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Quadriceps Tendon Rupture, Repair and Rehab - Page 33

post #961 of 10797



You want your knee in the center with the brace like you and I have, many on here start and finish with these braces, some start with this type then graduate to a full leg adjustable brace, some start and finish with the full leg brace per Tom. I personally want to finish with the zimmer type brace like you have.


I go down the stairs backwards, like going up but in reverse,  but I can't imagine going up or down with bilateral QTR's. What you have now is what you will have after surgery for six weeks, but with pain for the first few days. Get yr prescriptions filled before you leave the hospital. I would think you will be in the hospital for a few days or longer post surgery?


All the best to you Monday - Steve






post #962 of 10797

My leg is incredibly swollen, stiff and numb today. kfvdnfvfknd!


Camelliabowl, yes, yrs would be a tendon to patella repair. Mine took part of the patella bone with the tear, which I think tends to happen to some degree in most of these tendon at patella tears. The left side of my knee is the most tender and was the sorest point when I injured it, likely where the bone tore away? I had the 4 holes drilled as you did. I think you are in good hands with yr OS, don't think he was too conservative and yr results have been good. Also, the hot tub likely helped a lot. The heat can only help while yr stretching it, as Jakster mentioned previously. I'm going to give a hot tub and sauna a try next week, hopefully after I'm able to get behind the wheel of my car THIS weekend and start driving!


Steve in pa, great ROM, congrats on reaching 10 weeks and whooping those stairs! When at 35 degrees, it just doesn't seem possible that it's ever going to come back! My quad strength isn't too bad, I think? lol I think it's mostly the damage done to the quad and the tendon when the tendon tore that's the biggest problem? 


Have a great weekend all - Steve

post #963 of 10797


I have been thinking today about the type of rehab that I have been doing, especially in lieu of what the others have been writing.  I really think "heat" and "water" have played a significant role so far.  As soon as the OS allowed me to "soak" my incision (3 weeks PO) I have been in the tub daily.  I use a cryopack that is reusable and can be boiled and placed in a sleeve and velcroed around my knee.  I apply about 30 min. of heat, and then massage "longitudinally" (sp?).  I keep a bottle of Nivea body oil next to my chair and rub that damn knee all day long....but I do the ROM exercises AFTER I have done the heat therapy.  I Always follow the Heat and ROM with ice. 

My pain is on the outside of the patella like yours....very distinct ...I am going to ask the OS for his notes on my next visit.  That one spot feels like a bone and not a soft tissue ....hmmmm I wonder???


Take care, good luck Tim

post #964 of 10797


Originally Posted by SteveFinMD View Post


I am reporting in after my second PT session.  I have not hurt so much since my injury.  The PT tried to force a stretch by lifting my leg, folded at the knee, and leaning on it pushing my thigh back towards my chest.  It hurt at the time but I could barely walk 30 minutes afterwards.  I really think he was pushing too hard.  I was happy with the progress I had been making...walking pain free, driving, etc.  Now I am waiting (with ice on my knee) to see if this is a major set back.  Bummer.

 I wanted to follow up on the post I made earlier after my second PT session.  I did end up visiting my OS to see how severe my injury was.  Fortunately, he felt the tendon repair was still intact.  The OS could not understand why the PT was trying to force stretch my ROM on my second visit.  I spent 2.5 days in extreme pain.  Unable to drive and barely able to hobble around.  I iced the leg constantly and now it is feeling much better.  I have a PT appointment on Tuesday and I am scared to go back.  I will explain to the PT what happened, and that I can't afford to cancel everything on my schedule for 2.5 days after each PT session.  I really feel like finding another PT but I will need a referral from my Primary Care doc for that.  I will keep you posted after next weeks PT session.  BTW...welcome to the new members.  Good luck with your recovery.

Edited by SteveFinMD - 3/1/2009 at 02:35 am
post #965 of 10797

For SteveFinMD and others with forced bending at PT to increase ROM -

I read your last post and was wondering what was your ROM and what ROM did they push your leg to?


I'm posting my information and progress so far below. 

 See Post # 468 7/19/08 about the day they pushed my leg at PT.  It seems by a certain point in time they want the leg to bend to 60 degrees to break up scar tissue.  I know I worked like crazy to get to 60 but only ended up at 50 and then they did the forced bending, but not like they did to your leg.  After a session like that, it certainly motivates you to get ahead of schedule so no one will bend your leg like that again!  At least it motivated me.  While bending at home, I had slow controlled pain at time to get the leg to bend more and more, but at least I was controlling everything and was able to stop or go a little further.  There really is no getting around some painful sessions while getting the ROM up. 


Also, my therapists at PT said they would never recommend a CPM machine for a quad rupture, that is most suitable to a knee replacement patient.  The only way to go are the heel slides, 3 times a day, about 20 times each session, using a towel or strap, and getting that knee a little higher every time.  There is no substitute for hard work.


