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Quadriceps Tendon Rupture, Repair and Rehab - Page 252

post #7531 of 10860

@Marrs1721  Another Double Whammy!!  Totally sucks!  I am about 15 months into recovery from a double.  Fire Fighting at 6 months....no way I could have done it then or now.  I am strong now and able to work all day but still gaining strength.  Going down stairs still a bit wonky.  There are no tricks to recovery.  Once you get cardio fitness then it is GO TIME.  3 hrs/day at the gym.  I hope you recover fully but 6 months would be a crazy story IMO.  Leg muscle is friggin slow to respond to exercise.  Wishing you the best.  My rehab routine starting out was 1 hr on the recumbent bike, 20 minutes eliptical going backwards, 20 minutes treadmill forwards, 20 minutes treadmill walking backwards up hill, various leg machine workouts in between.  Once spring arrived I was able to bicycle and 30 mile rides were possible last summer.  The more you do the more you will be able to do.  6 month work return for me but not Fire Fighting.  I was a volunteer for many years and know how demanding it can be.    Feel free to ask me anything anytime.

post #7532 of 10860

Quadwife4life,

  If you can find the time read some of the older posts

they will give you some very good ides.

    All The Best,

    Calhiker

post #7533 of 10860
Thank you for the advice. I am can't wait to start doing the PT exercises on machines because like you said then it's go time! I love cardio. 6 months is what my surgeon told me. I have to shoot for that or a little longer. Firefighting is my career. My life. My source of income. Not doing it for 12+ months is not an option for me as disability will run out and we have a screwey contract about that. I have a positive attitude and great support. Luckily I am on a department that is slow in terms of fires, but busy on medicals. One day at a time is how I'm taking it.
post #7534 of 10860
Been a few weeks since I've posted so figured I'd give an update. Also, welcome to all the new fellow QTR's! It's a mighty big speed bump but you'll get past it.

So I just passed the 11 week post op mark. Got to 100 degrees ROM last Tuesday and I'm closing in on 110. Slow but steady. As for the bending, for me it's not coming easy. I have to go till I feel quite a bit of pain or I wouldn't be where I am now. My surgeon did tell me at my last follow up that my retinaculum was repaired as well. He said that it's very common for that to tear as well and that makes the bending more painful as well. He basically said " no pain, no gain".

I'm also doing more strength training... squats, leg presses, hip work, heel raises, and hamstring curls. Still have a long way to go but I'm definitely getting some strength back.

I have seemed to hit a bit of a stumbling block the past week. I've developed quite a bit of pain while walking. It has really been inhibiting my walking. Thing is, it's not at the site of the repair. It's on the bottom of the patella and slightly to the outside. I did notice a small pocket of swelling there ever since the surgery. Since it is at the bottom of the incision, I figured it was just some fluid pooling. But now I can feel what seems like a hard lump about the size of a pea on the bottom of the patella. This is where the pain seems to be radiating from. I do recall the surgeon telling me that the patella tendon looked good when he did the quad repair. So I'm gonna get back in to see him this week to see what's going on.

Hope all is well with everyone.

Danny
post #7535 of 10860
How much did your therapists place heat packs on your knees quads before rehab to warm them up before workout? Do they ice them afterwards it is that your job?
post #7536 of 10860
Quote:
Originally Posted by Marrs1721 View Post

How much did your therapists place heat packs on your knees quads before rehab to warm them up before workout? Do they ice them afterwards it is that your job?
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@Marrs1721 I did about 27 visits to PT and in the beginning I was getting heat packs for about 15 minutes per visit. Once my ROM got good the heat packs were skipped. I applied the ice packs after the therapy. Best of luck.

post #7537 of 10860

@Marrs1721 Never had heat packs but plenty of cold afterwards!  as far as firefighting at 6 months, maybe you can be part of the supporting cast by then, but I would say that you may not feel comfortable in a scenario where there are lots of obstacles steps and debris.  Stumbling and catching oneself on your quad(s) is a good way to pop it again!  I would break it in easy and at six months start doing plyometrics at the gym under your OS/ PT's guidance before returning to the "first string".  You are a bi-QTR so you don't have the luxury of a "good" leg to compensate.  You are young so you'll probably recover just fine but the last thing you want to do is have it happen all over again.

