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Quadriceps Tendon Rupture, Repair and Rehab - Page 4

post #91 of 10801
Thread Starter 
Hi Tiger Bait:

Wow. Sorry about your injury. I can't even fathom having two of these at once! Have you been in a wheelchair? I think you win the "worst injury" competition - hands down. Helps give the rest of us a little perspective on our own (relatively insignificant) injuries. Good luck, Tiger Bait, and welcome! I'm glad that this thread has helped others - it has certainly served its purpose for me - helped me to find others with the same injury and gain as much information as possible. Thanks to all who post.

Rode a stationary bike a little harder than I should have this weekend - quite a bit of pain last night and today - hope I didn't damage the repair at all.

Idaho Guy
post #92 of 10801

21 weeks!

Gents! (noone has corrected us yet on gender)

Here I am today (4/7) 21 weeks post surgery. And I can tell you, and hope give you encouragement and hope, my knee feels "different" in the last week. It is starting to feel more like a "regular" knee, although I am still aware of it 24/7. Not sure how you guys are doing, but when i sleep ( I am a "side sleeper", which was a major problem for me initially after injury) and I couldn't lay one knee on the other. I can now without any discomfort. I truly feel another corner has been passed. So keep up your regimens and keep up the attitude, I know it is tough, I fell mentally several times, but it will come!

Tiger Bait: Uff Da! ( like we say here in Minn)......my OS told me of a patient of his that had both knees but a year apart!! I cannot fathom both at once!! I think the good news is you dont have to worry about it anymore....I (we i think) worry about it happening to the other leg. I am already impressed with your attitude! Keep it up!

Sinrider: Yes, I have had similar feelings post exercise. My knee is best then and within an hour or 2 gets "stiff". But, my stiffness is less recently, I am hoping I can give all you guys a positive outlook soon.

Again, my OS said 6-12 months. Afriend of mine who had ACL said it is a year before her knee felt "normal". And my OS told me he would rather have ACL vs QTR.

IDG: once again, thanks for starting this thread, you can see it helps all of us.

I have upped my weights that I use for circuit training, getting stronger, less noticeable definition between the 2 thighs. I also am doing "laps" in the pool with 5# weights on my repaired leg. I go up and down the lanes. Our pool has has 3 lanes so I end up doing 7-8 laps. Then i "rest" walking back and forth lifting repaired knee high on each step. Repeat. And I do leg lifts in the pool!

I think we need to have a convention and compare scars!

Best to all!! Hold on Tiger Bait, you will do it!

post #93 of 10801

7 weeks

Hey - Thanks for the encouragement from all of you!

(Chihibulldog) It sounds like you're coming along great, and being a few months ahead of us, I know we can all learn from you. When were you able to start using the pool, stationary bike and weights? My OS told me 6 months for 90% recovery, and a year for 95%. I have not been in any pain, but my recovery is not as far as all of you. How much strain can I start putting on my quads?

(Idaho Guy) I have been in a wheelchair. You asked about my past injuries. I really haven't had any until a few years ago. I pulled ham strings 2 years in a row playing softball, so I gave up playing. Then, about 6 weeks before the BQTR, I felt something pull in my Achilles tendon playing basketball, so I gave up basketball. About 1 month before the BQTR, I jumped from a pickup and felt pain in one of my knees and was favoring it a little. Before that, my knees were perfect. I just thought I was getting older and was not in as good of shape. Now, with the BQTR, I'm giving up ladders! I wonder what I'll have to give up next?

I worked out hard with weights and ran 5 miles a day until I was 28. After marriage and children, I slowed down to 2 - 3 light workouts with weights and 15 minutes on the treadmill each workout, which I continued to do until this happened.

(Ankhsign) Thanks for the encouragement!

(Vermont Soldier) I've heard this is a slow, tough recovery, but you're always seeing improvement. QTR happens about 12 - 1 BQTR from everything I've read. I guess I'm the lucky one! I know it's a hard injury on all of us, but we'll all be Okay!

Thanks again!

Tiger Bait
post #94 of 10801

Watch Out for Blood Clots!

Hello all,

Until seven weeks ago, when I fell down badly and tore my left quadriceps muscle and tendon, I was a fit and healthy runner. I was fortunate to have had an immediate diagnosis of my injury and surgery the next day. My injured leg has been in an full-length brace with zero degrees range of motion ever since. I walk on crutches with half-weight on the injured leg. Every day I take a short walk (in terms of distance, not time) and am usually stopped by strangers, who, spotting my brace and crutches, tell me about their knee replacements, fractured patellas and ACL surgeries. I am deeply sympathetic toward all, but kept wondering when I would meet someone who had survived quad repair. Here you all are, finally. Nice to meet you.

Just a word of warning to all of you - watch out for blood clotting! A week ago - six weeks after surgery - I had unexpectedly strong new pain in my injured leg. This pain was followed by numbness in the foot (which was red and swollen) - also something I had not experienced since the original surgery. I went to the hospital emergency room. An ultrasound examination revealed the formation of blood clots. A dislodged blood clot can cause a pulmonary embolism, something possibly fatal. I am now on blood thinning medication and everything should be all right. If any of you experience similar symptoms of pain (not necessarily in the surgical area of the leg) and numbness, see a doctor immediately.

I look forward to learning more from all of your experiences.
post #95 of 10801

8 weeks

First off, Tiger bait, I share the sentiments of others. I hear the same thing as far as the timeline, from both the OS and another person I ran into that had the same thing happen to him 3 years ago (he's kindly offered me his exercise bike during rehab). It took a year before he felt like the knee was back to normal. Doc says the same thing.