5/28/08 Injury (complete rupture about 2 inches above knee, left leg, tendon to tendon) I was walking to my mailbox after work, but I was wearing a backpack weighing about 30 pounds and I think my left shoe slightly slid on a plastic sprinkler head, and the combination of a weight shift in the backpack and standing on only one leg trying to steady myself as I was about to make another step was just enough to do me in. It all happened so fast in a split second.)
6/05/08 Surgery, allowed to put weight on leg that day
6/18/08 PT started (after staples out) (stabilizer on 6 weeks including nights, except for PT, bathing, and just airing out leg)

7/15/08 Immobilizer off (got a hinged knee brace, open patella, only wore outside, not in house)
7/19/08 ROM 50, pushed to 60 at PT (4 times and held 10 seconds each – lots of pain & swelling  
    The first and last time my leg was ever pushed at PT—I got my ROM up myself)
    See Post # 468 7/19/08

7/23/08 ROM 78 degrees
8/04/08 ROM 90 degrees
8/12/08 ROM 105 degrees (Dr. wanted 90 by 8/12 – ahead of schedule)
8/23/08 PT stopped measuring ROM, but I was going all the way down on the Total Gym so no need to measure, full ROM

1/20/09 Last doctor appointment - Strength test  70% on Biodex machine, flexion strength almost same as other leg,  extension is weak.
New info – still doing my exercises every day (sometimes take a day off a few times a month)
The doctor told me to keep doing the same exercises, but I’ve increased my step height and some weights. The only thing the doctor told me, much later in my progress, was that he didn’t want me to go over 20 pounds in leg extension exercises. (Which contradicts his earlier instructions that I don’t go over 5 pounds). I think the reason for this is as my progress has been steady and improving, he evaluates my particular injury and recovery and realizes that based on my body type, etc., that 20 pounds max is right for me for leg extensions. I was very cautious in the beginning about adding weight over 5 pounds and only did it one pound at a time every month!
Since January 2009 
Flexion - adding one pound a month to my flexion (no need to add more weight as flexion strength was really good) until I get to 20 pounds. I just use ankle weights at home while sitting on the edge of the bed. Currently at 17 pounds   10 x 4 sets
Extension – Adding a pound every 2 weeks (until I get to 20 pounds). Currently at 13 pounds
10 x 4 sets
Steps – started on a 7-inch high stair at home (I have indoor stairs) After seeing doctor in January, I took another look at my prescribed exercises and it listed a 16-inch step! No way could I do a 16-inch step a few months ago. So decided to increase step height a few inches each month. I used a small 11-inch folding step stool the past month. Just added a 2-inch phone book (added two strips of rug gripper tape on bottom so it wouldn’t slide off the step stool), so now up to 13-inch step. Will use this 13-inch step for the month, then next month use the 16-inch step (maximum, will not go higher). I found a heavy duty molded plastic Rubbermaid step stool for only $20 including shipping. I use my stair railings to hold onto for safety.
Step Sets: 10 x 4 facing step (up on injured leg, down on non injured leg)
                 10 x 4 sideways to step (up on injured leg, down on non injured leg)
I was considering buying an official gym step with risers, but that costs over $135 and I don’t have much room for something like that. The step stool idea has worked really well, is inexpensive, and I really needed another step stool. It also makes a handy bench to sit on when washing the wheels on the car, putting on shoes, etc. 
I found the 16-inch step stool on Amazon – the cheapest is $13.99 plus shipping. It is very stable and sturdy. I place it at the base of my stairs and hold the stair railing with one hand for safety and stability, I’m not using the railing to pull myself up. To see a picture, just go to Amazon and copy info below.
Rubbermaid-Two Step Stackable Economy Step Stool, 18 1/2w x 18 1/4d x 16h, Almond (RUB42221)
Wall slide squats with therapy ball – worked up from 10 pounds total to 30 pounds total (15 each hand). Sets: 10 x 5. At home at first I didn’t have a therapy ball, but found it more challenging and easier on the back and easier to slide using a therapy ball as I did at PT.
I was able to find a smaller size therapy ball and various ankle/wrist weights on Amazon.  I tried several sports stores in my area to find weights like I used in therapy, but couldn't find any.  Easier to order online and have them delivered to the front door!
Here is the brand of therapy weights I found on Amazon that are sturdy and a good price (they aren't the most expensive, but they do the job, they don't leak and as long as you don't throw them around, they should last a long time).  Also, they have long straps so you have enough strap to wrap several around your ankle/wrist.  I found the ones in the stores did not have long enough straps to do the job right. 
Cando Econocuff Wrist/Ankle Weights
(they come in various weights from 1 pound to 10 pounds max)
Rest of my exercises are the same (I do all my daily exercises at home about 4am before leaving for work—it is easier than trying to do them at the end of the day):
Stationery bike (warm up) 10-20 minutes
Step machine (mini-stepper plus) – set at max setting 5 minutes
Stretch hamstrings (30 seconds x 3 both legs)
Knee lifts – march with my knees up high a total of 10 round trips across the living room
Fast walk (used to be a very slow walk) – walk as fast and smooth as I can a total of 10 round trips across living room.
Stabilizer – Stand on injured leg (other leg bent behind) 3-4 feet from wall and bounce foam ball against wall 15 counts x 5 (I found a good use for that foam ball when I no longer needed it under my knee for those table exercises)
Squats – no weights, just stand with legs apart, squat down slow and back up 10 x 4
Extension – weights (described above) 10 x 4
Flexion – weights (described above) 10 x 4
Stretching – lay on back on bed – use strap – one leg at a time – straight leg up 90 degrees from hip, foot slightly lifted up, hold 30 seconds x 3 each leg. Then lay on stomach on bed, use strap, one leg at a time, bend leg behind, pull on strap 30 seconds x 3.
After this if I have time, I still ice for 15 minutes. Usually, I don’t have time to ice. 
At lunch I walk down a long flight of stairs every day—about 40-50 steps (can do it now without holding rail, but steps are only 4 inches high), walk about a half block, get lunch, walk back up steps, then use an ice pack with my leg up for 20 minutes while I eat lunch.
End of day – walk about two blocks to train station
June is next and probably last Dr. appointment – the one year mark. We will test my strength on the Biodex machine again. I’m hoping my test will be about 90-95% strength! That is my goal.
I will probably drop by PT at the end of April and ask to be tested on Biodex just to see where I’m at.
Note: My doctor does not want me to jog. He is all for using a treadmill at an incline (I was up to 10 and good thing because walking up the ramp to the train is about 10 or more incline) and walking fast as there is no trip hazard.
I understand why my doctor doesn’t want me to jog because the other day I was just walking and I tripped on a bump in the sidewalk with my non injured leg and landed on my injured leg. I was able to steady myself and I didn’t fall (and I was wearing a backpack – about 15 pounds). However, I almost had a heart attack and I stopped for a few seconds until my heart stopped racing. I didn’t feel any pain, but I did go in the house and put my leg up on the couch. If I had been jogging, I would have probably fallen down from the momentum and who knows what that would have done to either leg!
All of our injuries and repairs are unique to us and it is up to us to listen to our bodies and decide what activities are worth the risk. Obviously if my leg tested at only 70% strength at the end of January, I’m still walking around on a leg that is not up to the strength of the other leg. My doctor told me to do my weights slow and steady and not do any fast, quick moves. I’m pretty happy with my progress as is my doctor. With the new weights and higher step I’ve added to my routine, I feel my leg is probably about 75-80% or more right now. I walk smooth and most people would never be able to tell I had an injury while walking. However, even though I can go up and down stairs without using my hand on the railings, I still don’t think that is as smooth. I try really hard, but I think if you saw me going up or down stairs you could probably tell I had something wrong with one leg. But, I’m working on that every day.
I have noticed a lot of progress in strength and stability even since January.  If I saw no progress I would be frustrated, but I notice slow and steady progress.  I think even at the year mark there will still be more room for improvement, so I just plug away every day.  Even that stumble I had gave me a little more confidence in that the injured leg and the progress I am making.
Best of luck to everyone on their recovery, especially on the new people on this list.




