The SPECIALIST'S OFFICE => Ruptured patellar tendon or ruptured quadriceps tendon => Topic started by: AeroDave on March 02, 2006, 06:58:52 PM

Title: Quad rupture rehab pain
Post by: AeroDave on March 02, 2006, 06:58:52 PM
Hello people

This is my first time I have ever been in any chat space let alone this one. Hope I am doing this right. Anyway, at the end of September 2005 I tripped on two steps at work and landed on the side of my left  foot. I ended up with a tib-fib spiral fracture in the ankle, but worse than that I experienced full bilateral quad ruptures. I was rushed to hospital where the next day underwent a 5.5 hour surgery where I got 9 pins and a plate in my ankle and the quads re-attached in each knee - I gather they sort of drilled three tunnels in each kneecap and fed the tendons in there and sutured them. Then I spent a month in hospital in cylinder casts and another month in a hospital bed at home.

So far everything has been going along pretty good - my physio says I am really ahead of the curve in rehab. Full ROM on the ankle, full ROM on the right knee and 90% on the left knee (my left knee lagged behind my right knee in rehab because I favoured it while my ankle recovered. Full weight bearing on both knees now too. My problem is that I have bad days and good days. Lately there seems to be mostly bad days. I experience really strange pain at the point where the quad tendons attach to the kneecap. Never before have I ever  felt this sort of pain. By the end of each day, I can barely walk up stairs. It feels as if (especially the left) my tendons are about to rip out of my kneecaps. Sometimes there is strange burning/tingling sensation that gives me the creeps - like I just ripped something.

I was fairly active prior to the fall despite my 55 years - playing a lot of ice hockey, golf, downhill skiing and cycling. Now, 5 months after the fall all I can do is spin-cycle classes. 

What I want to know is am I doing something wrong? Is this pain typical? Should I slow down? Should I worry. Should I rest more? If I climb into bed and stay there for a while, my knees seem to get better. My best days are after an evening when I get in bed right away and stay off my feet. It has been my goal to play hockey again. Is this asking way too much. What are the risks? Has anyone else out there gone through this ? Help!!!

By the way, about five months prior to the fall, I tore a hamstring severely playing hockey. After that I was always stumbling on the left foot - that's why I fell. I also have always had lots of knee pain and was about to see my sports medicine doctor about knee instability (hockey again)
Title: Re: Quad rupture rehab pain
Post by: Janet on May 16, 2006, 02:48:29 PM
Wow! You really did it to yourself!

What does your OS say about your progress? It seems to me you are doing well. I had a quad rupture in one leg (with no other injuries along with it), and my OS told it would be 12-18 months before I forgot I had an injury. My OS also told me he had a patient who had bilateral ruptures and that patient didn't return to work for over a year. As for me, it has now been seven years and I've had four surgeries due to complications and am looking at a knee replacement, so I'm not the best person to tell you about a normal recovery. But I never got full ROM back. At five months I couldn't even go around on the bike.

My guess is that you're just expecting too much too soon. Don't forget that you had a really major injury. It takes longer for soft tissue to heal than bone, and a really, really long time to build muscle. You may just be stressing the muscle and tendon as it gets tired (but I'm not a doctor, so that's just a  guess!). You should listen to your knees and rest when needed. Most recoveries go forward and then take a step back. But if you think you are backsliding or getting worse, go straight to your OS. Good luck and keep asking questions.


P.S. There is also a thread under the Post-op section from someone with a quad tendon repair. Nobody has answered except me. There just aren't many people here who are dealing with this. Perhaps you could take a minute to look there and see if you could help that poster, too.
Title: Re: Quad rupture rehab pain
Post by: Walpurgisnacht on June 21, 2006, 07:55:44 PM
Hello all. This is the first time anywhere on the internet that I've read of a similar injury to the one I have. I didn't rupture both quad's (just the left) but I did get a spiral fracture of my left fibula that required 7 pins and a plate. I wore a hip length fiberglass cast for 6 weeks before it was removed last Tuesday, 6/13. I'm still trying to get a PT to come to my home as walking outside is still fairly impossible. Still, I need the PT and at least the paperwork is being shuffled about. Until he/she gets here, I've been doing exercises on my own and have had varying success. ROM seems to be the kicker as I cannot bend to anything close to 90 unless my girlfriend is pushing on it on only after the first few tries, nd even that is at the my pain threshold. I've been walking on my leg and doing laps in my apt. building's hallway (30-35 yards) and did 10 lengths. Rested a bit and did 4 more before my ankle and still weak quad said stop. I want to add step ups onto a thick encyclopedia and mini-squats to help improve strength. Is this satisfactory for now or similar to what a PT would do? Please help. i do not want to waste any time doing nothing when I could be helping myself.

Title: Re: Quad rupture rehab pain
Post by: Janet on June 21, 2006, 08:26:21 PM
I wouldn't push it until you see a PT. You can do heel slides to keep your knee moving, and straight leg raises to get your quad to fire. Remember, your body is healing from a major injury. The last thing you want to do is re-injure your knee. I'd say keep it safe, simple and gentle until you see a PT.

Title: Re: Quad rupture rehab pain
Post by: Walpurgisnacht on June 21, 2006, 08:58:48 PM
Thanks, for the advice, Janet. I'm not doing anything that I feel pain with. The mini-squats are in my walker and the walking stops when my quad feels like it's about to cramp, fatigued, but no real pain as I'd feel with other movements, such as squats. I did the leg raises first one at a time, now sets of 15 as one continuous rep with no resting the leg down until the set is finished. Then I'll do the adductors and abductors the same way. After doing the mini-squats and the leg raises this way, I've been able to walk on the limb with greater comfort, or maybe less discomfort is more accurate at this stage. The doc cleared me for full weight bearing on the ankle and knee so I think I'm safe. Haven't felt strain on the knee but here's what I'm experiencing. I don't have any swelling at the all. It feels generally great except for the tightness on top where the quad was reattached to the patella. It feels like the muscle was pulled down a bit further than it was before and attached. I feel tightness on top in this thicker , super hard area of tissue, but no swelling seems evident, even after a hard exercise session and stretching. But this still seems to be what's limiting my ROM. Is that going to stretch out eventually or is it the rest of the muscle supposed to stretch to compensate?