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Quadriceps Tendon Rupture, Repair and Rehab - Page 28

post #811 of 10804
gellertt, Sorry to see you joining the club. Back early in this forum there was someone who tore both his quad tendons. Take a look around page 3 or 4. You'll find that rehab varies greatly between OS and PT's. Some have been very agressive. Others such as my OS seem to be very conservative.

Today I was able to get myself in the van and drive around the block. I'm gaining more strength in my quad. Still difficult to do a straight leg raise when laying down, but I can raise it when sitting in chair (or drivers seat). This clears the way for going back to work tomorrow. Hopefully I won't rearend any body. With my leg pressed hard and straight against the firewall, I can only imagine the damage that would cause!

I'm three weeks post surgery. Hopefully in another week I'll get the immobilizer off and start PT. I take the splint off when I sleep at night now. That make the leg more comfortable, but when I move around, I end up bending the knee slightly. It feels very stiff, but swelling is minimal. very little to no pain (unless I'm doing leg raises, then I definately feel it!). I think I will follow up on finding a pool to work out in. I've got access to local paved bike trail, I've got a universal gym in the basement, miles of sidewalks to walk (and a treadmill if the weather doesn't allow outside), so all I need is the pool.

Last night we had a church function. It was my first opportunity to talk to a lot of people about my injury (of course everyone was coming up and asking what happened). Wish I had a great story like skiing or skydiving, but no, not me. I fell out of my truck! (and no alcohol was not involved!). I think back about a trip I had to Russia. I fell on the ice in the middle of a busy street in Ekatinsburg. Didn't hurt anything (probably because alcholol was involved). I get out of my truck in my Brother-in-laws driveway, slip on a small piece of ice and wind up with the complete rupture of the quad tendon, and fractured patella.

Good luck to everyone on your continued recoveries.
post #812 of 10804

Thanks for the reply!

Dear Falcon71:

Thanks for your reply. You and I are pretty close to when we had our accidents. Today is the 4 week anniversary of my accident. Wednesday of this will will mark 4 weeks since surgery. So, you completely remove your immobilizers at night? Wow! My OS and the PTs in the hospital told me that was forbidden ESPECIALLY at night lest I roll over on my side into a fetal position with my legs on top of one another. On the other hand, it has been 4 weeks now and I can walk pretty well with the immobilizers on (think: Frankenstein). I can do a leg lift with my left leg but my right is not there yet. I may try taking the immobilizers off to see what happens but after I see my OS on Thursday of this week. I want to show him that I'm feeling strong and that I want to start low impact PT ASAP.

I'm assuming that you're not back to work yet, yes? Good to hear from you and if anyone else cares to chime in, I'd love to hear from you! Best, Tom in NY
post #813 of 10804
Thread Starter 

More nordic skiing . . .

Hi Gang: Welcome Gellert - your good attitude is going to help you through this - I can't imagine going through what I dealt with in BOTH of my knees! I'll echo Chichi's advice, and make a special plea for you new folks to GET IN THE POOL as soon as you can. It will make a tremendous difference in your attitude and in your rehab.

I am now 11 days short of a full year from surgery on my complete rupture. This past Saturday, I nordic skied the route of the Boulder Mountain Tour from Galena Lodge to the SNRA Headquarters near Sun Valley, Idaho. A distance of about 21 miles including the ski from our yurt to the start of the course. I've always wanted to do the Tour (one of the best nordic races in the world) - maybe next year. My 13 y.o. son and I did it - took about 2 1/2 hours - watched some beautiful skiers fly by - - - lots of fun! Was awfully sore afterwards, but still managed to do a short 5K run the next morning before heading back to town on Sunday.

I'm scheduled to see the OS on the 27th. I have questions for him about why this is taking so long to come all the way back - I am lacking agility and the tremendous strength I used to have. I do everything right - lots and lots and LOTS of rehab using weights, bosu ball, bicycle, hiking, skiing, exercise equipment, etc. yet it still is not coming back the way I thought it would by now. I COULD alpine ski, but there is no way I could alpine ski the way I am accustomed to doing - and am afraid that if I went out, I would push myself too hard and too fast. Hopefully he can tell me something I can do differently, or at least give me a little hope for the end of the season.

Take care all.
post #814 of 10804

Suggestions for pool work

Idaho Guy and anyone else ... can you guys elaborate a little about the nature of your pool work? I definitely want to go that direction and would like to find a PT who can help facilitate this. Thanks guys and although I'm in on the "2 for 1 Plan," I will definitely carry with me your very valuable feedback and suggestions for finding my way back from this most awful of accidents. Thanks, Tom in NY
post #815 of 10804

9 Months

Wow, what a difference a month has made. I would say I have made my best progress in this last month and would say my knee is at about 75%, and can see it being close to 100% here in a few more months at the year mark.

Stiffness is down to just tightness now, think I can credit this to seat all the way down bike riding I have done over the last few months.

Routine has not changed much. Hitting the bike in the morning for 40 minutes too an hour 4 days a week, 2 days I do 30 minutes on bike and 30 minutes on the stair climber and weekends I go out and get a good 2 hour mountain bike ride in. Do weights on leg(s) at least once a week sometimes twice a week, doing a dual leg workout with extra isolatation work on the repaired leg. Feburary planning on starting free bar squating again as my main leg workout again, feel the knee should be in good enough shape by then to handle it.