post #966 of 10797

thanks steve, tigger44 and camellibowl for the postive comments.  Update my situtamuatation as we say done south  went to my OS on 23 feb 09 and he tossed the cloth leg immoblizer and said crutches only when out of the house.  On the first day of not wearing the brace, by end of day had swelling and tightnees above injured area ( left leg above kneecap as all of you know the spot by heart)  Swelling and stiffness still remains 7 days out of brace.  Will ckeck in with OS this week to see if something has gone astray.  Still able to do straight leg raises lying on back and sitting. Am able to walk, but it hard breaking the walk acquired from the brace 7 weeks when you pulled the leg forwARD from the hip insort of a swing. ROM active is 30 to 45 maybe.  Not getting enough bend on the knee when walking or sitting to be comfortable.  However to my surprise though my injured knee can support extremely well.  has not buckled once since the 7 days the brace was off,   i was so looking forward to getting the brace off. and had high expectations for a  quick improvement only to be meet with this swelling and stiffness  setback.


As tough having that cast/brace or whatever you had on to immoblize your injuried leg, the real fight seems to start when it comes off.(as if continuing a life with that immbolizer device isn't hard enough, marriage, kids job, money, being single when it happens and living alone, driving, errands and etc well you get the picture)  We all have been there and done that i am sure.


Hang tough and wish all on this site a week of good improvement  keep that info comming.

post #967 of 10797



My ROM was 105 before the bending.  He did not get any more out of it in spite of the forced stretch.  Bear in mind that this was only my second  PT session.  It seems to me like some strength building was more in order than forced bending.  I went through this in 2000 on my other leg and never had to retreat to a wheelchair like I did after this session.  I have to think part of it was due to the fact that it is a PT assistant and not the licensed PT who was working on me.  My next session is scheduled for the day after tomorrow...I'll keep you posted.

post #968 of 10797

7 Weeks Post Op today!


Leg feels better yesterday & today, Friday discomfort was likely a response to Thurs PT. I have also reverted to leaving the zimmer on very loosely to sleep the last 2 nights, which seems to have helped? Worked the ROM yesterday pretty good, heat via heating pad, ROM exercises, then ice - did this twice while working the calf & quad all day long! Sunny but cold day but I think an outside walk is in order. Will also try to stuff myself into the drivers seat of my car today - crosses fingers! 


