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Quadriceps Tendon Rupture, Repair and Rehab - Page 31

post #901 of 10808

Hello all,


Tomorrow will be the one-year anniversary of my quad tendon rupture, a complete tear that required surgery, PT, and everything else, as you all well know from your own experience.


I have been diligent about doing all the necessary exercises to rebuild my leg.  I have regained almost complete range of motion, but the quad is still small and the muscles/tendons around the knee are still weak.  The knee especially has difficulty receiving weight while flexed (such as in descending stairs). It occasionally collapses while I'm doing nothing more than walking - though I have not yet fallen down completely.  (Still have good reflexes!)  There is a tight feeling in leg while walking, as if someone has  wrapped a band around my leg just above the knee, and I have a bit of a limp - there is not a smooth roll or bounce to my stride.  A little flat-footed, it seems.


I used to be a distance runner, but I have not yet attempted my first post-op jog.  My surgeon (whom I saw again two weeks ago) wants me to start on the elliptical machine at the gym.  He said that from this point onward he can make no promises about any future recovery.  He also said that it will take two years from the date of surgery to know with certainty what the permanent effects will be.  Meanwhile, I'm going to keep trying to regain my pre-injury level of athletic ability.  Still a long way from that target!  I was a little surprised to hear my surgeon say during my last visit that I have already made a better recovery than the majority of his QTR patients.  I remember at least one of you guys (was it you, "Vermont Soldier"?) making claims about being on mountain bikes just a few weeks after surgery!


It's been a few months since I last checked into this forum, but I would be happy to hear from any of you and answer any questions you might have about your injury and recovery and share my own experience with you.


Best wishes to all of you,


Philly Buster

post #902 of 10808

Hey Philly Buster

His comment to you was probably related to the idea that most people - more than 80% of Americans - are unfit and are not active...


They are the ones who heal slowly - if it all....on balance you (and everyone else here) are going to be way ahead of the curve by being fit to start and having a desire to be fit again... 


Will we ever be as fit as we once were? Some will, some won't...


I hope that eventually you won't be won't....






PS - become a reformed runner and get a bike? 

post #903 of 10808

Flat -


Thanks for the tips on swelling.  I'll start icing at work in addition to what I'm doing at night.  I was taking NSAID, but my OS said they might delay the bone and tendons healing.  I'm 7 weeks post op now so bone and tendon should be healed. 


I find my ROM is best in the morning.  I think the knee swells up during the day, so not as much ROM at night. 


Paulsenw - Wow, you're doing well.  I hope my rehab goes as well.


Keep up the good work all.



post #904 of 10808

Philly Buster,


I hope the Elliptical helps.  How old are you -- I was 46 when I got hurt, and had no history of injury, and that seems to have helped.  Interesting comment by your surgron -- my guy, who's a sports medicine doc at a big research University, had a higher base level of expectation.  I say work it to the normal limits of your ability and don't get down!  Feel free to send me a message if you have any questions -- I'd be happy to share my gym routine, which I think has helped with my recovery. 



post #905 of 10808

Philly - 


I'm interested in your comment  "There is a tight feeling in leg while walking, as if someone has  wrapped a band around my leg just above the knee".  I'm only 7 weeks post op, but I have the exact same tightness.  It feels like the surgeon inserted a 1 inch wide rubber band across my lower quad about 3 inches above my knee.  As I bend my knee, it gets tighter and tighter.   Has your OS said anything about this?  I plan on asking mine when I see him next week.


Keep your head up.  I think that last 10-15% rehab will be the hardest.  Lots of work and slow progress.  As with this whole QTR trip, the hardest part is the mental part.



post #906 of 10808

So much great info - thanks again Idaho Guy for starting this forum, all you quad ripper vets who are still reading and posting your experience and all us rookie rippers for posting and keeping this alive and fresh. I for one would have quite a different mind set if this forum didn't exist to bounce things around and learn from!



post #907 of 10808

Hi Scott


Good call


Seems to be (mostly) true.