Gellert:Sorry you have to join us here with double the fun! I started jumping in the pool around week 4. Walking in 4 too 5 feet of water just walking back and forth. The buoyancy lets you move and work the leg(s) with out irritating it much and the water seems to act like a radiator to help keep down swelling (at least it did for me). I did not do a whole bunch of pool work but what little I did worked great.
post #816 of 10804

5 1/2 Months Post OP

Hi all, it's been a while since my last post. I've continued to read along with everyone else.

I saw my OS yesterday and was officially released from his care. Although I'm probably 90% recovered he saw no reason to schedule any additional visits. " You know what you can do, just be smart and let your body tell you". I thanked him and mentioned that I hoped to not see him again.

I think the most noticeable progress for me happened once I was able to get in the pool and start walking again. As soon as you're comfortable getting in and out on your own, go for it.

I'm now back to cycling and teaching my Spin classes two to three times a week. I can still feel when I over do it though.. a little swelling then a little ice to take care of it.

My OS did mention that getting back to 100% could take up to a year.

I wouldn't wish this injury on anyone. Keep in mind though, you will get better.

Good Healing

post #817 of 10804

11 Months

It's been months since I've written in, but I've kept up with everyone a couple times a week. I'ts good to see some of the old timers...IG, VS, bulldog, and In2falling doing well.

Gellert - I am sorry to hear about your injury also, and I know exactly what you're going through, especially the sliding from the hospital bed in my den onto the wheelchair or bedside commode. I had BQTR and you can refer back to page 3 of this thread to when I started writing in to this forum. You are going through the hardest part right now, but when it's time to start working hard, you will get a little better every day. I feel I am back to about 90% now and would even be more if I hadn't been working so much overtime the past few months and had been getting to the gym more. I haven't been skiing, but I've been in the woods a lot this hunting season, and I felt great! Just know this is temporary and you will get better. If you have any questions, just ask, and if I can't answer them, someone else will.

Tiger bait
post #818 of 10804

3 weeks Post Op

Idaho Guy, I've been around quite a few ACL rehabs, but the guys on this thread are the only ones I know going thru the QTR. Thanks for starting this thread. The QTR seems to be a more difficult and longer rehab. In the words of my OS, " It's as bad as it gets." Keep up the faith and I'm sure you will get there. I'm impressed that you skiid 20 miles then ran a 5k the next day!

Buford, Not even 6 months and your at 90%? THat's impressive. I hope that my rehab goes as well. I'm going to have to steal my mountain bike back from my son.

Went back to work today. Felt good to get out of the house. Knee is a little sore and swollen, but not enough to keep from going back tomorrow. Drove my self in our van. It is a little uncomfortable with the immobilizer on. Hopefully I will get the immobilizer off next week and start rehab.

Keep up the good healing guys!

post #819 of 10804


Tiger Bait: Thanks so much for your words of encouragement. I'm feeling really strong at the 4 week mark past my surgery. I'm seeing my OS tomorrow for the first time since my surgery and really hope that he gives me the green light to start PT and ultimately, to lose these damned immobilizers. The rods in the immobilizers keep shifting position and poking me in my cojones (ouch!) ... what a pain!

Did you do any water rehab? I've been thinking about joining the Y and possibly taking an aquatic walking/jogging program as a part of my therapy. I'd also consider looking into renting a stairclimber machine and stationary cycling machine so that I can do work outside of PT. I can actually walk in my immobilizers (though, my OS would probably be horrified to hear that) and have been weight-bearing since the 3rd day after surgery.

I'm also interested to know how you got back to using stairs? I had my accident coming down a cement stairway when I accidentally took too many steps at once. Psychologically speaking, I think that going down any stairs is going to be a difficult thing for me until the knees get back some ROM. A friend of mine who tore a single quad told me that he was doing stairs (up and down) on his rear-end for a long time until his knees could handle it standing up.

I am so glad that I found this web site and that all of you guys have been so forthcoming with suggestions and sharing your experiences. I'm in a better place (head-wise) knowing that most of the folks on this site have bounced back. Looking forward to keeping track of everyone's progress! Thanks to you all for helping through my ordeal. Tom in NY
post #820 of 10804

1st OS visit.

Hi Tom. I had surgery on Jan 2. I had bilateral Quadricps Tendon Rupture. I feel your pain.

I just had my first post op appointment. The OS moved my imbolizers to 40 degrees. I'm in my 3rd week post op.

I've been doing my home exercise program that they gave me in the hospital rehab unit. This seems like were in for a long rehab. Lets stay in touch.

post #821 of 10804

Seeking home PT help

Hi all,

This is my first post. This forum is a wealth of information. I am posting out of frustration with my HMO. I am looking for advice and direction.

My tear occured on Dec. 15. Due to the holiday schedules, it was hard to get treatment. I finally had my surgery on Jan 9. On Jan 19 my surgeon removed the staples and said he would refer me for PT.

But... my insurance group sucks, and I was referred to a Physical Therapist who does not have any openings for a month! I asked the insurance, and they will not refer me to another therapist.

If I wait to start PT for a month, my knee will be very out of shape, and I will have a much longer recovery. I see some posts where doctors and hospitals gave patients handouts with excersizes to start with. Has anyone found any web sites with information on what excersizes I can start with on my own? Or has anyone who was given a handout considered scanning it and posting it somewhere where it can be downloaded?