Camellia - I'm guessing by yr ref to outer knee that it's yr left leg? My discomfort is inner knee, left side on my rt leg. Heat, ROM, ICE, I'm sticking with that plan even though my PT has suggested working the ROM with an ice pack on the knee!? I don't agree with this approach as the ice makes it less flexible, heat makes it more flexible??!! I made it clear I didn't agree!? 


SteveFin, keep that assistant AWAY from your leg! I'm glad to hear yr OS is as shocked as many of us here were. 105 degrees is great progress, the rest will slowly come with exercise, time, just using yr leg with day to day activities and PT - I feel in that order!


CQP - great to hear from you, I have read all yr posts & was wondering how you were doing. When Steve posted what his PT had done to him, I recalled yr post regarding don't let them push it, we know our own leg best! WOW, that's quite an exercise regimen you have there! Keep up the great work!


Melvin - "situamuatation"!! That's quite a mouthful! lol We are virtually at the same stage of rehab. You may want to consider wearing yr zimmer for a while longer with the back rods removed even if the experts have said toss it? Was yr repair tendon to tendon or at the patella?  With mine, you lift a flap at the top & slide them out.  The side ones also come off, but not as neatly. I have left those on. I took one out after 5 weeks, the second after 6 weeks. This allows you to bend yr knee but gives some support unless you try to bend it. Might also help with the stiffness & swelling but from what I have read on this amazing forum is that the stiffness & swelling that we both have will be with us for some time. My PT was concerned with infection because of my swelling but I politely indicated that I believe it to be quite normal for this injury! I swear, because of this forum, I provide more info then I receive but I try as best I can just to listen and shut the heck up! lol My PT also said no leg raises, even though I can do them as it puts too much pressure on  the repair. She indicated to concentrate on ROM, heal glides & hanging leg off the bed while lightly pushing down with other leg, etc., which i have accepted as good advice for now. The leg lifts can come later. 


I see my OS again this Wed, we'll see what he has to say then.


All the best to everyone - Steve

post #969 of 10797

Question for all

Fellow "rippers"....has anyone encountered or researched MEDICAL opinions about using Human Growth Hormone or any of the anabolic steroids in the rehab process?  It seems like one of the big issues at even one year Post Op, is the strength and size of the quad.

I am NOT proposing this as a soloution, I know nothing more than watching ESPN and Barry Bonds!!!  It seems like most of us are 40-60yrs old, and some of the things I read "suggest" that rehab and strength are results of the use of these supplements.  Again, this is not meant to be an endoresement...rather a question........is anyone up to speed with this or has anything been heard from the OS's???

I am willing to try anything within reason to assist in this upcoming rehab process...and since I am not a first ballot hall of famer or the home run champ......or even an olympic medalist.....I am interested.

Best of luck all...........Tim

post #970 of 10797

SteveFinMD - That is even more disturbing that your leg was 105 degrees - NO, don't let them bend your leg ever again.  I don't even know why they would do such a thing.  At first they have goals of 60, 90, and then over 100 ROM.  But you are way past the point where any scar tissue would be holding you up and you should not have anyone bending your leg.  My doctor & PT people said that after 100-103 ROM you are out of the water as far as ROM and scar tissue--and the rest will come just from doing proper exercises.  The exercises I used, especially the Total Gym at PT is what got my ROM increased and I controlled everything about that.  And then doing the stationery bike, first front to back and then finally I was able to make a full circle around, then lowering the seat a little. 


You need to talk to your doctor, head of PT, and maybe talk to someone else at a highly qualified PT facility that has experience with quad ruptures. Really, I don't think anyone here has had someone try to bend their leg when it was at 105. That is not right at all. 

post #971 of 10797

The Stone Clinic has the following quad repair rehab protocol, which I'm sure can be individualized depending upon the specific nature of the injury. J



•    The surgical leg will be weight bearing as tolerated, using crutches post-operatively
•    The surgical leg will be in a brace locked in extension for 4 weeks post-operatively (“out-of-brace” range of motion 2x/day within parameters set by surgeon)
•    Emphasis on VMO recruitment will begin in the early stages of rehabilitation
•    Muscle stimulation may be necessary to decrease pain/swelling and increase VMO recruitment
•    Maintaining upper extremity, trunk, and cardiovascular fitness will be of significant help in the recovery process
•    No resisted knee extension machines at any point
•    Core and cardio training daily


•    M.D. office visit post-op Day 1 for dressing change, review of medications, and instruction on a home exercise program (i.e. ankle pumps, quad sets, bridging on ball with legs in extension, hip abduction, hip adduction, etc.)
•    Gait training with crutches, pain and edema control, and muscle stimulation to improve quadriceps recruitment
•    Extensive soft tissue work for edema reduction and gentle tissue molding
•    Stretching to hamstrings, calf, and lateral musculature to maintain extension range of motion
•    Passive knee flexion to 40° with Physical Therapist only
•    Well-leg stationary cycling and/or UBE; upper body/trunk exercises
•    Passive/active knee flexion 40-60° (patient can begin ROM exercises at home)
•    Active open chain hip extension, hip adduction, hip abduction, and hip flexion (in standing) progressing to resistive band exercises as strength improves