 

Another tip...Don't worry if you do not reach specific ROM goals on a time schedule.  With this injury, for the most part, its the opposite of "no pain no gain", especially in the first 6-8 weeks.

post #7538 of 10860
Quote:
Originally Posted by Marrs1721 View Post

How much did your therapists place heat packs on your knees quads before rehab to warm them up before workout? Do they ice them afterwards it is that your job?

Therapy hasn't used heat prior to workout. I start off with stretching and straight leg raises and move on to the squats and machines. I finish with ROM work which includes prone knee bends, stationary bike rocking , and heels slides on wall. They have been doing what they call a Russian E-Stim at the beginning which is an intense stim of quad for 10 seconds and nothing for 50 seconds. This goes for 10 minutes and I have to contract my quad during that 10 seconds. They always do e-Stim and ice at the end. I do pretty much the same stuff at the gym on my days off.

If it wasn't for the new pain I have on the bottom portion of my patella, I would consider my recovery going well. My gait was pretty much back to normal but the pain I have now has set me back a bit.
post #7539 of 10860

MARRS1721,

It is not a short road back on this type of injury. BTW, I am close to your size at 6'2 1/2" 293lb but I am soon to be 65.

 

Another thing I forgot to mention is that I have found a solid, non folding walker works best for me getting around. Slow as a snail, but just works better than crutches. Also, I have not used pain meds since about two weeks.

 

As said, I tore the left Quad around 7 years ago. I did find the Recumbent Bike & Leg Press to work real well keeping the knee moving and loose.

 

And, when you THINK you have done enough PT, keep doing it. Just words of wisdom from my 1st quad tear. I think I quit too soon on recurring self PT and the knee healed, but it could have been better.

 

I am 26 days after surgery. No pain, but DON'T LET NO PAIN FOOL YOU. The repaired tendon has to heal well back to the patella. Even with no pain it can get slightly torn again. The whole name of this recovery game is, in my opinion at least, CONTROLLED straining of the healing point. Causing slight micro tears via PT which results in a better mending, for lack of better words, scar at the re-attach point.

 

By controlled, I mean under direction of PT and not trying to short cut any of your recovery. There is not short cut, it just takes time to rebuild the tendon bond and rebuild the quad muscle.

 

No heat, ice down area for 12 minutes at PT.

post #7540 of 10860
Hope you don't mind a non-skier butting in to the site. I'm a cyclist, but can't find anything useful about rehab following a torn QT repair on the bike sites. It seems to be a pretty common injury among skiers.

I'm a 67 year old regular cyclist who fell down stairs at home five weeks ago and had the repair op some 25 hours later. The usual pain at the start but things seem to be going well, although progress still feels slow to me. In a leg brace, locked straight for 2 weeks, set to 25 degrees movement for 2 weeks and now set to 90 degrees till my next visit to the doc in 10 days. At that visit I hope to have my PT plan set out.

I'm walking OK, walking about 400 slow yards outside each day using a walking stick for confidence and doing some very light leg-lifting and bending exercises each day.

I had knee ligament tears in my other knee a couple of years ago and was in a leg brace for weeks but that was a doddle compared to this injury and I was riding again in about four months.

My question is about likely return to riding a bike (road not stationary). Before the injury I'd signed up for a 120km sportive in early June 2015. It's a quite hilly route with a couple of very steep climbs. It's not a fun ride so I couldn't just ride it at a snail's pace.

Is this do-able or should I pass the place on this over-subscribed ride to someone else?
post #7541 of 10860
@Queasyrider

Plenty of non-skiers on here so no worries about that. Early June for a tough event would be really tough to get ready for, but I think it depends on you. I think it gives you something to focus on and point toward, but I think you need to be able to pass on it if you get close and realize you aren't ready yet. I had a similar choice for a running hilly half marathon and I couldn't get improved enough to do it, but I think cycling progresses more quickly. I would suggest you look back over old posts by cyclists on this forum---plenty of them have been on here.
post #7542 of 10860
@Queasyrider

To be more specific, by really tough I would guess that you would have a 10% or less chance to get ready based on the range of healing people on here have described. Maybe you are someone who wants that kind of challenge and figure you will progress more quickly with that kind of focus even if you have to abandon your plans as you get close. Also, I will say my surgeon recommended a one year wait post surgery before return to sport competition.
post #7543 of 10860


Queasyrider,

I think you are really pushing it to do a bike race in June. You looses so much muscle, and have to build it back up.