I know I need to take it easy on my rehab, but waiting a month for my first PT appointment seems like it will make it harder to have a full recovery.

Very frustrated,
post #822 of 10804


Dear Mike: Welcome to our "exclusive club" and hang in there, things will get better. I hear you loud and clear about wanting to do some PT on your own until your insurance company coverage kicks in. I would be happy to share with you the various isometric exercises that I was taught during my 12-day stay in subacute rehab. There were 2 focal points of my rehab: 1. OT (occupational therapy) where I learned to make simple bed to chair, bed to commode, bed to walker transfers; putting on my clothes, and maintaining my upper body strength. 2. I had limited PT. I was pronounced as being weight-bearing by my OS as early as day 3 after my surgery. Assuming that you have a leg immobilizer on, and that you can bear weight, standing and sitting up as much as possible is a good thing. Next, here are the isometric exercises that I do every day:


Assisted whole leg lifts (requires assistance from a 2nd person)
3 sets of 10 lifts to 45 degrees
*Be sure the person helping you helps you to lower the leg gently and see if you can focus on assisting each lift with your hip, torso and quad muscles - you will eventually be able to do these unassisted as your strength returns

Quad Sets
3 sets of 10 with a 5 second hold (focus on squeezing your quad muscle and hold it for 5 seconds, release/relax and repeat)

Glut Sets
3 sets of 15 - imagine you're squeezing a quarter between both "cheeks" - hold each squeeze for 10 seconds, relax and repeat

Inward/Outward Rotational Toe Touching
3 sets of 35 - with feet approximately 10-12 inches apart, simply rotate each whole leg inward to touch your toes, then outward and repeat

"Snow Angels"
3 sets of 35 - wearing socks, bring your legs together and then slide whole legs out ward to a distance approximately 24" apart and then back together again, repeat

Side whole leg extensions
3 sets of 15 - starting legs together, extend whole leg out to 20 degrees - hold for a second, gently return to legs together, repeat

Backward whole leg extensions
3 sets of 15 - starting legs together, extend whole leg backwards to 20 degrees - hold for a second, gently return to legs together, repeat

I do the above every day. Today was the 4-week anniversary of my surgery and I am feeling good. I am hoping to get a green light to start REAL PT when I see my OS tomorrow. Good luck and let us know how you're progressing ... keep the faith! Tom in NY
post #823 of 10804

Hi Bob! We're in on the "2 for 1" Plan ... ugh!

Dear Bob (and any other folks with bilateral ruptures):

Thanks for the message. I see my OS tomorrow (Thursday) and I'm a week ahead of you (my surgery was 12/24). My immobilizers can't really be set at any specific arc as they are pretty flimsy. My body weight ultimately determines the angle and I find myself regular resetting the steel rods as they are bending very easily these days (I'm 6' - 280lbs.). I am seriously hoping to show my OS that I am fit to start regular PT. I can do unassisted horizontal lifts (easier with my left leg, the right is a little slow in bouncing back), and truth be told, I am walking pretty easily (with my immobilizers on) and YIKES, without my walker (that's between you and me and everyone else on this board).

With my immobilizers off, I can feel numbness in both knees, but it is much more isolated than right after the accident where I was feeling upper leg trauma as well as just below my knees. Swelling now is non-existent, yet from reading posts here, I am mentally prepared for the return of swelling once PT begins.

My real hope and something a lot of guys here talk about, is pool therapy! I want it so badly. My accident occurred the first day of our family vacation in the Caribbean! Needless to say, I didn't even get to swim in that gorgeous, 80+ degree, turquoise blue water! Now, I'm determined to get into the water again.

I can tell you that I have been remarkably pain-free since the 3rd or 4th day after surgery. I dropped the morphine shots and Percocet while still in the hospital and the only medication I've been on since the surgery is Coumadin (blood thinner) because I'm considered at risk for blood clots.

****Attention everyone: if you have friends wanting to get you a really useful gift while you're convalescing, I just got two great gifts: the first was a gift subscription to NETFLIX and the second was a gift certificate for iTunes Store music downloads. The NETFLIX subscription gives you instant access to something like 12,000 movies on your PC/laptop (no limit to how many you watch every day), and the iTunes gift is great if you want to load up on tunes to listen to during PT! I've been doing a lot of movie watching while in recovery - you might find it useful to pass the long hours.

So, Bob: keep in touch (we can exchange emails or just keep the dialogue going here). I'll let you know what my OS has to say tomorrow ... my wife has made me make a list of questions to throw at him. Hang in there and here's to a painless and short recovery for all of us! Tom in NY
post #824 of 10804
Welcome to the newbies, but sorry you had to find this thread.

Gellert: regarding the pool, see my post on page 27, but that is for a few weeks down the road. We have a "wellness center" associated with our senior center. There is a therapy dept too. After I completed my PT with the hospital (125ROM) I asked my OS for a prescription for the therapy pool (hot pool with a treadmill). My new PT had me walking on the TM and slowly would increase the jets for resistance. But this pool has to be supervised and has to be billable. The PT also had me get in the heated pool used for laps and exercise. He had me walk, stretch, go to the deep end and jump etc. I also began regular workouts for legs and upper body with the weights. But I always finished with the pool. Any exercise I could think of doing in the pool I did. I think the pool was the main way I got the "hitch" out of my gait.