This week, I feel like I hit a brick wall in terms of ROM. Up to the past week, I've been moving along smoothly. But I've been stuck at 55 degrees. A full 60 degrees eludes me without assistance from the PT and a great deal of pain (when she bends it). But, the PT thinks the Dr will okay setting the brace at 90 degrees at the next visit this coming Friday. 90 degrees seems like a REAL stretch . . . no pun intended.

On the plus side, I can amble around with only one crutch now, putting a good bit of weight on the knee. I can finally get things on my own now and carry them by myself. My wife, who has been awesome during this period, is happy, too, feeling some freedom to leave me home alone for longer periods of time.

The thing I'm looking forward to is getting into the Kayak. I'll bet getting out won't be a breeze, though.

Welcome Philly Buster. Good thing you caught that clot. My wife had to give me a blood thinner via needle everyday up until week 6. That was standard procedure for my OS, I understand.

Did anyone else have a really swollen ankle? Since week 4, when the cast came off, I've been doing these 'ankle pump' exercises that are supposed to get the swelling down. My foot finally looks normal, but the ankle is still slightly swollen.

Thanks, again, to everyone sharing their stories.

post #96 of 10801

7 Weeks and Just Starting PT

Thanks for the welcome, brewman. My blood test today showed that the coumedin (blood thinner) has now caused the anti-coagulation of my blood to hit the target level. This allows me to start physical therapy on Thursday, exactly seven weeks from my date of surgery. My leg has been immobilized in a full-length brace, 24/7, all seven weeks. No knee movement whatsoever.

A lot of the guys in this forum report starting PT much sooner after their surgery. I guess every doctor determines when PT starts on a case-by-case basis. No two patients and injuries are identical, I guess.

Have any of you started PT this late after surgery? If so, do you mind telling me about your initial PT session(s)?

Thanks for you helpful advice,

post #97 of 10801



Yesterday, for the first time, I did not "feel" my knee when driving! I have been aware of it 24/7, it is always "there". And in bed, I could lay on my side and cross my knees over each other and not feel that "awareness". I feel I am beginning to see a change. So Gents, hang in there, it will come!

I am beginning to see some definition in the thigh, and for the first time, could see some development of the interior quad muscle by the patella. My OS told me this muscle is the first to atrophy and turns to "mush" (his word) quickly. I have done a little jogging on the treadmill and my hitch is lessening. My rehab protocol called for "light running" at week 16 (I am approaching 22 wks Mon) but could not do that.

VS- I beleive you said you had pain after a more strenous workout. Where was the pain? I had pain on the inside of patella, which th OS said was due to the strength difference between the 2 quad muscles, the outside being stronger and pulling the knee cap out so it doesnt track correctly. I cut back on the exercises that hurt it and did Aleve.

Tigerbait- we have a "wellness center" associated with our retirement home that has a warm pool and a therapy pool as well as circuit training equipment. After my post surgery rehab with the hospital (about 6 weeks) and at 125 ROM, I went to rehab at wellness center so I could use the therapy pool (Dr. approved) which has a treadmill in it. That began week 14. I went on my own at week 17 and my PT suggested finishing a workout with 10 min in the pool, walking, leg lifts, etc. My OS told me I could do leg exercises with body weight only. I am now doing 20# leg extensions, 30 leg curls, and about 40 # on leg presses. No pain, just fatigue after. I began stationary bike in rehab about week 6 which helped with ROM. 10 minutes to start. Take it easy, and slowly increased.

Brewman- when I was beginning ROM (heel slides) I came back the first time to rehab and was at 55 deg. PT said, great, but dont push it. So it was slow to get beyond 40-60 deg. Once i hit 90 deg (week 9) it progressed rapidly to 120 deg. How do you get out of a kayak? Roll it! I used my left arm to get out of the car, still do a little.

My surgery was on a Mon pm. That Thursday i woke to heavily swollen calf, ankle and foot. I was told to elevate, well above my head. The swelling disappeared as quickly it came, in about 10 days.

PhillyBuster- Welcome! I am somewhat surprised you were totally immobilized for 7 weeks, but as we read, everyone is different in terms of injury and OS recommendations. For me, I was immobilized about 4.5 weeks and then got my new adjustable brace. I began rehab 3 wks post.

I am surprised that most of you have crutches, recall I was told i would be on crutches for weeks but was sent home from surgery without any, so i was walking (if you call it that!) with immobilized right from the start. And i never heard anything about clots or blood thinners so I am glad i didnt have any issues i was aware of.

So guys, there is light at the end of the tunnel. I was out this weekend pruning fruit trees and hauling brush. It is still difficult to go down hills, but I managed and just experienced fatigue, no pain.

Hang in there Guys! It does eventually improve, sometimes just at a pace that we are not used to!

post #98 of 10801

Dr No Says............


9 weeks post op and my OS said no to PT again. I arrived in brace, without crutches and he gave me grief. He saw that i was weight bearing, in and out of brace, more grief. I asked for PT, more grief, I am too aggressive. He stated my wound site looks great, manipulation of the surgical site was great. He told me that I may not put any pressure on the surgery site at all. He opened my brace to 45 degrees. Hmmm.... So i will continue to work in the pool, passive ROM on the stationary bike, leg lifts without weight X100 reps and the upper body work. He was very surprised at my progress to 120 degrees flexion without pain. l will continue without over doing it.