I would pass, because the recovery on this type of injury is not short.

 

My left quad happened in late March, and I did make a trip to Hawaii at the end of April. But I was on crutches and it was draining to do that. Got special seating on the airliners though.

And I was hunting in Early October, but it was Pronghorn, so was not doing any big hilly climbing. Found cactus needles in my knee from bending down to field dress the animal. Did not feel them due to no surface feeling in the knee skin.

 

I would say to not do a 120k bike race. I think you risk compounding the injury and ending up with a loose or wonky knee.

post #7544 of 10860

Was ANYONE on a high potent  Antibiotic prior to the injury?

 

That was the first question my PT asked me because there is medical evidence that some high powered antibiotics weaken tendons. Effects Achilles tendon primarily, but will cause problems with all tendons.

 

I was on Azithromycin in late November.  Injury happened December 23rd.

No proof it weakened the tendon, but who knows.

 

PT said my being on the antibiotic will affect his plans for rehab.

post #7545 of 10860

Thanks for the replies. I'm no super athlete so I've probably been overly optimistic about my recovery, basing it on my recovery from a double cruciate ligament tear a couple of years ago.

 

Probably the 120 km ride is going to be beyond me and, while I like to set targets for improvement, there's no point in making them unrealistic.  So I'll carry ou my PT program and settle for a goal of just riding by June. I'll be gutted if I don't make that, but it's been such a severe injury I don't want to risk pushing it too soon. At my age long periods of inactivity are harder to come back from.

 

Dbrow16 - I started on Ciprofloxacin antibiotics 5 days before I had the fall.  It does say that there is a potential for weakening tendons and the Chemist told me to take care with putting high pressure on the tendons.  I mentioned this to the docs in hospital but they said it was probably just a bad coincidence and the fall would probably have done the damage anyway.  But they did say to stop taking the antibiotics as they might hinder tendon repair....interesting!

post #7546 of 10860
@Dbrow16 wow. I had a tick bite in November and was on antibiotics for 30 days prior to my rupture! Crazy
post #7547 of 10860


@dbrow16, I was on the highest form/s of antibiotics 6 month's prior to my bilateral ruptures. I was told by more than a dozen doctors ranging from Infectious Disease, GP's, Orthos, Neurologists, pulminologists and cardiologists that it was NOT the antibiotics that caused my ruptures. I was in a medical coma for 3 weeks about 6 months prior to my tendons rupturing. I firmly believe whatever they gave me during that time weakened my tendons a bit. I don't think it was the root cause...but negatively impacted them.

 

These days, I take what doctors say not so literal anymore. Unfortunately, I get more second and third opinions as well. I have been lied to by the best and worst and almost lost my life twice by varying poor doctor care.

 

I ONLY look out for myself. I have changed my diet and life outlook substantially since my bout with pneumonia then ARDS and the Bilateral QTR's.

post #7548 of 10860

NJ PETE, I agree and guess how small the world is. I grew up in Hunterdon County, a little town called High Bridge, 10 miles north of Flemington, 26 miles from Hopewell

.

 

 

Antibiotics info I found. It appears that they can cause tendonitis which could weaken the tendon. The way mine buckled under my left leg with my weight more than likely was the most significant cause. BUT, Who knows and I sure would not have made the connection. But the PT asked that question first visit.:

 

In recent years, a rare cause of tendonitis (or other tendon disease, including rupture) has been recognized: the use of certain antibiotics, including ciprofloxacin or levofloxacin. Why this happens is unknown. Tendonitis in the shoulder – The most common form of tendonitis in the shoulder is rotator cuff tendonitis ...