I found a few other links but this seems to be contemporary thinking...


Guess I'll just ice a bit more...thanks for the heads up



post #908 of 10808

Hi folks,


My surgery one-year anniversary was back on Feb 5th, and I did mean to check in.  But to be honest, it's very rare that it even occurs to me that it ever happened.  The only reason I'm here is that out of the blue I got an email about my EpicSki subscription, and I figured I would say hello.


I've been doing everything I always would at this time of year - alpine, tele, and cross-country skiing, snowboarding, riding my mountain bike (spike tires).  Mostly on hardpacked snowmobile trails, but I got lucky with a very special singletrack session this past Sunday after a good rain and freeze.  A total freakin blast!


No question - my recovery has been 100%.  My thighs are completely equal in size and strength, no weakness or limited range of motion at all.  The only time I feel any knee pain or stiffness at all is at home after a long day of steep icy bump runs.  But that's no shocker - it's always been that way for me anyway, and my knees are now 52 years old, surgery or not.  I feel lucky to be able to ski the way I can at all.  And I can honestly say I've lost nothing as to what I can or can't do.


Philly Buster, I think it was me to whom you were re wrt riding w/in weeks of surgery.


Good luck all - complete recovery is within reach for anyone who works at it.

post #909 of 10808

Thanks for sharing.  Am now a week post-surgery and find your story very inspiring.  Will start CPM tonight or tomorrow with 20-30 deg RoM.  Hopefully, will go well.

post #910 of 10808

   As far as I'm concerend sinrider is the craziest rehaber on here, so he is the man! lol.  I can't agree more about this board, a great source of information, idea's, and bottom line mental helpfullness to see that there is light at the end of the tunnel for this awful injury.  I know when this happened I thought my life as I knew it was over but thanks to everyone on here it helps you realize it is not over you can go back to doing what you did prior to injury.  Well my 4th week of pt has been a success.  I have reached 105 degrees today and also made a complete front and backwards rotation on stationary bike. Never thought i would be so excited about getting a revolation on a bike but I know on week 2 I never thought I would get a complete rotation.  I truely believe I would not be where i am now without going to the pool for 1 hour everday doing excercises.  So thanks to the pool pioneers.  I have been without my immobilizer brace for last 2 days, its getting better each day.  Keep a positive attitude and one day at a time you will reach the finish line.  Remember we're all in it TOGETHER!!!




post #911 of 10808

Philly Buster,

I am 4 months post op - left quad tendon rupture from patella - and saw my os yesterday. I have been making a steady recovery and the os told me he expects a complete recovery after one year from the surgery. For me, the key has been working really hard at my rehab - 2 1/2 hrs a week of pt 2xweek - and doing rehab exercises (including heel slides) every day. I'm going to the gym twice a week and working out with a trainer once a week. But all this work is paying off - the os cleared me to ski in late March, which would be about 5 months from the surgery, as well as to try running and tennis in a few weeks. My tendon is getting steadily stronger and my rom is at 145. I am 58, an active tennis player, skiier, runner, cyclist, so a full rehab is essential to me. I agree with one of the posts that said that the last 10-15% of rehab is very mentally challenging - it takes lots of discipline and focus to stay with this regimen, but the progress makes the work worthwhile.


To those new to this miserable injury, be optomistic. This injury is really tough in the beginning but after a few weeks,you will feel much better. Keeping your mental outlook positive and focused is essential to your recovery.


Speedy healing to all!

post #912 of 10808

Just a suggestion, but if a group of you wants to collaborate on creating a "wiki" please feel free to do so.  The new site platform would let you orgainze a lot of information, such as

causes of injury

medical alternatives

physical therapy and rehab


And so forth.  No one person needs to do it, just take a strong post and start it, and point the way.  Any one can edit and add to the information.

post #913 of 10808

They tried to make me go to rehab, I said "NO, NO, NO"!!


Kidding, slow n steady will win this race! Slow n steady indeed! 