TigerBait and I2F: good to hear from you guys!

MikeG: I think you will find plenty of exercises in the earlier posts here. One that is helpful for ROM is to lay on your back, put your injured leg on a cookie sheet, and slide your heel back towards your butt. The cookie sheet allows it to slide easier. I started this with my first PT and was told not to exceed 45 deg at first and eventually increase.

Best to All!

Keep pluggin'!

post #825 of 10804

Ready to start ROM PT @ 4 weeks!

Got some great news today. My OS has pronounced me ready to start ROM PT and I will have 3 weeks of visiting home PT and then, out-patient PT at a local facility. I have to keep the immobilizers on when upright for at least another month, but my incisions (I'm a bilateral rupture) are healed and now I can get into the shower again!

I'm shooting to get back to the office by March and am encouraged that my PT sees potential in my recovery. Check out the isometric exercises I've been doing that are outlined in one of my earlier posts. Those exercises and my OS's insistence that I start weight-bearing within several days of my surgery really helped me to progress to this point.

Hang in there everyone and keep posting! All the best.

Tom in NY
post #826 of 10804

Pool & Stairs

Gellert: Sounds like you're doing great and you're way ahead of where I was at this point. You asked about the pool and starting stairs. Start in the pool as soon as it's possible. It will help you feel normal again. You can do more in the pool than on land.

I started stepping up on a 1" book, then moved to 2", 3", 4" and then began raising my feet to the bottom stair and then the 2nd stair. I would do this as much as possible until I could go up completely. It may take a few weeks, but once you do it it becomes easier. At first I had to come down the stairs backwards, but with daily practice I came down frontwards and then it became easy. The staris was a big part of my rehab and now at the gym I go on the stairmaster first before I start my workout. P.S. Give your tendons enough time to heal before you try too much!

Tiger bait!
post #827 of 10804

4 weeks post op.

Greetings from a ruptured Pennsylavania quad victim. I am 37 years old in decent shape. I also have had a ruptured acheelis tendon in 94 also on my left leg, recovered from that in 4 months so hopfully this goes as well but i'm sure age will play a factor little more now. This site has been very helpful and inspiring. Ruptured left quad on 12/22/08 had to wait till 12/29 for surgery due to the christmas holiday. Did not have much pain when it happened or the week i had to wait. Intense pain about 3 hours after surgery and continued for the next few days. Had a 2 week follow up with os to remove bandage and stiches. had me try a leg raise and couldn't. Told me to start pt asap, also said i could put full weight on leg with the immobilizer brace on. started pt on 1/18/09 very limited session more talking then working. rom on this session was 35 degree's. Monday's pt was more work and less talking ROM 55 degree's. Felt really good seeing a increase in rom. Wed. pt therapist gave more exercises to do, I told her that I wanted to be pushed. I got to 65 degree's rom. Fri. got put on a bike to help with stretching only, no complete rotation, and also standing calfraises with my brace on they really burned but felt great. Fri. ROM 70 degree's with a little pain. my reaction was that SUCKS! after making the large gains early then only a 5 degree jump. pt said its normal to not make as big as gains as you get closer to 90. Leg feels really good after 1st week of pt. haven't used the crutches for a week outside the house been about 2 weeks inside. os said probably 6 weeks till i could go with out the immoblizer brace. all we can do is take one day at a time trying to be better then we were the day before. good luck to all and stay positive
post #828 of 10804

8 Month Update - 70% Strength tested on Biodex (Injury 5/28, surgery 6/5, PT start 6/18)

Welcome to all the new people. Remember this word "patience" and you will all do fine.

It has been two months since I last saw my doctor, so I was hoping to have new information to report and I do. Appointment was 1/20/09.

For a quick update -
5/28/09 left quadricep rupture (about 2 inches above knee, so tendon to tendon repair) just walking to my mailbox (age 48)
6/5/09 - Surgery (Dr. ok'd me to put full weight on leg after surgery--but immobilizer on for 6 weeks except for PT)
6/18/09 - Staples removed and PT started (3 times a day at home AND 3 times a week at PT facility)
NOTE: If you have no one to assist you with "assisted" leg lifts, then put a towel around your leg like a sling and lift it yourself while you make the effort--it does the trick & worked for me.
7/15/09 - No more immobilizer
8/4/09 - 90 ROM
9/30/09 - Full range of motion
December - able to go up AND down stairs (slowly) alternating legs without holding onto handrails with a lot of muscle control.
(but I don't do it when in a hurry, in the dark, and when it is wet) I always use handrails when getting off and on bus and train.

Do my PT exercises at home every day (includes flexion & extension with weights, wall slides with therapy ball and weights, squats with no weights, stair exercises, balance, stretching, stationary bike, step machine, knee raises, and walking) Dr. has put my limit to 20 pounds on extension exercise with weights. He has not allowed me to run or jog.

My ortho doctor had me extend my leg and felt it and pretty much was going to write me off as not having to see him again. He said I was way ahead of other people with the same kind of injury and there wasn't much more different for me to do. Just keep doing my exercises because it was going to take time to get the strength up. He did say I could go to the gym, but I just want to concentrate on getting my injured leg up to the strength of my other leg using all the special exercises I am doing at home before I go to the gym. There isn't much more different I can do at a gym right now, except for using a treadmill and putting it at a 10 incline for 10 minutes and going as fast as I can.