Welcome to the new QTRs! PBuster, good info on clotting. Just when i thought it was safe to go outside! My OS provided me a script for 81mg of aspirin from day one. Not sure if it helped but it was for that purpose. Tiger, I must say that I had a real gut reaction when i read your post the first time. I have shared your experience with a few friends. Everyone sends you positive thoughts and energy to get past this.

The weather in Vermont is getting nice. Time for some serious walking! I never thought I would say that. I must say I am looking forward to it. The best of days to you all.VS
post #99 of 10801

New QTR Patient/Victim

Hey gentlemen! Here goes>>>>

March 8, 2008 Hollywood, CA
During a concert while slightly inebriated I slipped on a beer drenched staircase, fell to the landing (some three or four steps) and went down hard on my left knee. I'd like to tell you I was injured during Olympic Hurdling Trials, but it just wasn't that sexy! Drove back to San Diego next morning and went to UCSD Medical ER. Physician diagnosed patellar ligament rupture. WRONG!

During Ortho visit on Mar 10, O.S. diagnosed QTR IN ABOUT TEN SECONDS, confirmed moments later through MRI. Scheduled surgery Mar 13. After some personal trauma, (first surgery), all went well. I have to say that I did a little too much research online and had a bit too much information,(like color photos of surgery). In retrospect, I would have preferred complete ignorance. OS does about 4-5 of these surgeries per year. He was pretty confident. No patellar drilling required, but the tear was complete.

Drugged to the gills for two days. Percocet! Itching, constipation, acid-indigestion etc. These was two of the most miserable days of my life! I know many of you make it seem like a walk in park, but I have to confess, for me it was an epic b.tch. I'd rather crawl naked across the North Pole in January than go through this again! Got a call from the OS day after surgery, that was nice. And now I have clots to worry about? Sheesh!

Day 12: OS office visit, staples removed, set brace to 30 degrees ROM. OS sent over a flexion machine (danniflex 400) to preform ROM at 30 degrees for six hours per day. This machine is fabulous.

Day 19, OS office visit, increase to 50 degrees ROM. Also increase machine to 50 degrees flexion. I haven't heard anyone mention this machine. What is with that? It is clear that my OS is aggressive with rehab and after some paranoia about tearing the repair I am glad he favors moving things along.

My biggest trouble is with laying around so much and my sex life has not improved much post surgery. Wife is tired of being asked for things and is considering an affair with the pool dude. Kidding. I lift weights in bed and yesterday strained my back (upper) doing so. I have a pool at the house and I am curious when all of you pool users first went into the pool without a brace? I am now at Day 29 and I feel like I am ready.

OS warns about "peak load to failure" (his term) resulting from a fall or something stupid. I only remove the brace when in a chair in the shower. I'd love to not sleeping in it. I find it difficult to get a good night sleep and its tough being on your back for so many hours at a time each night. I take aspirin at night.

When can I expect to be free of the brace entirely? My brace is a velcro foam deal that is quite cumbersome. Have any of you found a better light weight brace? I'd like to have a more comfortable brace if I am going to be using it for several more weeks.

IN all, I think I am doing remarkably well. I can drive and walk OK with a cane. I haven't used crutches since week two. All tips are useful, especially when it comes with ideas to improve sleep.

I also feel for some of you who have had to endure the ice and snow while going through this. I cannot imagine having the confidence to walk on ice with this injury. I am thankful for San Diego weather.

Best to all and thanks for all the great info on this injury.
post #100 of 10801
Welcome phillybuster and as others have said, we wish you the best of luck in a speedy and painfree recovery. I wish the same for us all. Tiger bait I am still in awe that you can do this times two. One is more than I'd wish on anyone. So hang in there.

I have been puching like crazy this week to stretch and get back in shape. I am 7 weeks post surgery now. (why do I feel I shouls be in AA when I say this - no disrespect to those in AA) and have progressed well in the last week. Since seeing the surgeon last week I have progressed from 70 to 105% flex. I still have a lot of swelling and I tell you these tylenol 3s just don't cut it most nights. PT said to wait another week on the bike and see if some of the swelling will go down. She said that my "knee is not happy right now". It sure as heck isn't happy I can tell you.

It's encouragng to see everyone progressing and hope all continues for each of you.
post #101 of 10801

Starting PT

Thanks for the welcome, ankhsign. Seems like you and me had surgery about the same time. Mine was on Feb 21. My first PT session is scheduled for this week Thursday. When did you start PT? What was your first session like? Would like to hear how the lengthy road toward recovery starts. My physical therapist forecasts 6 months before I walk without a limp, 12 months before I can lift my leg horizontally onto an ottoman, 24 months before I can run again. This seems like a long time. How does it compare with what your doctors or physical therapists predicted for you?

Thanks for sharing your experiences.

post #102 of 10801

7 1/2 weeks

Hey - One thing I've learned about this injury from reading this forum is that it's not caused by being a couch potato your whole life. Everyone seems to have been so active and sports minded.

Philly Buster: I met a guy on the internet who had BQTR 2 years ago, and 12 days after his surgery, he started feeling strong new pains in his legs and went to the ER. He suffered a pulmonary embolism. A multiple emboli passed through his heart and into his lungs. He was put in ICU where he got great care, and thinks that saved his life. He was not on blood thinner. I was put on blood thinner (Lovenox) at the hospital until 3 1/2 weeks. Then I was told to start taking an aspirin a day, which I am still doing.

Brewman: It sounds like our ROM is about the same. My PT had them to 57 degrees yesterday. I think it is because both our OS were very conservative and because I was in full length straight braces for over 6 weeks. I bought what they call a loop and now I can move and really work my legs a lot by myself. Getting the OK to become more aggressive, I've made a lot of progress this week, especially with walking, even though I have to use a walker. I think the ones who walk and start PT sooner are better off, but anyway...so far, so good!