 

http://www.webmd.com/osteoarthritis/news/20080708/fda-warning-cipro-may-rupture-tendons

FDA Warning: Cipro May Rupture Tendons

Rarely, tendonitis is caused by an infection, such as gonorrhea. Tendonitis is most common in the shoulder, elbow, knee, wrist and heel, although it can happen anywhere that tendons are found in the body. For uncertain reasons, tendonitis is also common in people with diabetesicon1.png. In recent years, a rare cause of tendonitis (or other tendon disease, including rupture) has been recognized: the use of certain antibiotics, including ciprofloxacin or levofloxacin. Why this happens is unknown.

 

 

CRAP, cannot take anything any more without potential problems. Guess I need to wrap up in bubble wrap, roll to the corner and suck my thumb!

post #7549 of 10860

10 1/2 months post op and my knee swelled up today after climbing up and down a ladder to work on ice jams.  I thought I was all done with the swelling issue but , obviously not.  I'm putting ice on it now.  Talk about a long process!  However, on the positive side I am able to ski and it's getting easier going down stairs.  The OS still claims that is a result of insufficient quad strength, even if it's strong enough to ski with.  I'm going to the gym three times/week and that is helping a lot to regain strength.

 

I wish all you new folks the best of patience, hard work, and faith that you will get back your life as you knew.

 

Peace,

 

john

post #7550 of 10860

@Queasyrider.

I'm 58 and also a road rider. Nothing too long. And the winters here prevent riding except on a trainer. I am almost 5 weeks post op and the idea of even riding on a trainer seems far off right now. I could not tell from your post if you tore the tendon or ruptured it. If ruptured, I doubt you will be able to ride such a hilly ride unless your gears are set so you don't have to get out of the saddle. Where I live and the way my gearing is currently set up, almost every ride I ride there are parts where I have to get up out of the saddle. I can't imagine being able to do that anytime soon as in the next almost year. The quad is going to be so weak and puny that I just can't imagine it. I do have an old clunker mtn bike with granny gears so I will probably do my first rides on that thing. Anyway, just my two cents from another cyclist.

post #7551 of 10860
@jefftheKlutz

This site is a great source of info on the injury from people who have gone through or are going through it. We are all different but it is possible to follow the common themes of people's rehab experiences, the setbacks and the successes.

In my case it was a full rupture and I was lucky I had the repair op the next day rather than giving the tendons time to spread further from the patella. I still have flashbacks of my missing the top stair and remember thinking as I fell down that this was going to hurt! But I was lucky in that I could have landed on my head. Gas & air and intravenous paracetamol from the ambulance men were great.

I must have a tendon weakness as in the past I've never broken a bone but have had torn Achilles, torn knee ligaments, rotator cuff injury, tennis elbow and now this. But the ruptured QT is definitely the most painful.

While it is a huge disappointment that the rehab period is likely to be so long I just have to accept it and stick to the PT program that I'll be given.

I won't return to cycling too soon as I do a mix of road and MTB riding and have been known to fall off once or twice, resulting in some of the above injuries! I'll start off on a stationary bike and when I'm sure I'm ready will stick to flat roads and trails until I get most of my leg strength back.

I'll definitely follow this thread as I go through my rehab, so thanks in advance to all the contributors.
post #7552 of 10860
I am 1 yr (Feb 7 2014) single QTR fell on black ice at night. Now 63 and skied Blue, Elk & Camelback here in Pa Poconos over last 3 days. Going to Snowmass CO 19 days for 6 days skiing. Just saw OS for what turned out to be arthritis in other knee & he gave cortisone shot .
I would say skiing is an easier motion ( minus bumps which I am not permitted in 1st yr) than biking, running or even ladder climbing vis a vis SUSTAINED quad strength.
Hit the gym hard on leg presses , bosu ball balance& squats. Core strength should not be neglected.
I do stationary & road bike us elliptical for mobility & stamina training . Could ride 30 miles after 9 months.
Played golf best ever this past season as I focused on better turn & wt shift off knees with aforementioned core improvement.
Can now kneel on QTR KNEE with little discomfort .
Ice is your friend--boost cold with self mixed alcohol/water ice pack but not directly on skin!
post #7553 of 10860