•    M.D. visit at one-month post-op
•    Move to functional brace with ROM limits- max 20° of flexion progressed by 10° per week
•    Regular patellar and scar mobilization with appropriate intensity to allow healing
•    Passive/active knee flexion 60-100° in physical therapy
•    Continued gait training as needed
•    Closed chain exercises (i.e. proprioceptive training- 4-way leg pulls, balance boards)

•    Continue to increase flexion in brace by 10° degrees/week
•    Passive/active  knee flexion 90-120°
•    Begin two-legged bicycling with minimal resistance
•    Begin partial squats if good quad control
•    Small step-up beginning week 7 if good quad control
•    Low-level eccentric training (i.e. leg press with low resistance with slow return)

WEEKS 8-12
**Must have good quad control to progress through this phase.

•    Full passive and active knee flexion by week 12
•    Additional lateral exercises (i.e. lateral stepping, lateral step-ups, etc)
•    Continue all exercises with emphasis on functional and proprioceptive program
•    Increase resistance to all exercises (single leg squats by week 12)
•    Increase eccentric challenges (i.e. small step-downs)
•    Increase resistance on biking to moderate level by week 10


WEEKS 12-16
•    Conditioning is emphasized in this phase
•    M.D. visit at 3 months
•    Can come out of brace if good strength
•    Functional test
•    Begin low-level jumping exercises
•    Aggressive cycling by week 16 if good strength
•    Continue to progress resistance, eccentric challenges, and proprioceptive difficulty as tolerated
•    Single leg squat test for 1 minute should be 80% of uninvolved leg. 

**Patient should be independent in exercise program to progress to the next phase.


•    M.D. visit at 6 months
•    Functional test
•    Progression of program by increasing intensity of strengthening, higher level plyometrics, hopping exercises
•    Should have appropriate training and instruction in safest progression to sport activities (i.e. skiing, running, tennis, soccer)

**Patient must pass M.D. exam and functional test before being released to full athletics.

post #972 of 10797

Rehab protocol - great stuff jakster, thanks for sharing!

post #973 of 10797

Me: surgery 11/12/07 (why is it i dont have to look at the calendar to remember??!!!) tendon to tendon.


First, greetings to all the new QTRs!  So many i cannot list them all. Sorry for your injuries but you have found a great site to help you along your path to recovery.


SteveFinMD:  you mentioned your PT bending your knee! Amazing!  My first visit to PT did limited work and shown how to do home exercises. Heel slide was the big one. Cant recall exact ROMs (you can look back to mine if interested, but no big deal), but I think I was to get to 50 by next appt. Of course I was driven to exceed and could do 55-60 ROM and PT told me, that is really nice, but please follow the protocol!!! So I did not push much beyond the recommended after that, until I was told to go forward.


Camilia:  there is a thread devoted to glucosamine/chondroitin.  I used that to ease knee pain from running several years ago and for me, for whatever reason, it helped.  (Aleve was better though! helped me through fascitis).  So I brought glu/chon to my OS on my first return visit and boy!, did I hit a hot spot. He went off on that and how it cant work (he is also a PhD in biochem and kinesiology), going thru the biochem of its breakdown (I could follow because I minored in biochem in my MS) etc....and how the public is being taken for billions of dollars...blah blah....so I shut up. It helped me with prior injury knee pain but nothing with QTR. For what it is worth.


WilltheThrill: where are you? how are you doing?


Best to all! Keep Pluggin' !





post #974 of 10797

Hey all.


Some really good information on here lately!  THanks Jakster and CaliQuadPop.


Just got back from my first PT session.  I'm 9 weeks post-op, 9.5 weeks Post injury.  My OS has been very conservative, only been allowed to start bending my knee the last two weeks.  At start of PT, my ROM was 73 degrees.  At end my ROM was 81 degrees even though the knee was feeling a little pain and seemed tighter (swelling).  This was a lot better than I was expecting.  Got the standard exercizes to do at home.  Heel slides, leg raises, quadiceps flexes, hamstring streches, hanging knee extensions. Rode the exercise bike though no complete revolutions.  It felt really good to do something that I felt was making progress.


Walking is getting better.  My gait appears more normal than it feels.  As many others here, I concentrate on making my left leg match my right.  I have climbed the stairs normally, but not too many times.  Still go down leading with my bad leg, one step at a time.  Most difficult right now is dealing with downhill slopes.  I have several that I have to go through when leaving work.  I really have to slow down.  Also at the end of the day my quad is tired and weak, so it tends to give way a little. 


Well, gotta get outa here.  Keep up the good work all.



post #975 of 10797

Question:  I'm 2.5 weeks post-op and am noticing some swelling on the kneecap; it seem like there is a lot of fluid between the patella and the skin.  Is this typical of what others have experienced?




post #976 of 10797

   FALCON great job on your first pt session your rom is great for your first time.  I believe we are same day qtr 12/22.  My rom on monday was 126 which is dissapointing to me but it is a one degree increase in the right direction from fri. so i'm pleased with that.  going up stairs is getting easier but going down is another thing.  I did go down the steps normal on monday but very gently and thinkingly(if thats a word).  There is about 10 steps leading to pt.  starting to do more box work with step ups, overs, and one legged mini squats.  Time is ticking down for me as i have landscaping business and spring is comming quickly.  seems like things are slowing down in pt. due to small gains. 