Stay positive all you fellow quad rippers!

post #914 of 10808

This is a great idea. I'll play.


I was thinking of combing through all the posts and trying to summarize OS approaches to this problem. I think it is really interesting to see the diverse approaches...ultra-conservative to a bit more aggressive.


I met a fellow where I live the other day who QTR'd while trail running...his OS put him in a straight leg cast for 8 WEEKS...I'm at 8 weeks today and simply can't imagine just starting now.


Our shared PT thinks the OS is a completely mad....


There is an interesting journal called the Physican and Sports Medicine that often discusses these things. I think a summary of OS and PT approaches based on this list might have legs too...Any other MD/PhD's in the house have an opinion or want to help?



post #915 of 10808

Well, with nearly 1000 posts in this thread, it seems there is a lot of demand for the topic. Any wiki would be very hot with the search engines and could link to this forum thread.  Its really easy.  Just go to http://www.epicski.com/wiki/ and start a new Wiki with this same title.

"Quadriceps Tendon Rupture, Repair and Rehab"

I'm sure once it starts, new informtion will be edited and appended quickly.  Images and photos can be added, but please be sure you have permission before posting copyright material.

post #916 of 10808
Originally Posted by Flatlander09 View Post


I was thinking of combing through all the posts and trying to summarize OS approaches to this problem. I think it is really interesting to see the diverse approaches...ultra-conservative to a bit more aggressive.


I met a fellow where I live the other day who QTR'd while trail running...his OS put him in a straight leg cast for 8 WEEKS...I'm at 8 weeks today and simply can't imagine just starting now.


Our shared PT thinks the OS is a completely mad....


There is an interesting journal called the Physican and Sports Medicine that often discusses these things. I think a summary of OS and PT approaches based on this list might have legs too...Any other MD/PhD's in the house have an opinion or want to help?



The diverse approaches are a result not only of different opinions/practices, but more often due to patient factors.  In short, quads/extensor mechanism injuries are highly varied injuries that range from significant strains to complete ruptures, and occur anywhere from the muscle to muscle-tendon junction (common) to the tendon itself.  Patient tissue quality (age, smoking, fitness, genetics), extent of injury, functional expectations, and complicating medical or social conditions all play an important role re. deciding on the best therapy.


FWIW, I hate when physios comment about treatment decisions when they may not have all the facts - or knowledge - necessary to offer an opinion .

post #917 of 10808

Thanks jdistefa....all good points... thanks for that ... the whole landscape is certainly broad for a lot of reasons...


post #918 of 10808

sinrider and rlb,


You guys are amazing!  How do you do recover so fully?  Perhaps I should ask the nature of your QTR injury.  Did you guys have complete ruptures or partial ruptures?  


Mine was complete.  I am 51 years young and was a good distance runner with no history of injury before my QTR.  I have stayed in good physical shape this past year during recovery, even though I have not been able to be too active.  I've been riding a stationary bicycle and using all kinds of weight machines at the gym for both legs and upper body.  It's very frustrating that I cannot run or jog - yet.


Keep up your inspiring examples!


Cheers to all,


Philly Buster

post #919 of 10808

Thanks for your supportive words, Flatlander09, and your suggestion about taking up bicycling.  Yes, I've thought about it, but I don't like sports that require equipment.  That's why I've pretty much stuck with running and soccer.  My OS suggests swimming, which I've tried in an indoor olympic size pool, but I guess I still prefer to be active while outdoors and can look around me while I move.... 



post #920 of 10808

Thanks for your reply, paulsenw.  What was the nature of your injury, and when did you have your surgery? How long have you been doing PT?  


Like you, I was lucky to be part of a major research university with a good sports medicine program.  It's been kind of interesting to notice that my OS has kind of reduced expectations as time has passed.  I was 50 when I had my QTR last year.  A good athlete with no prior history of injury.  I clearly remember the OS telling me before surgery that full recovery would take 2 years, but I could expect to regain 98-99% of my pre-injury abilities by the end of those 2 years.