@Queasyrider

I know what you mean about the pain. I've had four broken bones and a few sprained ankles and the only thing that even came close to this was the second broken arm whan I was about ten. Compound fracture and the doc had to put it back in place. And back then (60's) they didn't give me any pain killers. One thing that I completely forgot about in regards to your June ride is how much training you are going to miss prior to it. I would think that a ride that long that you would be getting in shape for it now and forward. And that ain't happening. I have my clunker sitting here on the trainer teasing me. Anyway, my poor quad on the leg is so shrunken. Good thing is that riding is great for building up quad strength. But it'll be torture this season to not be able to go for a nice 30-40 mile ride in great weather. Oh well. We gotta follow the protocol and be patient.

Jeff

post #7554 of 10860

@Rickster747

Thanks for the info. Great to hear that you are doing so well. Interesting about the part about kneeling and not feeling much discomfort. Says a lot. I mean that after a year it would be an issue. But that's the nature of this beast. Takes a long time to "really" heal.

post #7555 of 10860

@ Rickstar747

 

Just FYI - when recently considering having a cortisone shot in my knee, I read many articles stating that cortisone had an adverse affect on tendons. Quite a few articles about NFL players that had shots in their ankles and that suffered ruptured Achilles tendons shortly after. Having been through this twice, it scared the begeezus out of me, and gave it a miss.

post #7556 of 10860
Scoobs,
I heard that as well & asked OS.. He does not recommend more than 3 cortisone shots in a yr & said affects cartilage making stringy if used too much.
This is only my 2nd shot in that knee in 2 years so I think we are being conservative in treatment .
post #7557 of 10860

Folks what are the symptoms of the arthritis?  Does it ache at night on the inside (medial) of the knee?  That's what Im getting sometimes now.  Keeps me awake...

post #7558 of 10860

When my OS checked my old knee for arthritis, he placed his hand on my knee cap whilst I was sitting on a bed and asked me to extend the knee a few times. I believe he was feeling for crepitus- which is a grating feeling indicating the smooth surfaces are shot.

 

I also read that with arthritis you often wake up stiff and sore and - in the early stages - that soreness gets better during the day.

 

I sometimes have the pain you are describing in my old repair. I do not believe it is arthritis but a symptom patella femoral

post #7559 of 10860

I use voltaren gel for my arthritis. It is a deep penetrating analgesic available by prescription. I also used it for relief for the rotator cuff surgery which also reveled  some arthritis spurs.

Voltaren works really well for me.

 

Well, as to what it feels like, I can tell you I sure know when a storm is coming in. The arthritic areas ache but not just on the inside.

 

 

4 week since surgery checkup tomorrow. I HOPE the Ortho Dr. will get a lockable brace and give me some range of motion.

At the PT, my range of motion has been about 35-40 degrees. I have no real pain in the knee except when they lift the leg while I am laid back, or when PT test ROM limits.

I think that is outstanding. 

 

PT sees no real issues other than the knee is tight (expected) and the muscle is pretty well shrunk down. I am doing quad sets and standing and moving leg out to front, side and back.

 

7 weeks since injury.

4 weeks since surgery

post #7560 of 10860


My symptoms were aching around front inside of left knee (NOT the QTR right knee) even when I was walking. I work out 5-6 days a week using leg presses, hamstring strengthening, stationary biking & elliptical as well as bosu ball balance on each knee. And it was flaring up after this as well even with ice. Lingered for 1 month.  Originally in July 2013 it was diagnosed as medial meniscus tear (minor & not recommended for repair) so I received a cortisone shot (Kenalog 1cc) at that time which settled down the inflammation. This time he said via x-ray yesterday that meniscus tear was usually more toward back of knee, hence the same shot 19 months later, again to settle it down. 1 day later all evidence of arthritis gone. If it stays away, I will not return to him.

Should last several months and will get me through 1 week of skiing in two weeks at Snowmass CO.

 

By the way, he says one can get up to 3 shots of cortisone per year before adverse effects occur---cartilage fraying.

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