    JAKSTER I still have alot of swelling in the front of knee and inside.  pt doesn't seem to concerend with it at this point.  keep icing and elevating.  I know its hard to keep  up with icing, because i don't do it enough either. 

    NEWBIES sorry for you luck but as i'm sure others will agree start reading from page one and by the end of the thread you will have a different outlook on this devestating injury.  I know i certainly did. 


EVERYONE keep up the great work we will make it  back!

post #977 of 10797



It seems that swelling and fluid buildup are different for each of us. While I think all of us had swelling that was helped by icing, not all of us have had "fluid" buildup. My swelling was all above the kneecap basically. However I have had fluid in the back of my knee almost since post op surgery, and I'm now at 10 weeks. Today I had the fluid drained at my OS visit, where it now feels a little better, but remains to be seen if the fluid returns or not. The pressure I felt from the fluid buildup seems to have been aggravated by the PT, so not sure what I'll end up doing if the fluid returns. I'm also now on an anti-inflammatory drug as I continue with my PT.


I'd say if the fluid build up (not just swelling) doesn't improve in the next few weeks, you may also need to have it drained and take an anti inflammatory too.


At 10 weeks, my rom is 120 passively, exercise bike and treadmill with no problems, and am able to do limited stairs up/down when I'm fully limbered up at the end of PT. All swelling is gone except the fluid issue behind the knee. Still have that stiff feeling at the repair site, along with some pain when doing "normal" stairs, and any knee twisting movement.



post #978 of 10797

7.5 weeks PO-Patella "snapping"?

Fellow quad rippers.....My rehab seems to be going ok so far.  At my last PT session on Monday (3/2/09) my ROM was 120*.  I have been able to use the stationary bike now and am doing morning/night sessions of 30 min at very low resistance...but I can go AROUND!!!!!


I have started slight wall squats, straight leg dead lifts with light dumbells, hip bridges on stability ball, and knee "lockouts" with a theraband. 


I have an occasional snapping in my patella....seems to be a tracking type of an issue....doesnt happen all the time.....then it will "snap" then be reasonably stable for a while.  It isnt painfull, just annoying.

The PT felt around, and said I have what amounts to...Patella Alta.....apparently when the tendon is shortened...it has a tendency to shift the patella to a slightly "higher riding" position on the femur.  He thinks this should be correctable with the PT/exercises and strengthening of the quad.


Any feedback from my fellow "rippers" re: patella alta???


Keep working at it guys.....This site is really helping my mental state as I grind through!



post #979 of 10797

Hi All, It's 10.5 weeks since surgery on 12/22. I guess I'm entering the discouragement phase. The first 2 weeks of PT I went from 60 ROM to 90. The last 2 weeks I went to all of 92 ROM. I do my exercises faithfully every day but can't seem to make much progress right now. My knee feels like it has a blood pressure cuff as tight as it can be wrapped around it with a 5 pound weight on top of that. Does anybody else have this same feeling? I am still wearing a short knee brace and using a cane. I think the cane is because of my fear of falling again. I know this is not an injury with a short recovery time but having a hard time getting my mind to accept that. Well enough complaining, back to doing my exercises.

post #980 of 10797

Afternoon fellow QTR's,


9.5 weeks post-op (12-31)   Finished up my first week of PT.  Started with 71 degrees ROM, am now close to 90 ROM.  0 - 60 feels very smooth, no pain.  60 - 90 it's pretty tight.  I am icing more and keeping the swelling down seems to help more.  My PT was disappointed at my second appt. as I was still swollen and sore from the first PT session.  I didn't work it hard because of the soreness.  My ROM was actually less than before.  She had me go through my exercises then determined she needed to increase my ROM.  While I sat on the table with leg hanging, she pushed lower leg until it was more than 90 degrees Maybe close to 100 -105 degrees.  She would hold it there for 30 secs, then release.   She did this 3 times.  HOLY COW THAT HURT! Pain was internal to the knee joint but was at the same level as when I tore my QT.


  After she was done though, my ROM was greater and my knee actually felt pretty good.  No Pain, No gain I guess.  Just breakng up that scar tissue.  


Munchkin,  my knee feels tight also.  Icing to keep the swelling down has helped that immensely.  I'm walking on my own now (no brace, no cane or crutches).  While at times, especially on downhill slopes, I don't feel steady, it is getting better all the time.  It will just take some time to get confidence again in our leg.  Like the physical rehab, we need to push the mental side as well.  Keep trying to do a little more each day and build your confidence up. 


Keep up the good work all.



post #981 of 10797

8 Weeks Post Op Today - Rt leg QTR 01/09, Surgery 01/11


Hello All,


The knee remains swollen, stiff as a board(!!), numb and sensitive to touch, even to just sheets & covers touching it. I still prefer to sleep with the zimmer on the leg but with just the bottom strap done up. When I toss n turn I can then help lift the leg by lifting the top of the zimmer.


