raise my left leg to right myself and knew something was wrong and after gathering myself to an upright position (thanks to some assistance from incoming workers) I surmised my best option was to get to an emergency room ASAP.  I felt no pain at this point and because it was my left leg I pleaded with my helpers to load me into my vehicle as I decided it best to drive the 1 hour back to my hometown hospital. I was met in the hospital parking lot by my wife who wheelchaired me into the emergency room.  After X-rays it was determined I had a completely torn left quadriceps tendon and would need surgery to repair.  14-JAN-2014 was historic in my life in that I had to use the first "sick day" of my 34 years of employment. Surgery was done on 16-JAN, 2.5 hours, but was home by 1:30pm.  Took the prescribed pain pills for 1 day then an Advil PM at night for a week to help sleep.  Staples out in 2 weeks and carefully balanced on 1 leg to shower with the help of a chair to get over the shower edge.  Was allowed to start PT at 4 weeks though followed a regime at home 3X a day to keep accelerating the recovery. Got ROM to 130 degrees. Finally was fitted with a hinged knee brace at 7 weeks and returned to work at 8 weeks.  Probably could have returned much earlier if I had a desk job but as this was a workmen's comp case I had to follow orders.  I was back on the golf course by mid-May...albeit in a golf cart, but was walking again with the knee brace by early June.  Did mostly cycling and a lot of walking during the summer and graduated from PT in early June.  Started a running routine on a treadmill at the local YMCA that I belong to in October but have not pushed that too much as am happy with my 1 mile at a 8 min pace.  It usually takes about a 1/2 mile for the knee to feel somewhat normal.  Ran 1.5 mile last weekend and knee was sore for an extra day so will continue to ramp it up at a slower pace.  Given all that's happen I know I am not as invincible as I once thought I was and maybe I will never be able to run another 1/2 marathon again but I am grateful for where I am after 1 year post op... as I have read many a story on this site that have struggled much more than I. 

Mike Golfrunner

So you had your ROM to 130 degrees by 7 weeks? Now I feel like I'm really behind with my ROM. I'm at 8 weeks post op and am only at 80 degrees. Did you start bending immediately after surgery?

I also am trying to get back for golf in a few months. The biggest challenge will be walking and carrying my bag for 18 holes.

Danny
post #7447 of 10860
@mike golfrunner
Hi mike! Sounds like a great recovery. What were you wearing before you were fitted with a knee brace at week 7? An immobilizer?
Did they follow the same protocol as umass?
Which Hosp did the surgery?
Did you find that physical therapists were familiar with your injury or were they referred to you by your surgeon?
I never took a sick day in two years either. The only other one was when my back went out.
Did your surgeon say anything about the same thing happening at some point to your other knee?
It seems that most everyone on the site that has recovered has continued in the gym after. I never had time for the gym with my family and work. But I did play a lot of baseball all my life. Active but not disciplined. Hope I can get back to normal life. The picture is encouraging. @rednighthawk
post #7448 of 10860

@Mike Golfrunner, congratulations on your recovery.  You've done a nice job in getting almost back to your life as you want it.  Don't be a stranger, and continued good success.   John 

post #7449 of 10860


Didn't get the ROM to 130 until week 11.  Had a good PT guy who knew my goals of getting back to work ASAP ...and back on the golf course.  Really started working on the ROM aggressively at week 8. Did a lot of balancing work in PT to strengthen the knee.  I found this link from UMass:

http://www.massgeneral.org/ortho/services/sports/rehab/Quadriceps%20and%20Patellar%20tendon%20repair%20rehabilitation.pdf

that I did a lot on my own at home along with the protocols from my PT.  My PT claims he had worked with the same injury before.  I was in an immobilizer for the first 7 weeks.  The surgeon nor the PT never mentioned about the same thing happening to the other knee.  Have seen on this forum a few stories about this and will remain vigilant and cautious to avoid at all cost!!

 

When allowed back on the golf course use your hinged knee brace for support given initially given the uneven terrain especially if you hit the ball to uncharted area's of the course as I am prone to do on occasion.  Be smart at first and put your clubs on one of those 3 wheeled push carts, you don't need extra weight on that mending knee...and watch your step! You should also use the injury and brace situation to your advantage on the 1st tee box when negotiating the wagers of the day!  Actually played not too bad in the beginning as the knee forced me to tone the swing done a bit and to concentrate on good balance.

 

Mike

post #7450 of 10860
Quote:
Originally Posted by old bruce View Post

Great photo, John. Can pictures of @Eric308 on his rower and @skicarver on his bike (with socks) be far behind?