The doctor said I could use a step machine (I have a small one at home and it works for now), my stationary bike, and elliptical trainer (I have never used one and don't know how that would work any better than walking or using a treadmill).

He still doesn't want me to run or jog--even short distances. I try to explain, I don't want to do that for regular exercise--just be able to do it for a short distance--like trying to get out of the way of a car that doesn't stop at a red light, or some emergency. He said not now.

I suggested that maybe we should test the strength of my leg on the Biodex machine next door at physical therapy. (I think he forgot we have never done that yet.) He said "Good idea, let's do it now!" So we went over there and I got on a stationery bike to warm up for 10 minutes.

My doctor did mention that he has a friend who is also a doctor and he ruptured his quad tendon (it detached at the knee) and his friend is not doing as well as I am.

Everyone's injury is a little different than the next person's and there is a different combination of surgery, timing of surgery, timing of PT, cooperation of patient, etc. It is a real team effort. But, the bottom line is it your leg and you have to do the rest of the work on your own.

We did not do the Biodex test two months ago because the doctor said I didn't have enough strength back then and I would only get discouraged if I tried to test. If I had a knee replacement, I would have been put on the Biodex machine for training. However, a quadricep rupture is a whole different injury as many of you new people are realizing.

The Biodex machine is a large machine hooked up to a computer (see photo below). They strap your thigh in and then adjust the machine and strap your ankle in. You lift your leg as high as it will go and then about 90 degrees back. Then you go kick your leg back and forth that range as fast as you can for 5 counts, then rest, then 10 counts. Then they readjust the machine for the other leg.

First, they explained no one would have 100% strength in both legs as most people favor one leg or the other. Just like you might be right handed, your dominant leg would be 100% and the other one would be close, but not usually 100%. Well, all my leg exercises are done slow, except for walking and biking so I don't know how I can improve my speed.

My injured leg measured 70% strength of the other leg. However, my flexion was very strong and close to the regular leg (that is bending my leg back). Of course that is better because I'm up to 17 pounds doing 15 x 5 sets every day on the injured leg! My extension is weaker--I am up to 10 pounds 10 x 4 sets on my injured leg. I started with 1 pound, so that is progress. The max my doctor said I should do on extensions is 20 pounds. So, I have my work cut out for me. I am going to increase my weight by 1 pound every 2 weeks. I bought two 10-pound strap-on weights because I'm already strapping on three 5-pound weight and two 1-pound weights and it is getting time consuming!

I would suggest if you are 7-8 months out or more and curious as to exactly what your strength is in your injured leg--then see if you can get a Biodex test. If you have PT, ask them where you can get tested on a Biodex machine. It pays to find out where you are so you can adjust your PT and measure your progress.

My doctor changed his mind about not seeing him again after that Biodex test. I think he is curious to see what my strength will be at the one-year mark. So, we scheduled an appointment in June 2009. I'm going to see what I can achieve by then.

No new exercises were mentioned to me. He told me to just keep doing what I'm doing and it was going to take time to get the strength up.

He mentioned it would be less strain on my leg to drop some weight and he said he is not one to talk. That has been my goal also--increase strength and lose weight so the leg doesn't have to work so hard. I'm sure December was shot a bit as I was doing great in the summer working out a lot and not eating much. I take my daily vitamins, try to get 8 hours sleep a night, eat more salads w/protein, cut carbs and sugars and do my daily PT.

My doctor has been very aggressive about PT since the beginning and I have listened to him.

I never tried to do certain exercises before a certain time because there just wasn't strength in the leg to do them. I never had a leg buckling problem because I took my time getting to certain exercises - such as stair climbing up and down stairs with alternate legs. That is an advanced exercise that takes a lot of time to work up to. I asked my PT people how to train for going down stairs and they showed me what exercises to do.

Here is my doctor's explanation about why he doesn't want me running. There is too much chance of tripping or stumbling on something and I could be in real trouble again. I have to agree with him. I am safe with treadmills because I can hold onto side rails and go as fast and smooth as I can without fear of tripping on rocks or something.

Until my injured leg is much closer to the strength of my uninjured leg, I guess certain activities are out. It only makes sense. If you are doing something on a leg with only 70% strength, guess which leg is likely to collapse in case of a fall or trip? I'm not willing to screw myself up after coming this far.

There may be certain activities I just don't do anymore. It all depends on what risk I'm willing to take. I have to work at least another 20 years and I am enjoying just being able to walk normal again (I have a very smooth gait --worked very hard on that--and no one would now be able to tell I had an injury--unless they saw the scar.) Also, it took so long just to walk normal up and down the stairs--I'm enjoying that too. Just a few months ago I looked very awkward with my foot flopping down on the stair while I held onto the rail for dear life.

Every day at lunch I walk down a long flight of stairs and back up those stairs. I could take an elevator, but why? The more stair practice and walking you can get in your day, the better. I especially like walking up steep hills and down them--lots of good practice. I get better every day.