Week 8 was a week of firsts, walked without a brace with crutches around the house a week ago, do this daily to work on my gait, jammed myself into the drivers seat and drove, walked without brace and crutches at PT on Thursday. Quite unsteady as the knee where the repair was done needs much work. ROM increased to 71 degrees from 55 the previous week.


Third visit to OS Wednesday where permission to go without brace & crutches on a common sense & as comfortable basis was given. The no brace part needs much work! 


ROM & strength at the repair (which I guess is also VMO related?) to get that stability back are the goals for the coming weeks. Hope to achieve 90 degrees on the ROM this week but will be satisfied with anywhere in the 80's.


Stay positive all! PMA remains the biggest challenge as the road to recovery is long and quite lonely!




Edited by Tigger44 - 3/9/2009 at 11:20 am
post #982 of 10797

What do I do now?  Fell down stairs at work.  Workman’s Comp.


11/25/08   QTR. Tendon torn away from bone.

12/09/08 –   Surgery. Three holes drilled. Tendon sutured to bone. Positive strep throat culture kept me out of o.r. for a while.

01/20/09 -   Staples out. Dr visit.

01/27/09 -   First PT. Given heal slide exercises and dismissed. 15 min.

02/10/09 -   Second PT.  Asked if I was doing my exercises. Measured ROM. 90 degrees. Dismissed. 7 min.

02/12/09 – Dr visit. Ask for new physical trainer.

02/13/09 - 02/16/09 – 02/18/09 – 02/20/09 – 02/23/09 – 02/25/09 – 02/27/09 – 03/02/09 – 03/04/09 – 03/06/09  1 ½ hour to 2 hours sessions with great new PT.

03/06/09 – Dr visit. Releases me. Tells me that I am doing great and I don’t need to come back. And I don’t need any more physical therapy.  ROM is at 112 degrees and strength getting better.


So I’m done?  I know the exercises.  I know the stretches.  I have even ordered a Goniometer to track my progress.  How many sessions/Dr. Visits before you were turned loose?


Edited by IowaQuadRipper - 3/9/2009 at 05:39 pm
post #983 of 10797

Hi everyone, It has been a while, I am great and getting better!


Iowa, my OS NEVER provided an order for PT. His rationale was that I was doing all of the work (rehab) that I needed to do. My outcome at 13 months post surgery is that things are great. Skiing in VT has been great this year and I was able to take full advantage with my son. I am on one end of the rehab spectrum having received Zero PT. I firmly believe that if you stretch, walk on even and uneven terrain (with and without weight), walk in the pool, swim, get on a bike and ride hard and easy, that your quad strength and agility will return. You are retraining your leg how to carry your body. Work it. One foot in front of the other!


The best of days to all. VS  

post #984 of 10797

Great to know.  I didn't really know what to expect when it first happened.  I've got a really good spinning bike and one of the old aerobic riders.  Believe it or not the aerobic rider has really helped me get my act together.


I've come back to this forum for encouragement many times.  I'm rooting for you all.  Thanks!

post #985 of 10797

Hello all,


Just wanted to give an update.  Am now 3.5 weeks post surgery for right QTR.  Haven't missed a day of work  (Friday surgery) , have been going to gym for upper body and left leg work, and have been doing adduction/abduction exercises morning and night, eating LOTS of protein.  Did mult-day trip to NYC in which I crutched for up to 14 blocks at a stretch, and am now in Europe crutching through airports on a multi-day / multi-city swing.  I'm actually finding that being on the crutches with the brace, set for up to 30 deg ROM, is helpful.  I'm at the point where I can contract my quad on every step, and while very tight, the leg is doing well and recovering some strength already.  Can now do step ups onto a 6 inch block now without difficulty.  Am looking forward to getting into a formal PT program in a few weeks after I see the OS.  Because of the work I do, I really don't have a choice--particularly in the current economic environment--not to travel and get out.  However, I feel the movement and extensive crutching about is actually facilitating relatively rapid recovery.  I'd probably not be as active if I didn't have to be because of work.  So perhaps erring on the side of more rather than less activity could have benefits for people with this injury.

post #986 of 10797

IowaQR:  sorry to hear about your injury. I too did the step slide injury.  My injury was 10/27/07 and surgery 11/12/07.  I finished my initial PT 1/23/08 and PT suggested continuing my exercises for 2 more months. I received a prescription from my OS at that time to use our retirement community's heated pool with a treadmill which was under the supervision of a different PT.  As you have probably read, pool activity is highly recommended by many of us QTRs.  After a short time I moved to activity in a regular pool which was (continues to be) helpful.  I also had regular sessions on my own using rotational weight equipment at my club.  I took the summer off from that beleiving my outdoor activity was strenuous enough. Wrong! When I went back to the club I was surprised how much I had lost.  So my suggestion is to continue the boring home exercises and add other outside exercises (weights) and a pool if available.


Best of luck!



ps...sorry for the dismal Hawkeye BB season!

post #987 of 10797

This is a horrible injury but what appals me on reading cases like Idahos is the degree of medical negligence which there appears to be in the USA in diagnosing and treating competently quadriceps ruptures.