@old bruce....as requested. Best exercise ever for total body and cardio!

post #7451 of 10860

@Mike Golfrunner,

Was wondering whether you had knee pain while running before your accident.  I have torn both quads (5 years apart) and I've had sore knees/quad tendonitis since high school.  Im 53 now.  Glad to hear that you are getting along well now.  I'm at 14 weeks currently, and I agree the UMASS protocol is one of the best that Ive found on line!

post #7452 of 10860
@Eric308 Thanks for the action shot! Now all we need is @skicarver and maybe a golfer and powerlifter or two.
post #7453 of 10860


@brucetherunner

 OMG...that's tough going thru this twice.  Had been avid runner 5-8 miles/week for 30+ years with no unusual knee problems.  The surgeon and or my regular doctor would not commit to say this was a contributing factor to the injury but my doctor is a converted cyclist (he has completed a few marathons) and now encourages to all his patients who are work-out warriors to be smart about long term effects from running on knees.  Used to love a 5 mile run along the shores of Lake Michigan but if I have to settle for a bike ride or long brisk run/walk I am OK with that too so as to avoid a repeat injury.  Don't ever want to miss a walk with my dog or turn down a round of golf again!

 

Mike Golfrunner 

post #7454 of 10860

The Bilateral Wonder....Puttin' the power down!!

post #7455 of 10860
Attaboy Skicarver.
post #7456 of 10860


Nice video skicarver.

post #7457 of 10860
Quote:
Originally Posted by Mike Golfrunner View Post


Didn't get the ROM to 130 until week 11.  Had a good PT guy who knew my goals of getting back to work ASAP ...and back on the golf course.  Really started working on the ROM aggressively at week 8. Did a lot of balancing work in PT to strengthen the knee.  I found this link from UMass:
http://www.massgeneral.org/ortho/services/sports/rehab/Quadriceps%20and%20Patellar%20tendon%20repair%20rehabilitation.pdf
that I did a lot on my own at home along with the protocols from my PT.  My PT claims he had worked with the same injury before.  I was in an immobilizer for the first 7 weeks.  The surgeon nor the PT never mentioned about the same thing happening to the other knee.  Have seen on this forum a few stories about this and will remain vigilant and cautious to avoid at all cost!!

When allowed back on the golf course use your hinged knee brace for support given initially given the uneven terrain especially if you hit the ball to uncharted area's of the course as I am prone to do on occasion.  Be smart at first and put your clubs on one of those 3 wheeled push carts, you don't need extra weight on that mending knee...and watch your step! You should also use the injury and brace situation to your advantage on the 1st tee box when negotiating the wagers of the day!  Actually played not too bad in the beginning as the knee forced me to tone the swing done a bit and to concentrate on good balance.

Mike

Thanks for the clarification. And congrats on your recovery. You obviously put the work in. And good idea about the first tee wagers! I'm thinking I should get at least 2-3 a side because of my knee. The thing that really sucks though is that last year I was playing some of the best golf in my life and hitting the ball further than I ever have. So getting those strokes may take some work! Thanks again Mike and good luck buddy.
post #7458 of 10860

Checking in:

 

At 15 weeks, just had an apt with OS.  Everything's good, he was impressed with my "functional progress", and asked what exercises I was doing.  So I gave him a rundown of the UMASS protocol, and some of the extra things I had been doing for ROM (Im nearly there!).  I didn't tell him that I had been jogging 2X per week since week 12, but I asked when it would be OK to run.  He said APRIL!  Sooo... I'm going to try not to jog/run for a while until the quad is a little stronger and more stable.  and skiing is definitely out for early spring :(.  Don't want to run the risk of aggravating the mild arthritis that I seem to have in the knee.

 

Functionally, I am good.   I can take two steps at a time up now, but I'm not exactly bounding down the steps like a teenager.  I cant get into a full squat yet and quad extensions still are a challenge.  I have been doing 3/4 squats on the bosu ball with my bodyweight.

 

I still do the recumbent bike, but not for strength...just for ROM.  I crank the seat all the way down to zero and put my toes on the pedals and do 3 x 100 cycles with zero tension in between sets of bosu and leg presses etc.  I think it is the #1 best exercise for ROM!  For cardio I do the ARC trainer, and I go for 30 minutes with an indicated calorie burn of 550 (I don't quite believe its 550 but I am getting the HR up to 150 at times)

 

Cheers!

post #7459 of 10860
14 days post op

Just had my 1st post op appt.- stitches out yesterday. Finally, surgeon gave me a copy of his protocol and list of rehab places. Totally different from the one his association gave me. This new one has specifics for the first two weeks post op that would have helped me tremendously had he faxed it when I asked (twice). It does have 30degrees in pt weeks 2-4. @brucetherunner -but no permanent unlocking of the brace until weeks 6-12! Yikes.