Chihibulldog: Thanks for your rehab information. I'm still not quite ready physically for some of this, but mentally I am. It won't be much longer. I'm glad to hear you're starting to get some definition in your quads. Mine have really shrunk, and my thighs have really changed.

Ankhisign: Thanks for the encouragement! This injury is new to all of us, whether it's one leg or two. We'll do what we have to do because I think we all have the drive to get back, or even better than we were. This is a great forum!

Thanks again -

Tiger bait
post #103 of 10801
5 weeks...

Bluebirds and meadowlarks have returned, newborn calves are plopping to and fro, and I'm hobbling a half mile pasture loop, twice a day w/ velcro brace and crutches! Life is good! Can empathize w/ those calves and their first attempts at walking.

Visited w/ OS last week. Showed him my 30 degree and he said, 'Let's get on w/ some more rehab!' Seems we all have docs who approach this injury in a variety of ways. Mine? Very proactive and not to fond of PT work. A real advocate of self-rehab. Mentioned that rehab intensity has much to do w/ how much degeneration the tendon had prior to QTR.

Mobile w/ brace and no crutches around house, full weight bearing. Use crutches on pasture trail due to uneven terrain. Loads of stretching, massage, ice. Sleeping w/out the brace is a new lease on life!

Working on getting to 90 by May 1 w/ quad isometric flexes thrown in the mix. Wants me to show him a straight leg lift on May 1 and jumping on the exercise bike by May 2. I like this guy!

Keep up the varied and diverse rehabs!

The best to all of you!

post #104 of 10801
Phillybuster I injured my leg on February 18th and had surgery on the 19th. I just started my first physio on Monday April 7th. First appt was assessment, lots of stretching to see what I could do, untrasound, ice and she gave me lots of different stretches to do. She told me to do stretches 3 times a day (there are 7 different stretches) and to also ice 3 times a day. She also suggested I see the Dr re inflamation as knee is still quite swollen. I still walk with a slight limp, more so in the morning until leg gets warmed up. I can tell you that as the PT warned me the stretches hurt like he.. but she insists that I have to do them. Surgeon told me the same thing. I can do about 3-5 straight leg lifts depending on the day. Of course everything I do to it hurts. But I can do it. I can walk now for about 30 minutes although the leg does not like slopes especially downhill slopes. I see the PT for the 2nd time tomorrow and she said she'd get me on the bike. She'd like me on the bike to start building muscle back. I sure lost a lot of muscle in 6 weeks. The mornings and late evenings are the worst for me. I do one set of stretching in the a.m. before work, one set duriing the say at work, walk as much as I can during the day, and do a final set of stretches in the evening. The worst one for pain is sitting in my office chair on the edge of my seat and my leg flexed at about 80 degrees. Then I slowly sliding the chair forward (its on wheels) until my foot is about half way under the chair with my foot flat on the floor. Whoever invented this stretch was a sadistic person as he really hurts. But I must confess it does help stretch and has increased the range of motion. PT says do it till it hurts and then do one more set. Hope this helps. I'll let you know how the second PT visit goes. Good luck and let me know what your PT has in store for you.

I have 6 months until my vacation, so I darn well better be able to do lots of walking by then. It is my motivation to get better as soon as I can.
post #105 of 10801

Thanks, Guys

Your stories encouragement mean a lot to me. You are the only guys I've met who have been through this. Those of you who are farther along in recovery - thanks for pointing out the light at the end of the tunnel.

Tiger Bait - You are right that a couch potato would probably never suffer a quad tear. My OS told me that most of the quad repairs he has done have been on "weekend warriors", i.e., guys 40-50 yrs old who have always been athletic but whose tendons have lost the suppleness that they had when younger. If I hadn't been strong enough to run so fast, I never would have fallen so badly and suffered this relatively rare injury.

ankhsign - Thanks for sharing your initial PT experiences. Sounds like you have made good progress in just two days. The office chair exercise sounds like torture, but you have already achieved 80 degrees ROM. Wow! When I met my PT for our first discussion last week, she told me that she is only going to bend my knee a 2 or 3 degrees per session. Our first session will be this afternoon. I'll let you know how it goes!


post #106 of 10801
Thread Starter 

10 Weeks Out

Hi Guys:
Welcome PhillyBuster - although welcoming someone into this club is not something I would wish on somebody, it is nice to have company in our misery.

This has been a great thread. Like the rest of you, when I was injured, I was desparate for information - there is not much out there - the docs don't know much, the PTs don't know much, none of our friends have had this injury, etc. I'll bet that collectively, we know as much about treatment and rehabilitation of this injury as our respective docs and PTs. I've gained as much information out of this thread as my PT has given me, and I've gained MORE than my OS has given me - that is not a knock on either of them - they are both great - but are limited by the number of times they have seen this injury.

PhillyBuster - about PT: I started PT on Feb 4, three days after surgery. They had me bending my knee to 30* at first, massaging the leg, doing isometrics, etc. I've progressed to the point where I am doing "wall sit" knee bends, straignt leg lifts, "short arc" leg extensions, balance work on the one leg. I am cycling between 20 and 45 minutes a day on a stationary bike, and am walking 1500-1800 yards in a pool three times a week - along with all other exercises at home.