I am 69 years of age and was reasonably sporty and still a fairly keen swimmer and walker. I ruptures two of the four quadriceps tendons in my right leg at the end of September. Even in Greece I was correctly diagnosed virtually immediately subject to  confirmation by a scan later the same day.


The most important thing is that surgery has to take place, if complications are to be avoided, within 24 to 48 hours at the most. My surgery was done reasonably competently although some of the internal stitching was done in such a way that it has left a lumpg of hard muscle just above the knee.


However my surgeon failed to advise me of the need for immediate physiotherapy - par for the course in Greece where a rival prfoessional would never be recommended by a proper doctor. I was given the wrong exercises and it was only at the beginning of January that I consulted a physiotherapist .  Fortunately she is tremendous. Having qualified in the UK and worked at a leading hospital in London she had worked on famous footballers leg injuries from the UK premier league and including Chelsea FC.


She was concerned about the delay but now hopes to have me right by Easter.  She started off by giving me a range of exercises designed to replace wasted muscle in  the right thigh and also to enable me to get full flexion and extension in the damaged knee. I was initially over 5 degress off being able to straighten the damaged leg.  Now I can get it 100% straight.  The exercies progressed so that now I am doing exercises raising and holding my damaged leg up with 2.5 kilogrammes of weights strapped round the ankle. I am also on a cycling machine and treadmill for the past two weeks.


Even after five and a half months I still have problems going downstairs and steps.  The knee does not feel safe when it has weight put on it in a bent position and this is the last thing which she will start work on for the next three weeks or so. I still get a pulling sensation in  the muscle above the knee and in wet and cold weather it still hurts.


Without the physio I could have become lame because the imbalance would have eventually affected my hip and my ability to walk normally.


The two main things are to get immediate surgery where surgery is required and not to leave it in the hope that it will get better - if it is severed, it wont.  The second is get  a top grade sports injury specialist to start physiotherapy from day one after surgery.  Had I been advised to do that I should have been mostly recovered by New Year instead of it dragging on until Easter.  As it is I dare not run or jog yet and that will take longer.  I go for a 3.5 km walk nearly every day  and have now also started walking barefoot in soft sand on a beach.


I hope this will enable others to escape some of the problems which the medical profession appears to create with this type of injury, all too often.



post #988 of 10797


Originally Posted by chihibulldog View Post


IowaQR:  sorry to hear about your injury. I too did the step slide injury.  My injury was 10/27/07 and surgery 11/12/07.  I finished my initial PT 1/23/08 and PT suggested continuing my exercises for 2 more months. I received a prescription from my OS at that time to use our retirement community's heated pool with a treadmill which was under the supervision of a different PT.  As you have probably read, pool activity is highly recommended by many of us QTRs.  After a short time I moved to activity in a regular pool which was (continues to be) helpful.  I also had regular sessions on my own using rotational weight equipment at my club.  I took the summer off from that beleiving my outdoor activity was strenuous enough. Wrong! When I went back to the club I was surprised how much I had lost.  So my suggestion is to continue the boring home exercises and add other outside exercises (weights) and a pool if available.


Best of luck!



ps...sorry for the dismal Hawkeye BB season!


I will get better. Hawkeyes, I don't know.


My first post didn't sound very good.  The group of PT's I had freaked out when they found out I wouldn't be coming back.  Which kind of upset me.  The first trainer I had didn't give a whup.  Which was very evident.



post #989 of 10797

Here's an update on my progress.....  I tore both (yes, both) quadriceps tendons on February 22.  Had the surgery on March 2.  In 2 days, it will be two weeks post-op.  My doctor had me start physical therapy one week post surgery.  This forum has been so helpful and inspiring to me and I am eternally grateful.  I can't believe how little information there is on the web about BQTR.  It seems to me that about 95% of all quad tendon ruptures are either left or right.  Yet there are a few of us bilateral people out there....  I had a really rough time for the first week post-op.  But I'm now taking this one day at a time - and benefitting from all the info and advice on this forum.  Thanks to all.

post #990 of 10797

9 Weeks Post Op Today - Rt Leg QTR


Not much new to report, the knee remains quite swollen, stiff and numb which is EXTREMELY frustrating. The more I try to work it, the more it swells, which of course makes it VERY difficult to want to work it! #%^%$#&*


Reached 80 degrees ROM this week but anything past around 30 degrees is pushing through stiffness. I've concluded this is the norm but a small part of me thinks there is something else wrong in there?


Looking into smaller knee brace choices available out there - one that will help with the stability issues now and also be of use down the road when I play any of the various sports  I am fond of. Any recommendations out there? 


Welcome IQR, keep up those exercises and just work it as a normal knee, as difficult as that may be, as I am discovering. Great to hear from you VS, Jakster, Bulldog, Ian & Adrian - good to hear everything went well for you Adrian - have been wondering how things were with you - keep up the super attitude and effort!


March Break here and the weather looks gorgeous for some outside walking!


Stay positive all - Steve

Edited by Tigger44 - 3/15/2009 at 02:29 pm
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