One year after surgery and about 10 months after starting PT, which I've been diligent in performing 5x week (about an hour each time), plus walking at least 2 miles a day, and I would place my recovery at maybe 66% after one year.  I have regained about 98-99% of flexion and extension, and I can walk long distances at a moderate pace with some discomfort, but I can't hustle or scram - so I always look both ways before crossing streets!


Would be happy to compare notes with you!



post #921 of 10808

I'm curious if anyone has tried Bikram (or "hot") yoga during their recovery from QTR and repair?  I had an ACL rupture (skiing accident) in the other leg repaired 10 years ago, and as soon as I had some motion in the leg I began going to yoga and doing a number of the poses that isometrically loaded the injured leg.  My surgeon, Kevin Stone, (see www.stoneclinic.com) whose practice includes many high-level athletes was amazed at the rate of recovery.  I remember him taking me back to the PTs and asking me to demonstrate what exercises I had been doing.  I was able to lightly jog on grass 28 days post ACL-surgery, and have had 100% recovery with no difficulty kneeling, bending the leg, etc.  I'm thinking about whether I can use some of the yoga poses to accelerate recovery from the QTR and surgery.  Would welcome any perspectives. 

Thanks.  J

post #922 of 10808

14 weeks


56 y.o., 6ft, 210lbs, no health issues, full rupture on Oct 24th, Repair on Nov 17th – tendon to patella


I love to read this forum to use as a baseline of where others are in their recovery.   My surgery was 3 weeks after the rupture and I'd read that the delay might cause me a reduced recovery.  Its frustrating because I'm ready to move on but it was a reality check to hear that others reported that, even after a year, their leg still does not "feel normal".  My leg has never felt normal and my expectations are set by what others reported.  I think many of us will recover faster than Idaho Guy because he was courageous to set the baseline for the rest of us to compare against.  


At 14 weeks, I think I am within the recovery range that others reported.  I never used a brace or crutches and only used a cane and the Velcro immobilizer for the first 4 weeks.   I can now go up/down the stairs normally without holding the railing.  I no longer limp when walking.  My ROM is 135 but not as good as the good leg (140).  I used to feel the banding and stiffness when I walked, but that disappeared when my ROM improved past 90 degrees.   I still go to PT twice a week but they are ready to drop me because of my progress.   They no longer work on my ROM but rather on mainly leg strength exercises. 


I think for walking the stairs, the exercises that helped me the most was:

- balancing on the bad leg on a soft foam pad.   There was a leaning curve until I could balance.

- pressing 50 lbs using the bad leg on a leg press.  I'm trying to increase the load every week.

- The StairMaster machine is great exercise because you safely start with small stair heights and build up. 


When walking, I used to be mindful to always use the good leg for curbs and stairs but now I purposely use the bad leg for the exercise.


My next goal is to be able to skip and jog again.  I don't do either very well but I practice every day.      



post #923 of 10808

Today marks 9 days post-op,  Got in the CPM machine for several hours yesterday for the first time, and there was no problem or pain getting to 30 degrees range of motion.  I won't go further until the orthopod gives me the ok.  Went to the gym yesterday for the first time since injury occurred, and managed to get a reasonable workout out in. 


One exercise that felt particularly good was balancing on the injured leg (in extension with the brace on) and isometrically contracting the quad as hard as I could.  I did this several times for 60 seconds at a time, and it feels less tight this morning.  (I slept in the cryocuff last night to be sure to bring down any inflammation.)


I see the OS tomorrow for the first time since surgery, and he will remove sutures.  No staples, fortunately.  Am looking forward to getting on to rehab.


It's been raining a lot here in Northern California, which means lots of snow in the Sierras, and I'm somewhat frustrated that there won't be any skiing on the agenda this year for me.  But next year will be an incentive to get back into better shape than ever.


Hope everyone is having a good weekend.



post #924 of 10808

Hoist lowered on left foot, 100% QTR RT leg at the patella, 6 Weeks Post Op today, QTR Jan 9, surgery Jan 11 




Since 2 weeks post op I have been cleared to take the zimmer off when not walking & cleared to do passive PT exercises, which I have done based on exercises I have read about on this forum.