I was very optimistic after the last week I had until I went to PT this morning and she brought me back down to earth. I had thought that I would be able to get out of the brace and onto a bike for real after the Doc saw me next week. (I know SinRider is on a bike now, but he is a freak of nature ). She had me do some bosu ball work and some theraband work this morning - the theraband was literally excruciating. Afterwards, she said she didn't see any way that the doc would let me out of a brace, because the theraband work was similar to stairs, and that the bike was simply too chancey (lots of big, steep hills here in Boise - that I can't resist riding up when I'm on a bike). Well, so it is - I'll just keep after it - we all know there are setbacks emotionally with this injury, we just have to pull through it.

You guys all help with that aspect of it - without this forum, I'd be going crazy - thanks to all of you for contributing.

One other thing: my PT told me that she wonders if my propensity to be balanced on the outside of my foot while walking contributed to this injury - she is having me do a lot of inside foot work on the bosu ball as a result. Also, she is going to have me jump into a year-round weight training program instead of just the "pre-ski season" and "pre-cycling season" programs I typically do each year.

There was an inch of snow in town here yesterday morning, but I am headed to a track meet for my son this afternoon. Supposed to hit 77 on Sunday - spring in the high desert!

Best of luck to all of you guys (are there any of the fairer gender who get this injury?).

Idaho Guy
post #107 of 10801
Hey - I walked into my bathroom with my walker and straight braces yesterday and used my bathtub and commode! My wheelchair could not fit through the door and before this week I was no weight bearing on both legs, so this is a real accomplishment for me!

Bitterrooter: I'm glad you mentioned that rehab intensity is related to how much degeneration the tendon had prior to my BQTR. My OS said when he did the surgery, I had signs of tendonosis and that my tendons looked older and my bones looked younger than my age. He said overuse could be one cause of this. Has anyone heard how to slow it down or stop degeneration?

Some of you might have seen this already, but to view the tendon repair surgery video online go to http:/www.arthroscopy.com/quadsurg.htm. It is kind of graphic to watch. You can see that the leg is moved through a range of motion just after the wound is closed.

Tiger bait
post #108 of 10801

4 weeks out 50 years old

Qtr full rupture- ROM 60 degrees, entered pool at home today for first time! A little scary but with San Diego sunny day, could not resist. I read these posts and wonder if my OS is the least conservative of the bunch! I was at 30 degrees from day one, and up to 50 degrees by week three. Some of you I see no movement for weeks! What gives with the descrepencies? Is it not true that this early movement promotes healing?

My OS talks about risk in terms of "peak load to failure", in other words caveat emptor! Work it but don't break it! I asked the OS to diagram his handiwork with the tendon, to alleviate my worry about it failing; I have to say that is some serious seamtress work!

The OS gave me a flexion device (danniflex 400). You lay you leg in this thing and it flexes you leg to the desired degree (six hours per day). I got this at week two and it is a huge help. I recommend it to anyone just out of surgery.

My question to you veterans out there is when can I expect to walk without brace (safely), and when can I expect to ride a bike? Also, when am I ba k to normal without thinking about my knee?

Thanks for the great posts! Although I could really complain about the two weeks post surgery, it already seems like a long time ago. I am feeling better every day. The best part of it is the realization that life can be fragile, and losing the ability to walk offers a new vision of what matters in life.
post #109 of 10801


My post above was done on a iPhone, sorry about typos!
post #110 of 10801
SD, As Tiger points out, during surgery, your OS tests for about 45 degrees flexion before they close. You ask all of the questions that we have all been asking during the initial shock of this injury. This thing (bi.ch) is a roller coaster for sure, gains, feeling good, getting smacked back to reality but all the time knowing that you dont want to push too hard as blowing the surgical site is a real possibility. You must heal the tendon reattachment! Movement is good but this is key. A guy in New Hampshire did this last winter (google "crazyguyonabike"). There is a hotlink to his site on page one or 2 of this thread. Bulldog has great insight on longer term repair and mileposts.

Bottom Line as my OS (DR NO, 9 weeks and still no PT) says, dont push too hard, it will get better.

I am looking forward to following the 6 yo through the mud filled woods next week during school break. He has a new TREK 5 speed with hand brakes. I will walk in a brace. Man I love the spring!
post #111 of 10801
Question re swelling. I am 7.5 weeks post surgery and still have a lot of swelling. I'm wondering how much swelling everyone else is experiencing. I am pleased with my progress todate. However the PT really put me through my paces this week, especially today and my knee is not happy. Last Tuesday I had 70% flex, this Monday I was up to 105 and today I topped 117. But man today the knee hurts like....... Well, you all know how bad the pain can be. So the PT is sending me back to the Dr to investigate the swelling and pain below the knee cap. She has me cutting way back on exercises and stretches until I get the swelling checked out. So just thought I'd ask how everyone else is doing and is the knee being twice the size of normal typical for 7.5 weeks post surgery.

And kudos to tiger bait. Sounds like you're making some great progress. Keep it up and well done. I hope this continues for you, and for all of us.

Thanks everyone else for your support and words of wisdom. This is the one place I can go where people understand what I (we) are going through. Hang in there everyone, we'll be back to normal in no time.
post #112 of 10801

Post-Surgery Swelling and Beginning PT

I am with ankhsign in offering big kudos to Tiger Bait!

ankhsign - regarding your question about swelling: the foot of my injured leg has been rosy red and swollen, enough to draw strangers' attention to it, for probably the last three or four weeks. I am seven weeks out from surgery today. So my foot actually looked better for the two or three weeks after surgery than it looks now. The swelling in my foot is, however, due in some (large) part to the blood clotting in the calf and thigh. (A note on blood clotting: My OS never prescribed Lovenox or even aspirin to help thin my blood post-surgery. He said that he was only concerned with clotting in the first few days after surgery. The blood clotting that occurred in week six was almost certainly due to the prolonged immobility of my leg - I hadn't yet started PT. Its symptoms were a strange new pain and numbness. For those of you whose doctors have not raised the issue of potential blood clotting - take the initiative and raise it with you doctor. This is a serious, potentially fatal issue.)