Stitches weren't painful but extreme pain when dr took my leg and attempted to let it dangle. My whole body shook. I closed my eyes- my wife said the doc looked very surprised that I could not lift or hold my leg at all.

She tried asking questions and showed him the umass protocol we had printed. He didn't even look at it- tore one page we gave him in two and threw it in the trash with a laugh. Very rude. He then told us about his protocol etc. and that any pt could do it. 😳

We asked about CPM and they said that would be the worst thing for a qtr repair! What? Umass has it on its protocol. Anyone? @eric308 @gulfagain @nj Pete @bigggfred

About the only thing he said to me was, (pointing to above my knee), "see, there wasn't anything there before. now you have something. That's better right?"
Wow! no people skills.

One exercise on his list 0-2 weeks was activating the VMO muscle because it dies right away. That's the muscles I had lots of pain in after repair so I may have been partially torn for awhile.
It listed electrical stimulation for that muscle if leg lifts were unsuccessful- right away post op.
(he never told us any of it.... maybe that's why I had not the strength he was expecting!)

Protocol says cryotherapy and he told us no ice.
Also Found out (Thanks to his assistant) that I haven't elevated (properly-high enough) since the operation. you're really on your own with some surgeons.

Fortunately my wife has a personal electrical muscle stimulator. So we downloaded directions of ems for VMO and did a 20 min session. After, I felt like I had a new leg! Had no problem changing my pants on my own and standing upright on the leg for a couple minutes with no brace with no fear. It felt strengthened. Did another session tonight and was finally able to lift my leg like magic and do heel slides up to apox 30deg! As the current goes through the VMO actually flexes quite a bit visibly.

I'd recommend it to everyone. Even after recovery the VMO is the one muscle that can be overlooked causing a smaller and weaker thigh. The other quads muscles they think are controlled by separate nerve so even if you're using your quad muscles you may not be using VMO. This can cause weakness in longterm recovery. Studies: EMS strengthened muscles by 20% and caused healing and fiber growth and repair. Not giving medical advice but it's the only thing that has helped in my very short time of post op healing. My wife said she bought it for $49.

I didn't choose any PTs on his list, just in case they know him and don't want to stand up to him. I got into a non profit Hosp with a gym that is well known for its rehab on even the most severe injuries. The team has 5 pt OCS's and a pool. They have treated many professional athletes.

So my long phase 2 begins Friday. I'll post updates for new members and lurkers.

Sorry for the long post but I remember that the long detailed posts were the ones I looked for and read in the beginning of this injury.
Snow this weekend. At least I can get my shoes on now!
post #7460 of 10860
@Johnny Pegleg, When your OS says no unlocking of brace till week 6, listen to him. This means when you are moving around. The repair is not ready to be bent under load. Of course when you are working on passive ROM it can be unlocked or taken off, provided you are sitting down on couch or floor. But work on the ROM as much as possible now. And don't try to be a hero and walk with brace unlocked or off! You will get there in time
post #7461 of 10860

@Johnny Pegleg....Wow, your surgeon is a total asshole. As for me, I was also locked in the brace at zero for six weeks except for PT and my home exercise sessions. I never used a CPM or used that electrical stimulation deal. However, I iced and elevated all the time. I think a big reason I didn't have any muscle loss (including VMO) was that they had me weight bearing and no crutches just a few days after surgery. I also started PT at three weeks post and hit 90 degrees my first appointment. I know for a fact that NJPete used a CPM and will also highly recommend icing. Regardless of your dickhead doc it sounds as if you have found a great source for your PT. At this point it's pretty much up to you as far as the pace of your recovery, but having a competent PT staff is huge. I took it as a personal competitive challenge and my goal was to be back to normal for a 5000 mile road trip out West four months post-surgery. I did it at 3.5 months. Hey, best of luck to you. Maybe you should copy the below link and show it to your surgeon. Maybe he'll pick up some tips.:D

http://www.iskinstitute.com/kc/knee/quadriceps_tendon_rupture/t1.html


Edited by Eric308 - 1/22/15 at 6:36am
post #7462 of 10860

@Johnny Pegleg

 

Wow your OS is a tool!  Just goes to show you that he probably doesn't do a whole lot of QTR's compared to ACL's and Knee replacements.

 

My OS wrote an Rx for Electro Stim but I never did it.  Wonder if I should check into it now...Sounds pretty cool.  Anything to stabilize the knee.