You have to have a lot of patience with this injury. I know my strength now and I know my goal. I've told my friends I will return to the gym when my leg strengths are almost equal. I told them it would take about a year and it looks like that is what it will take. You just can't rush it. So many times the doctor kept telling me this was a very serious and rare injury.

He hasn't said I could NEVER do certain activities, he just doesn't want me to do certain activities right now until he sees an improvement in strength.

Just keep working and taking one day at a time and be positive and you will make progress.

Look at former President Bill Clinton's progress--12 years after his quad rupture (his was tendon to tendon) at the Presidential Inaugeration!

I watched the inaugeration and I paid very close attention to former President Clinton going down a long flight of stairs with Hillary. Clinton had a quad rupture in almost the same place as mine in his left leg in 1997. Look at him 12 years later walking down those stairs very smooth, not holding any handrails, and not even carefully looking down at the steps! He was shaking people's hand from the left side to the right side. He looked really good going down those stairs with no effort.

Biodex machine below (newer model than the one at PT, but still similar. To do the other leg, they push the chair back, then push the leg thing to the other side, then turn it around, then push you back and strap you in (there is a right and left leg attachment that they have to change).

post #829 of 10804

Knee CPM machine, anyone tried one?

In a previous post I read that the individual did rehab with a home Knee CPM machine (I believe it was a Danniflex 400i). These machines help increase ROM through a repetitive flexing motion while the patient is lying down. Here is one example of such a machine:


My question is, have any of you "veterans" out there used such a machine? If so, did it work for you AND MORE IMPORTANTLY, would you recommend renting one to help with home PT?

It seems to me that this type of machine would be of tremendous value while lying in bed watching television as it helps to gently flex the knee and ultimately, strengthen the quad muscle.

Please let me know if any of you are familiar with this rehab protocol and if your OS has talked about it with you. Thanks.

Tom in NY
post #830 of 10804
surgery 11/12/07

Steve in Pa: sorry to hear of your injury,but there is lots of info here if youtake the time to read all the posts. best to the Steelers!

CQP: good to hear from you! glad you are progressing.

Gellert: no, never had any in home apparatus except the elastic straps. some have had cooling devices to help with swelling.

All: as most of us can attest, this is not a sprint....keys are to do your exercises and keep as positive an attitude as possible (not always easy, especially early on). I can do whatever I want, but I am certainly aware of slopes, especially slippery ones, and stairs (my "downfall"!).....

Keep Pluggin'
post #831 of 10804

3.5 weeks Post Op

I appreciate all the posts on the different exercizes everyone is doing as part of PT. I go in Wed. for 4 week Post Op appointment and I am hoping to get released to start PT.

I am curious if the extent or type of QTR plays into when PT can start. CaliforniaQuadPop states he had a tendon to tendon rupture and started PT at 4 weeks. Steve in PA started PT two weeks post op.

My repair entailed tendon to tendon, tendon to patella, patella to patella repair. Yeah, sounds like it all came apart. My OS said that I had to wait for any knee flexion until the tendon had reattached itself to my patella. At that time I could start PT.

Any others with this level of repair and when did you start PT?


post #832 of 10804

4.5 weeks post-op

Falcon71: I asked a similar question a while back and it seems that everyone of us has a different protocol based on the conservativeness of our OS in addition to other extenuating circumstances, like the patient's age and weight. I also have been told by my OS that if tendon tears are clean, they generally take longer to heal initially ... when the tendon rupture takes some bone with it, the repair/healing time may be faster (bone to bone) and in some cases, stronger. In my case, I had clean tears in both knees requiring titanium tacks to reattach the tendon to the knee cap ... yet, I guess that the combination of being a relatively quick healer and my OS's insistence that I weight-bear, was a good omen (thus far).

Some of the information on quad ruptures that I read in medical journals seems to be evenly divided on when it is appropriate to start weight-bearing and early PT. My OS's orders to get me standing and weight-bearing as early as 2 days after surgery was an important event in getting me to start PT now 4 weeks past surgery.

Best of luck to you and keep posting so we can share experiences.

Tom in NY
post #833 of 10804
Falcon: It takes a good 8 to 12 weeks for the tendon to heal back to the patella, and think you said you also fractured your patella which probably takes a good 8 weeks to heal also like any bone fracture.

I did a complete clean tear of the quad tendon off the patella and was repaired quad tendon to patella. Doc drilled 4 holes in the patella and sutured the quad tendon back to the patella, he stated that he tested the repair too 60 degrees before closing me up and said I could work it passively 10 degrees a day up too 60 degrees right away. I also stayed on crutches for a good 6 weeks and a cane for a week or so after that. Of course all my early ROM motion work did not help me to much since I needed a second surgery to clean out scar tissues adhesion's when my ROM got stuck at 100 degrees.

I started PT around week 4 and went there for a couple of week before dumping them and doing my own PT. My insurance sucks and was costing too much plus it was easier for me to do PT at the gym in the morning during on my own schedule.