I started PT today, seven weeks out from surgery. I had a long chat with my therapist last week before starting. She was knowledgeable about my injury, has worked with others before and answered all my questions to my satisfaction. She warned me that there is a long road ahead - probably a year until I can lift my leg horizontal to the floor. I wasn't expecting such a lengthy recovery and felt down - but then I tried to put it all in perspective: I can expect a nearly full recovery to my previous levels of activity (regular distance runner) in a minimum two or years. Better than never being able to run again! (Though I'm starting to think about giving up running after recovery and taking up swimming instead....) In PT today, the therapist had me lie on my stomach and she helped me flex my injured leg to 40 degrees. She said most of her previous quad tear patients flexed 60-80 degrees on at their first PT session, but they also started PT around week 5 instead of week 7. A healthy uninjured leg, she said, can flex 140 degrees.

My gratitude to all of you for sharing your experiences and support!

post #113 of 10801
Hey VT soldier, I checked that site. This guy is like the final scene of Terminator! Bad luck all around. He doesnt say whether he was in a brace during re-injury? Also, I have read that anchors are no longer recommended for repair. His surgeon used anchors.

Although I am now at 60 degrees rom four weeks out, this is per OS directive. He never wanted to to keep weight off the leg either. Even straight out of surgery, he recommended partial weight. I guess I am confused by the varying opinions of surgeons. Although my tear was complete, the patella was fine, meaning no drilling. I wonder if that is the difference?
He does say, DO NOT take off the brace. And do not try to evevate the leg! Flexion, but no extension what so ever!

Maybe my OS is crazy, but he graduated Geo. Washington University and is pretty young;considered a top OS here in San Diego. I am learning more each day, but let's face it; we all want our legs back!

My obsession here is all about the balance between pushing it to an appropriate limit without risking re-injury. Any thoughts on weather my progress seems rushed? Like the pool @ four weeks out? The progress from week two to week four seems amazing. I have a hunch this danniflex flexion device at six hours per day is huge. Has anyone else brought this bad-boy home?

I am writing this from an iPhone while in bed on the machine watching the TV. Apologies for any typos!
post #114 of 10801
Hi to Fellow Travelers in Rehab!

Some recurring themes: one is the difference in rehab protocols and at time post surgery; we all seem to have differing rates. My best guess is the difference in the injuries and resulting surgeries, and perhaps experience of the OS.

What I have been wondering as I hear these differences is how many of you had tendon to tendon repair as opposed to having to have the patella drilled and the tendon reinserted?

For me, I was lucky (one bright spot in this nightmare!), there was sufficient tendon still attached to the patella with sufficient ciruculation that tendon to tendon sutures made the repair. I suspect that for some of you with long immobilizations. For me, I received a flexible brace 3 weeks post (December, early Christmas present!!) but it still did not give me much flexion, it was too stiff for my atrophied leg to overcome.

The other thing is the ups and downs of rehab. It continues! Keep the attitude and adjust regimens and/or pain control and you WILL improve!

Another item that has me perplexed is the concern for clots and use of blood thinners. My OS never mentioned clots nor prescribed thinners. Scares me now!

IdahoGuy: I found the use of Therabands very helpful, looking back. My PT had me increasing the resistance fairly quickly. One exercise that was particularily helpful was to attach the band to a dresser (or other immovable object) and to my ankle and move my leg in all positions, 20 reps each, forward, left and right, and back. So I moved in a circle to do these. Another was to attach to my both ankles and do "leg lifts" with the injured. I also used it to increase ROM. I laid on my stomach and tried to bring the injured leg to my butt, impossible at first to go far. Every week got better. As I progressed, I used the band to assist. And I think you are the first to mention balance. As I progressed, maybe 7 weeks out, my PT had me stand on my repaired leg and try to maintain balance as I slowly moved my head left/right...tough at first! Then try to close your eyes and move the head. Surprising how balance was affected.

TigerBait: congrats on improvements! I do not recall my OS discussing tendon degeneration. Interesting. Also, my OS report on my surgery mentioned after complete, while still under, they did 90 ROM to test result. It hurt to read that later!

SDAmigo: welcome! but as others point out, it is not something we would want you to have to join in on! Walking without brace: I kept my flex brace on to 10 weeks. At that point, my OS told me to ditch it but wear it outside (here in MN we have the ice and snow, and there was concern for slipping, tripping, injuring the repair). It was probably week 12 before I walked outside without it, but then only for support due to inclimant weather. As I mentioned earlier, I think and feel my knee 24/7. It was great last Monday (21 weeks) when in the car and in bed that nite that I realized I didnt "feel" it!! Great feeling. I dropped the Aleve the next day and now, 4 days later, took an Aleve as I have had more issues post-exercise; primarily stiffness.

VS & IDG: certainly there are the ups and downs. Knowing that helps some, improvement will come. Also, we don't want to tear the repair. My OS told me when a saleman showed him these sutures and said you can't break them (and they are fabric of some sort, and will be in my knee forever), he tried and ended up cutting his hands trying (he is a fit guy, bikes, runs etc). He told me if there is a failure of the repair, it will be because the tendon rips thru the sutures!! OUCH!! VS, although it isn't funny to you, I do get a kick out of your calling OS "Dr. No"!