Thanks again to everyone for sharing! Quad sets, heel glides, hanging leg over the bed to let gravity pull it down, snow angels, foot and toe movement, etc. Since this time, I have had a ROM of around 35 degrees and no matter how hard I try, I cannot get it beyond this point!


I had my first "formal" PT session this past week and my PT couldn't move it beyond this point either. The exercise suggestions were the heel glides, quad sets and gravity which I have been doing for several weeks. I have read, it will come, it will come, but it sure doesn't seem that way based on the past few weeks of effort! It's like trying to bend a friggin 2 x 4! I need at least 60 - 75 degrees ROM to allow me to get into our car to drive, and I NEED to be able to drive, and I thought I would be able to as of this week!  


I want to be able to get into a pool for aqua therapy but I don't feel there is enough stability without the zimmer to do that yet. hopefully, this week.  :(


 I'm going through a stage that I am thinking something must be wrong in there for this leg to be stuck at 35 degrees ROM with the effort I have put forth to increase it. Leg lifts with or without the zimmer is no problem so I have some decent strength there. I use heat to loosen it up, then ice to help with the swelling. It is stuck where the tendon was re-attached to the patella, as one would expect.


Any comments would be very much appreciated.


Continued good luck to all with their rehab.



post #925 of 10808



One suggestion would be to try stretching and ROM exercises in a very hot room or sauna.  Muscle is viscoelastic, i.e., elasticity increases with temperature, and it might be helpful.  Applying a heat pad of some type during exercise might have the same effect.


Good luck.



post #926 of 10808

Thanks J,


I do the heating pad without much apparent success but will keep doing it regardless as the hope is that all of a sudden it will get past this block. Where I plan on doing the aqua therapy also has a sauna & hot tub and full workout equipment. I will be living there soon! Unfortunately, they don't keep the hot tub very hot but I will give the working and stretching it out in the sauna a try. 


Getting there is an issue thus the need to drive. It would take me about 45 minutes to walk there at the rate I can walk at present (in the SNOW - lol) but I just might do so just to give the sauna a try. MUST get that ROM going asap so I can drive - I'm to dang tall to get in the car without more ROM then I have now! lol 


I am glad to be at the 6 week mark as I can now turn it up a notch without as much fear of ripping the repair apart. 


Glad to hear things are going smoothly for you.




post #927 of 10808

Hi. What a great thing yall have here, Sorry to here of all the misery, at least now I know I am not the only one dealing with this right now. Let me throw mine in. I'm 46 years old and I totally tore my left quad tendon on December 10 th 2008. Leaving My office there are twelve steps to street level. I go up down these many times a day, part of my job involves a lot of walking around downtown San Antonio. Anyway, new shoes or something I trip at the top of these stairs and my left leg folds under and I crash down on top of it hearing the POP followed by WHITE HOT pain. After landing at the bottom and trying to figure why I cannot lift my leg to get up I notice an Ambulance parking twenty feet from where I am sitting. After ruing the EMT's lunch break I am in the hospital where unlike Idaho guy I stay Three nights with round the clock care complete with Morphing drip at the push of a button. That made post surgery a little better. Coming up on three months since my injury rehab is pretty much the same as everyones. Right now my Ortho says  I can do stationary bike with light resistance and swimming. I can go without crutches for short distances but I can feel my left leg get weaker as the day goes on, stairs and curbs are still a problem I look like an old man going up and down them. I find out on the 27th when I can start strength training with weights. Ill keep everyone posted. Stay Positive


post #928 of 10808

Did my first post-op visit with the OS today, and all went well.  Sutures came out nicely.  I'll be doing passive ROM exercises with flexion up to 30 degrees for the next four weeks, and then we'll move into "real" physical therapy.  OS also suggested that I keep the hips strong by lying on both sides and stomach and doing leg raises.  However, no leg raises while lying on my back that would put direct tension on the repair.  He was confident that I would have a 100% recovery, which was comforting.