Sounds like you did quite a number on your knee. Hang in there and let it heal up, PT and rehab will come soon enough. Don't want to go to crazy early on and ruin your OS's work and have complications or another surgery.
post #834 of 10804

8 weeks post op

The more I read and then re-read these posts there is a huge variety it PT. I had casts on for 6 weeks (bilateral quads) but was weight bearing within 24 hours. I had at home PT but he showed up late, canceled, etc, (he showed-up 4xs) so I canceled all further appointments and did things on my own. Mostly I went on walks, leg lifts, and ankle pumps. I've had braces on since Jan 8th on the 22nd I saw my Dr. and she said I can open-up my braces to any degree I feel comfortable with. When I got home I opened them up to 30 degrees the next day I opened them up to 45 and today 60. I go for at least a 1 hour walk each day plus I started doing lite streaching in my hospital bed with the braces off. I ditched the walker and went to trekking poles which really help with my stride. I dont start PT until next week at a highly recommended center.
post #835 of 10804
guys how long did it take to get to 90 degree's? was it harder to get there or after you've gotten to 90 to get full range? seems like from what i've read once you get to 90 it seems like thing get a whole lot better. was disappointed monday at therapy was hoping for 80 degree's since i was 70 on fri. and really pushed hard a home over the weekend and only gained 2 degree's. pt said not to worry work for 80 by fri. but i'm not a patient person. lol. 2 degree's doesn't make me feel like a gained anything, but i guess every degree is one step closer. guys that are in the hinged braces were you put in those right from the start or did you start with a immoblizer as to what i am in now. would love to be in a hinged brace to start walking with a bended knee. i still have 3 weeks till i see the doc. again, of all days fri. 13th. if you were in a immobilizer how often did you take it off at home and work you leg. i'm starting to take it off more trying to work the knee more each day. I have taken it off now when sleeping at night and it feels great to sleep with out the brace on. how many times aday do you do your home therapy. currently my pt wants me doing therapy 3 times a day! I have read here where some guys iced the knee all night. do you feel that this helped you with movement or stretching of the tendon? once again thanks for any replies this is a great resource for real life answers to the common injury we all have. good luck to all with rehab and congrats to those who are heald. GOD BLESS!!!
post #836 of 10804
Thread Starter 

One year out . . .

PT protocol: my injury sounds like it was similar to In2Falling. But, my OS had me go to PT 3 days after surgery - a very painful experience! For those who ask about the pool - just get in to about chest level (where you have very little, if any, weight on the leg), and start walking slowly and carefully. I don't think that anybody on this forum who has done this would dispute that it has helped them at all levels of rehab.

I went to see my OS on the one year visit. I have been having problems getting my strength back. The OS explained that with three surgeries on the same knee, I have been having what he thinks are real issues with pain from the bone on bone contact between the patella and femur. That pain has been preventing me from really "amping" up my athletic performance and making my recovery complete. So, he injected my knee behind the patella with cortisone and has put me on prescription strength anti-inflammatories in an effort to reduce pain so that I can crank up the intensity in my workouts (read lift heavier weights). I explained to him that I don't pay much attention to the pain anyway, but he tells me that it is almost certainly what has slowed my rehab and recovery down. So, no workout tonight while the knee recovers from the injection, but tomorrow, back to the gym again.
post #837 of 10804
Originally Posted by gellertt View Post
My question is, have any of you "veterans" out there used such a machine? If so, did it work for you AND MORE IMPORTANTLY, would you recommend renting one to help with home PT?

It seems to me that this type of machine would be of tremendous value while lying in bed watching television as it helps to gently flex the knee and ultimately, strengthen the quad muscle.

Please let me know if any of you are familiar with this rehab protocol and if your OS has talked about it with you. Thanks.

Tom in NY
I don't have any first hand experience with Quad Tendon Ruptures but I might be able to help from my experience on the other side of the treatment table. I am a PT that works in out-patient orthopedics. As with anything there are always differing opinions and there is more than one correct way to do things. This is especially true in the medical field but here is my $.02:

I am not a big fan of CPMs. One of the reasons is they are a PITA to set up correctly. I can't tell you how many times I have seen a patient that comes in for their first out-patient PT visit saying "I got the CPM up to 120." Then I measure their knee flexion at 95 degrees. The CPM may be at 120 degrees, but if you are not lined up correctly or not strapped in all the way, your knee is not bending the full 120 degrees.

Another reason I don't like CPMs, many research studies have shown that there is no difference in surgical outcomes between those that use a CPM following surgery and those that don't. Most of the time you see them used following Total Knee Replacements. An OS that only does Total Knee and Total Hip Replacements told me that the only reason why he has his patients use the CPM while they are in the hospital is because it makes the patient feel like something is being done to help them.

The main reason why I don't like CPMs is because it is a passive modality. You are lying there while something is moving your knee for you. If you are just lying around watching TV there is no reason why you can't do 10 heel slides every 45-60 minutes. PT research studies have also shown that people who are actively participating in their rehab do much better than those that want to go to someone that is going to "fix their knee."

So based on the above, no I would not recommend that someone rent a CPM to help with home PT. Personally I would tell you to save the $ for next season's lift tickets. Are there exceptions? Of course. A 75 year old lady that falls, breaks her knee cap and 3 ribs is probably going to need a CPM. It is unreasonable to expect someone in that situation to be able to do her own knee ROM exercises while recovering from 3 broken ribs.

Are you in a situation that would justify having a CPM at home for a couple of weeks? Only you, your OS, and PT can make that decision. Usually the decision is based on other medical conditions and social situations. If you want a CPM for home because you think it will accelerate your healing or increase the chances of a successful recovery, then I would tell you that you can do what you want but odds are the CPM will make no difference.