Anksign: about swelling. I had serious leg/ankle swelling at my first PA visit 2 weeks post. He asked what I was doing and I said elevating. He said show me. After I showed him, he took my immobilized leg and brought it vertical as I laid on the table (scared the H out of me!) and said that is elevation. I probably lost that swelling 3-4 weeks post. But knee swelling persisted for a long time, and I still have some, although no longer is it 2x the good knee, just a noticeable difference. I had kneecap pain on the inside which OS said was due to differences in various quad strengths as mentioned earlier. A couple of times I had pain on the foot side of patella but Aleve helped with that and seemed to be associated with too many "step-flexes".

My PT told me 135 flex was normal. I went to a 2nd PT after I exhausted the hospital PT. He told me ROM varies from person to person, and some may (healthy folks) only get 130, some even less.

I will be 6 mo post on May 12. I gained the most ROM as I progressed past 90. When I got to 102, my PT said don't expect big jumps anymore, just incremental improvements. But I came back at 112 and 120 the next time (9.5wks). Obviously as we get closer to "normal', it slows.

It amazes me how many have joined your thread IDG! And I am sure each of you has read that this affects males much more than females for some reason. I still take solace in the fact that the NFL offensive lineman was back in training camp 10-11 months post injury! Sure, he had more PT help and is younger, but it gives me hope!

Best to All!! Keep up the work, ask questions of your HC providers and keep up your attitudes as best as possible!

post #115 of 10801

Greetings from the land of recovery!

Ahoyotoyo gents -

9 weeks ago today, right about this same time, my wife was driving me home from the hospital. I have only a vague recollection of it, as I was doped up but still in excruciating pain. And trying my damnedest not to puke (I failed).

And yet I’ve just now come back from my fifth road ride in a week, all 16 or so miles except for a sweet sunny 22-miler on Sunday. I really feel my power coming back – I’ve been grinding up some long hills, both standing and sitting. This last ride I averaged over 18 mph, even with lots of wind and hills and stop signs. Hardly stellar, but for now I’ll take it. And all of this has caused me no pain at all.

So what’s the secret? Well, in the first weeks post-surgery, I utterly ignored my doc’s orders.

When I did the other knee (8 years ago, not 7 as I had previously reported), I listened to the docs and let em keep my leg locked straight, crutches only, for 7 weeks after surgery. No PT or exercise of any kind. And when I was finally allowed to hinge the brace (very slightly) and walk without crutches, I felt utterly weak and crippled. My entire leg was emaciated and yet bloated at the same time, painfully filled with edema, fluid accumulated from so long a period of inactivity. I wouldn't have dreamed of trying to get around without the brace. As I mentioned in earlier posts, just learning to walk right took months.

So, despite the same rules this time around, the crutches got ditched almost immediately. The day after I came home, I tried walking in the locked-straight brace and found I could do it easily, with absolutely no pain at all. Since our house is littered with small children, dogs, cats, and toys, keeping crutches out of the mix was obviously a huge improvement. No-brainer there.

The week after surgery, when my staples came out, the doc said I could take the brace off to take a shower. The minute I got home, I did so (you all remember that first-week crud buildup). On the way into the shower, I took a few steps sans brace. Shaky, scary, and weird, but doable nonetheless. So from that point on, I wore the brace less and less – first around the house, then at work, and then out for walks on the road. You newbies (welcome! sorry you had to be here) can scan backward for my previous posts if you’re interested in the gradual escape from the brace.

I did no formal PT (those of you driving somewhere to do that know it takes a good chunk out of your day). But at home, I gradually increased my ROM by using my good leg to lift the no-so-good one to horizontal, and then letting the lower leg droop slowly til it wanted to stop. Over and over and over again, gaining a little more every day. I did gradually deeper one-legged squats, hands always ready to save me. And once I could, I did endless leg-extensions, at my desk, under the table at meetings, at dinner, on the couch watching TV.

The point is, this time I focused primarily on getting my basic functionality back as quickly as possible. We’re not all looking to get back to bike-racing or skiing or playing football again two months after surgery. But fercryinoutloud, crutches and braces are extreme impediments to our normal daily activities. I have two pre-school children and my wife works evenings – somebody (me) has to feed and dress and bathe and change diapers. Stumbling around for weeks locked straight was simply not an option. I’m pretty sure most of you have equivalent obligations.

Given the wide variety of rehab schedules dictated by the various orthoguys indirectly associated with this thread, it’s obvious there’s a need for them to get together and revisit the actual requirements of this process. There is absolutely no reason for a guy to suffer locked straight for 7 weeks or more with no PT just because it’s always been the protocol. Several of the docs have prescribed a far more aggressive schedule – it seems that should be at least an option offered to any patient looking to restore at least a basic quality of life.

Now maybe I’ve been a reckless idiot, risking permanent damage by taking my dog for mile-long walks every morning, against medical advice. But at this point in my recovery, the results seem to show I’ve been doing the right thing. It’s rare these days that the injury even crosses my mind – my knee reminds me when going down steep stairs, or when I forget and start to kneel to change a diaper on the rug. But otherwise, it’s like it never even happened.

Of course there’s the possibility that I’m an uber-healing freak of nature. But I sincerely doubt it – last time around, 8 years ago, I did it the doctors’ way, and it sucked. I suffered all the same experiences you guys are having now. And yes, s you know, eventually I got full function back. But I feel like I missed out on almost a year of good times I could have had.