Hope all are doing well.



post #929 of 10808

9 weeks post-op - Bilateral quad rupture


Hello everyone: It's been about 4 weeks since my last post and I thought that I'd chime in with an update on my recovery. I suffered bilateral quad ruptures after falling down some cement steps on the first day of our family vacation in the Caribbean back on December 22nd. Following a harrowing powerboat transfer back to a large airport and then transfer back home on a long plane ride, I was operated on Christmas Eve. I was weight-bearing (Dr.'s orders) within 2 days of surgery. I then transferred to a subacute facility for 9 days of learning to make bed transfers to a wheelchair-commode chair-car and some OT and upper body strengthening. Finally, I was discharged and came home (with a hospital bed). Another 3 weeks of sleeping downstairs in a hospital bed and using the commode chair/porta-urinal and then a breakthrough! By early February I had successfully conquered stairs again (up and down) and was able to sleep in my own bed again!


I still have the immobilizers but do not wear them much as I have been having home PT (lots of deep tissue massage to get rid of scarring and any risk of adhesion). My ROM at the beginning of home PT (which began 3 weeks ago) was 35 degrees (left knee) and 38 degrees (right knee). Now 3 weeks later I am 90 degrees (left) and 105 degrees (right). I see my OS again this Friday 2/27 and will 'graduate' to outpatient PT beginning next week which coincides with my return to work. Based on everything I've read on this forum, I am looking forward to getting into the PT gym and eventually, into a swimming pool.


I credit the progress of my recovery thus far based on these contributing factors (not in any particular order): 


1. surgery within 2 days of my accident - getting off of morphine and Percocet while still in the hospital

2. weight-bearing orders within 2 days of surgery (with immobilizers on)

3. time in a rehab facility to work on making transfers and OT work to maintain upper body strength

4. having the use of a rented hospital bed at home for the initial home portion of my recovery

5. GREAT home PT (deep tissue massage and ROM work)

6. exercises - Exercises - EXERCISES!

7. stair practice at home (first WITH immobilizers on, then off - GO SLOWLY and with SUPERVISION)

8. a desire to want to get back to walking normally again

9. support from my wife and kids

10. support from friends and colleagues


This forum has been so incredibly helpful and a place to find encouragement during the toughest times I have ever experienced. Being a "2 for 1" bilateral rupture victim is "twice the fun" for sure, but for those of you who are single or just beginning life as a bilateral victim ... there is HOPE ahead! The real key in recovery is to have a support base at home and to stay in touch with folks on this forum. It is through our sharing of experiences here that each of us will find answers and optimism as we get back to walking again.


I'm excited to start outpatient PT ... there's still a long road to recovery ahead, but I know that I can get through this thanks to the encouragement and information I have taken from members of this forum. All the best to each of you as you continue on your journey to wellness. Keep in touch!


Tom in NY

post #930 of 10808

8 weeks post surgery


starting the 6th week of therapy. Gained 5 degree's since last fri.  Rom on monday 115, doing alot more with weights, biked for 15 minutes and did 1.3 miles in finally one direction of movement.  Getting easier on bike everyday did 2.5 miles on bike in afternoon.  walked on treadmill with both feet a whopping 5 minutes at 2 mph.  yahoooooo.  Still doing the pool 1 - 1 1/2 hrs. a day then lifting 1 hr. after.  started working on step ups in the pool yesterday felt good but still uncertain about trying steps out of the pool.  Pt said its ok to start trying steps up and down.  But be very carful going down to hold  onto a railing.  Have'nt wore the immobilizer brace for about a week inside or out.  I did put it on during a wrestling tournament on sat. due to the number of people, but it only lasted about 20 minutes.  It was driving me nuts after not being in it for 4 days, so off it came!  Keep up the hard work everyone and positive attitudes we will make it to the FINISH LINE!!!!!!!!!!!!!!!!!!

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