I hope this has helped with your decision and please don't hesitate to ask any other questions. I will try to answer them the best I can.
post #838 of 10804
Originally Posted by steve in pa. View Post
guys how long did it take to get to 90 degree's? was it harder to get there or after you've gotten to 90 to get full range? seems like from what i've read once you get to 90 it seems like thing get a whole lot better. was disappointed monday at therapy was hoping for 80 degree's since i was 70 on fri. and really pushed hard a home over the weekend and only gained 2 degree's. pt said not to worry work for 80 by fri. but i'm not a patient person. lol. 2 degree's doesn't make me feel like a gained anything, but i guess every degree is one step closer. guys that are in the hinged braces were you put in those right from the start or did you start with a immoblizer as to what i am in now. would love to be in a hinged brace to start walking with a bended knee. i still have 3 weeks till i see the doc. again, of all days fri. 13th. if you were in a immobilizer how often did you take it off at home and work you leg. i'm starting to take it off more trying to work the knee more each day. I have taken it off now when sleeping at night and it feels great to sleep with out the brace on. how many times aday do you do your home therapy. currently my pt wants me doing therapy 3 times a day! I have read here where some guys iced the knee all night. do you feel that this helped you with movement or stretching of the tendon? once again thanks for any replies this is a great resource for real life answers to the common injury we all have. good luck to all with rehab and congrats to those who are heald. GOD BLESS!!!
Your rehab is a marathon, not a sprint. Try your best to not compare your numbers every PT treatment. Instead look at how you are doing week by week. Even compare how your knee was doing to 2 weeks ago. It is much easier to see progress that way and much less frustrating.

How quickly you get to 90 degrees really doesn't matter. All that matters is that you continue to make progress. When you start to plateau or go backwards is when you need to worry. Generally speaking once you get to 90 degrees it is all downhill from there in terms of your ROM. Why? I really don't know. I have never heard or read a definitive reason but that is what patients usually report during their rehab.

I am 99% sure that all Quad Tendon Repairs start in an immobilizer for at least some length of time. This immobilizer might be a hinge brace that it locked out at full extension. If you start to flex the knee too soon, you can tear apart the repair and end up right back in the OR. That is why it is usually a month before you go to PT. There is nothing to do except let it heal for the first 4 weeks.

When you get to unlock the brace for walking depends on the severity of your injury and is up to your OS to decide. I would guess around the 1-2 months post-op. Be sure to ask your OS when you are allowed to bend your knee while walking and if you have any ROM restrictions. Sometimes they forget to tell you or write it down. It will save your PT from making a phone call.
post #839 of 10804

4 weeks Post Op

Had my 4 week Post Op appointment today. I was hoping I would get released to start doing something. Not gonna happen. 2 more weeks in the immobilizer. No bending of the knee. Xray showed that the patella fracture has started to heal, but still some gap in part of the fracture. OS said that the tendon will heal at the same rate as the patella fracture, so he wants to wait a little longer. Plan now is:

2 more weeks in immobilizer
Following 2 weeks to take immobilizer off 3 times a day and start moving and bending my knee to increase ROM. Following that, another appointment (8 weeks post op) and start PT. He also mentinoned that I should start massaging my knee lightly to start

This was disappointing. Got to remember, I'm only 4 weeks in and this is a marathon. I must say that while taking xrays today, they had me standing without the immobilizer. Moving my leg a little here and there to get it positioned just right. Sure felt wobbly, weak. May have been as much in my head as anything. I'm not sure I could have walked without the immobilizer today if I wanted to.

I need to keep a positive attitude and not get in a hurry.

God Bless.

post #840 of 10804

Almost 6 weeks post-op

Scott (Falcon71):

We're kind of in the same boat when it comes to having to keep the immobilizer on for a while longer. My OS was of the same opinion, however, I was weight-bearing very early on after surgery, so I have been cleared to start visiting home PT to get some ROM back. Currently, I have about 38 degrees in one knee and 35 degrees in the other (I am a bilateral rupture victim). My immobilizers come off February 27th.

What I am finding out is that ICE is a quad rupture's best friend. I do not sleep with my immobilizers on anymore and have been very comfortable at night except for the fact that my bathroom needs require me to use the emergency plastic urinal bottle ... aside from that, I find that using an ice bag at night on my knees is great and actually may be helping me to stretch out a little. I have also been massaging my scars with some ointment my wife picked up from CVS (to help minimize scars post-surgery). My PT told me that it is important to work on massaging the visible scar/incision line (some use skin moisturizer, others use Vitamin E from capsules that have been punctured - although, it's kind of smelly and sticky). The scar ointment I have is applied 2-3 times a day, so you might want to try some of that. Aside from helping to get rid of some of the visible scar, it's important to massage the wound to keep the scar tissue from adhering to your tendon inside of your leg and to minimize any internal scar tissue build up which could affect your ability to maximize ROM. My PT explained it this way, "it's like when you are wearing a tee shirt underneath a button down shirt and you pin the outer shirt to the tee shirt in certain areas. What you really want is for the two shirts to remain independent of each other. Give this a try for now.

Good luck as you continue to heal and keep posting your progress here. I'll try to let you know where I am at in my own recovery, too (especially since we're pretty much on a similar timeline in recovery).

Tom in NY
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