So having done it their way before, I thought I’d try something different. I’m 51 years old, I don’t have a lot of years left to play at the intensity to which I’ve grown accustomed, and my kids won’t be babies for much longer. So I pushed the schedule, and look what it’s gotten me - I’m riding my bike again, hard and fast, only 9 weeks after surgery. No pain, no wobbles, just plain fun.

As to stats – both of my injuries were complete tears all the way across the assorted quad muscles. Both surgeries involved drilling holes in the patella and “baseball-stitching” the tendons into strands which were then pulled down through the holes and knotted together in front of the patella. I couldn’t guess the angle any more, but I can actively flex my repaired leg to where my heel is about a foot from my butt. By comparison, my other leg only goes about six inches farther. Since the first week, I’ve been taking nothing for pain or inflamation - no ice, no ibuprofen, nothing. And I haven’t needed it - nothing I’ve done to this point has caused me pain. All my various flexes and exercises have gone just to the very edge without crossing the line. I guess that’s the advantage of doing your own PT – you have complete control.

VT Soldier - very sorry to hear your OS is so ultra-conservative, stomping on your quality of life. Looking forward to comparing scars and chatting PT. When you say "1st house on Jericho side of Crossover", does that mean it's on your right when heading away from Guard base? What days and times should I look for you?
post #116 of 10801

One Week After Surgery

Thanks for the information on the forum. My rupture timeline is as follows:

March 6: Injury occurs playing soccer. Seemingly harmless play going for the tackle, but I heard a tearing sound before I fell to the floor.
March 7: Visit medi-centre; sent for x-rays. X-ray report will be available in 2-3 business days.
March 19: Follow-up appointment with family doctor. He refers me for an MRI.
March 24: Appointment at private MRI clinic.
March 26: Follow up appointment with family doctor to read the MRI report.
April 1: Consultation with orthopedic surgeon who recognizes the severity and urgency, and puts me in the on-call line for surgery.
April 2: Surgery proceeds in the morning. The orthopedic surgeon is optimistic that surgery went well and the long term prognosis will be good.
April 3: Discharged from the hospital with prescription for Gabapentin (3 times a day for two days for nerve pain), Celebrex (once a day for seven days, anti-inflammatory), and tylenol 3 (as needed). The nurse also gives me 18 percocet pills as a free take-away. I am wearing a zimmer splint and am allowed to bear weight on the leg.
April 11: The pain comes and goes but at least I am able to move around the house reasonably well. My next appointment with the OS is April 21.
post #117 of 10801
Thanks Chihibulldog and Phillybuster for your notes re swelling. Maybe I have to elevate it even more than I have been. I will try that. I suspect I also pushed too hard too fast. Although I am very pleased that 7.5 weeks post surgery that I am now at 117.5 flex, today I am paying for it. PT says that I am really stretching that tendon and scar tissue and this is "good pain". Not from my standpoint it isn't.

Hi Duncan. Vancouver here. Hope things go well for you and you're up and running around in time for stampede.
post #118 of 10801

war dogs

geezers, look at the member names. What is this? Sounds like the ortho version of the local VFW pancake feed!
post #119 of 10801

More on Swelling

ankhsign - I was at PT today and asked about swelling. Knee of my injured leg is maybe 2X size of knee on my good leg. Therapist told me that the knee of injured leg will stay big for a "long time". No just knee, but my entire injured leg is swollen as well, due to recent blood clotting. Therapist told me that this blood clotting-related swelling in the leg should go away soon - even though the swelling in the knee will remain. She said, "Your leg is actually much skinnier than it looks. The swellling just makes it appear normal-sized. As soon as that swelling goes away, you will have a stick leg."

Duncan - It looks like you survived three weeks or more with an untreated quad tear. How did you get by during that time? My leg was flopping like that of a marionette with its strings cut from the moment of my injury. I was admitted directly to the hospital and had surgery the next day (Feb 21).

IDGuy - Thanks for sharing your experience in PT. Your first-day experience matches mine.

Tiger Bait: How are you doing?

Wishing you all a restful weekend,

post #120 of 10801

8 Weeks Today!

Hey - What's up? Yesterday, I worked a lot on my knees for ROM and today I plan to try walking more. I'm still in straight braces and the doctor said another month, but I'm going to push for adjustable ones when I see him Wednesday.

Sin Rider: You're right about the surgeons getting together. There's way too much difference in rehab schedules. You've done it both ways and have a lot of good opinions on each. Freak of Nature? I don't know, but you're sure an inspiration for me to push a little harder.

Bulldog: My OS report said my tendons ruptured from the top of the patella with some bone fragment still on the ends. Holes were drilled in the patella and sutures were run through the holes up into the tendon. Then, 2 limbs were pulled through a center hole and two other limbs each pulled through their own hole. The sutures were pulled down tight, secured and tied -- same on both knees.

Ankhsign: Swelling hasn't been too bad for me, but I use bags of frozen peas to put on my knees for 10 minutes after working them. The kids laugh, but the bags form around the knees and don't fall off. They say they aren't going to eat the peas....

Philly Buster: I'm doing good! You're right about when the swelling goes down you have stick legs.

About a month or so after my injury, I came across two BQTR 1 1/2 and 2 years since surgery on the internet. I learned so much from them. A few things were, massaging your adhesions and quads for scar tissue, because this may inhibit ROM; that soft tissue takes 12 - 13 weeks to heal completely; and to always have a great attitude. They have been true friends. We can all learn so much from each others experience and knowledge! I know I have...

Tiger Bait
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