 

You wrote
Stitches weren't painful but extreme pain when dr took my leg and attempted to let it dangle. My whole body shook. I closed my eyes- my wife said the doc looked very surprised that I could not lift or hold my leg at all.

 

And that reminded me of when I was getting my staples out one week post OP.  They left me in the room alone sitting on the narrow table and told me to take the brace off.  I did but my leg then slipped off the side of the table like a noodle and flexed to 90 deg.  I let out a muffled yelp (it burned for a couple of minutes) and had to lift it back on the table with my other leg.  Fortunately my OS had pre-programmed that ROM in before he zipped me up so it wasn't a disaster, but that was the most pain that I've experienced from this ordeal.

 

Your Dr. should not be surprised that you couldn't lift your leg what an @$%^.

 

Glad to hear your moving along, before you know it you'll be back to work.  Have you experimented with driving ?  Its your left leg, correct?  Are you wearing a compression stocking?

post #7463 of 10860

@skicarver Thanks I have done the exercise walking backwards on treadmill strange sensation but I can feel pulling on VMO still doing it slowly

 

9 months post op tomorrow double quad (bilateral) steady exercise regime, 7 day program, 2 visits to personal trainer doing cardio, weights & legs, 3 days I do a 60 minute walk, 1 day 60 min exercise bike, seems to be no progress on right leg, it still feels very tight & alien to rest of my body, left leg is great no problems

Just seem to have hit the wall at the moment. Mentally I feel strong Im busy running my Construction company, have a few beers every weekend lifes good, just need my right leg to come & join the party!

 

Best of Luck to all you quad people

post #7464 of 10860
@The Quadman

What helped me the most on loosening the knee on my qtr side was the exercise bike. Following the advice on the forum I lowered the seat to help maximize rom and "loosen" the knee area. If I were in your shoes I'd try adding more days of the exercise bike even if it's just 15 minutes. It really, really helped lowering the seat.
post #7465 of 10860

@The Quadman Agree with Old Bruce, Lower the seat, but use low resistance  I think the repetitive compression helps with the scar tissue.  Does the right leg look different (ie more swollen)?

post #7466 of 10860
@brucetherunner hi no swelling in either knee right knee is 20mm smaller than left knee its under developed and vmo muscle small they may need to operate again I am waiting until twelve months post op to make my decision my physio. Measures strength in legs both legs still improving hence my decision to wait thanks to all comments from forum you all know the struggle cheers the Quadman
post #7467 of 10860

@The Quadman  I am about 15 months post op and still improving.  It is only been the last couple months my hamstrings have started to kick in.  I attribute to nerve regeneration and muscle balance length getting closer to where it needs to be.  I found that improving slowly in not hitting the wall.  Even 1% a month will get you to the finish line.  Just keep putting in the work even if you do not notice rapid improvement.  You will notice the improvement in every day activities getting a bit easier.  My Surgeon always told me a bilateral QTR was 4X serious, if not more , than a single tear.  Add in the equation we all heal at different rates and the variables increase even more.  I am starting to get some leg size back. You can see in the trainer video I am no ballerina.   Movements in the first 20 degrees on bend still do not feel natural.  I am hoping it is just strength and muscle balance.  The last thing I want is to have more procedures.  I have zero pain but do stiffen up a bit after supper.  

This damn VMO muscle is hard to target.  The other exercise that helped me was multiple pilates bands just above the knee and do knee presses from locked to 25 degrees.  If you can't find them let me know and I can shoot you a quick video.  Progress in the VMO is all about triggering full contractions.  With the nerve damage it can be near impossible until the nerves regenerate.  Try to fire your different muscles without exercise and you will see the difference.  Getting these leg muscles to fire is not easy.  Using proper cycling shoes attached to the pedals also enables me to pull up on the pedals.  This has proven to develop my hamstring more than they might have been.  Keep pounding away and you will improve.  Show it no mercy!!

post #7468 of 10860

@skicarver...and everybody else. Here's a good site for VMO exercises. I do or have done most of these. Click on the red prints for actual videos. Oh, and skicarver...thanks for clarifying you're no ballerina.;)

http://sportskneetherapy.com/the-best-vmo-exercises/

post #7469 of 10860

@Eric308  Maybe the Ballerina dream is still alive with your link to the Plie' Squat!!

post #7470 of 10860
Quote:
Originally Posted by skicarver View Post
 

@Eric308  Maybe the Ballerina dream is still alive with your link to the Plie' Squat!!


@skicarver...good point. I was thinking I'd like to be doing sit-ups under her Plie' Squat.

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