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The SPECIALIST'S OFFICE => Ruptured patellar tendon or ruptured quadriceps tendon => Topic started by: Griceberg on December 08, 2014, 03:39:27 AM

Title: Weakness and atrophy after quad tendon repair
Post by: Griceberg on December 08, 2014, 03:39:27 AM
Hey everybody.

I had quad tendon repair over 8 years ago and I continue to have atrophy, weakness, and soreness in my leg. I've asked a few doctors why the atrophy isn't reversable and have yet to get an answer. Has anybody on this site gotten an answer from any doctor about this issue? I'd love,to know why it never gets back to normal. My right thigh is like a wet sponge.
Title: Re: Weakness and atrophy after quad tendon repair
Post by: Stuart Rulka on December 09, 2014, 06:21:38 PM

Griceberg, firstly, condolences are in order. Most of us with a RQT have experienced some degree of atrophy but have managed to regain most of our loss.
   With all due respect I suggest very strongly that the Doctors are not the right people to whom to pose your question. Find a Physiotherapist with experience handling rehab of this injury and put yourself on his/her hands. The OS is, of necessity, concerned primarily with ensuring the success of his Surgery, rehab is secondary. Only a Professional in Rehabilitation Medicine, experienced with dealing with this relatively rare injury, and who has kept current with the latest techniques, can focus exclusively on your recovery. All others must recommend a very conservative approach. After 8 years you will need expert help!
Good luck.
Title: Re: Weakness and atrophy after quad tendon repair
Post by: mojocpa on December 10, 2014, 05:32:21 PM
I did the double over a year ago and I have to say my quads are stronger now than before the fall. Having done the double, I had to use the muscles equally versus a single that may "cheat" and rely on the good leg. Just a guess. Dave J
Title: Re: Weakness and atrophy after quad tendon repair
Post by: Griceberg on December 10, 2014, 06:09:47 PM
Hey guys. Thanks for the replies.

Let me just say this. I had been involved in sports most of my life. For a good part of that time, I participated in powerlifting. Not to make myself out to be a genius, but I know how to train. I've got extensive practical experience and education related to weight training/sports training. I also had two sessions of PT after my surgery with a good therapist.

My question, which I might not have asked in the right way, is this: Why does the contour of the muscle not return to normal? Why does the atrophy remain?

I guess what I'm saying is that when I ask the doctor aboutthe surgery and he says, "It's fixed," it's only fixed and not "normal." What I want to know is, why wont the muscle and tendon grow back and function like normal? It's in the right place.

I can work out like a champ for months and my right leg is clearly smaller that my left. And what little gains I do happen to make are totally gone after about a week if I don't work legs a couple of times. It is extremely disappointing and discouraging. Not to mention, I'm embarassed to wear shorts any more.
Title: Re: Weakness and atrophy after quad tendon repair
Post by: fishy on December 11, 2014, 10:23:00 PM
Fishy here....double RPT.  My PT said that I could expect about 80% recovery of muscle mass, contour though is more like cottage cheese.  I have run 50+ marathons and I was very proud of my tight gluteus and beautifully contoured legs.  Age took some (67 yo) and the accident took the rest.  I am now 18 1/2 months post injury and walking is mostly normal, stairs are slow and going down stairs is still really slow.  I really had a great Doc and my PT was a seasoned Army Captain (I had my operation and rehab at a VA hospital in Anchorage, Joint Base Elmendorf/ Ft. Richardson, JBER)...I rehabbed with 20something testosterone driven troops that had leg injuries far worse than mine....and I still need to continue to rehab by exercise....it will be a life long thing for me.... hope this helps....  Bob
Title: Re: Weakness and atrophy after quad tendon repair
Post by: Stuart Rulka on December 12, 2014, 02:59:39 AM
Griceberg, as usual I seem to represent one extreme. Almost as ancient as Bob (2months short of 67)  my quads are basically symmetrical again. Not as well defined as they once were, but the age thing..... I was in good shape when injured, hiking 1hr  of steep grade at 90% max cardio 4 times a week. Fortunate to have Surgery 16 hours after rupture. Started PT at 2weeks, riding a bike at 3 and back hiking one of the world's 10 most dangerous Hiking trails (Vancouver's Grouse Grind) at 6 weeks.
  It is my contention that  my recovery owed everything to the rapidity with which my PT ( Chief of PT for the Vancouver Olympics) got me moving. This was completely at odds with my OS , who originally wanted me to put off hiking for a year, then relented to a mere 6 months. Had I followed his advice I might never have regained my former Quad strength. Still 10% off my former times but at 66 a six week layoff will do that.
 This is why I keep reiterating that the Surgeon does the a Surgery but should let the PT look after the Rehab!
I really don't understand why you have been unable to regain your Quad contour and strength. Must be some other factor at work.
Title: Re: Weakness and atrophy after quad tendon repair
Post by: destroyedbothtendons on December 13, 2014, 04:26:51 PM
Fishy,
18 & 1/2 months and you are still struggling down stairs?  That's not what I wanted to hear.  I was actually expecting/hoping to be pretty much functional by that point.  I will be at 1 year this upcoming week.  I am finally able go down steps without stopping both feet on the same step and without turning my body.  Of course there needs to be a railing and when my left leg is supporting most of my weight I am really holding on. 

Good Luck to you.
Title: Re: Weakness and atrophy after quad tendon repair
Post by: fishy on December 18, 2014, 07:36:50 PM
Fishy here.... hey Destroyed....., yeah, I had hoped to be able to do much more than I currently can do.  There are soooooo many positive things to take from this event.... I got my legs back.... I can walk and function so I can go forward to complete my lifes journey.... I may not run but I can walk, I may not climb and descend without trouble, but I can climb and descend, period.  And the pain is diminishing.  I imagine that I will continue to improve because I want to improve.  Keep up the great postings, and I will be doing the same.   Thanks, and to all.....stay positive    Bob
Title: Re: Weakness and atrophy after quad tendon repair
Post by: bballkingofnba on December 19, 2014, 09:17:31 AM
How is your range of motion in the leg? Do you have full extension and full volitional control of your quads?
Title: Re: Weakness and atrophy after quad tendon repair
Post by: mojocpa on December 19, 2014, 03:09:06 PM
I am with Fishy on this one. Declines and going down stairs still suck, but at least I can do them. I am not in a wheelchair or using a walker or crutches. If this is what life gives me, I will gladly take it. 
Title: Re: Weakness and atrophy after quad tendon repair
Post by: destroyedbothtendons on December 24, 2014, 05:35:36 PM
Don't get me wrong as I am not complaining about my woes.  Last year at In-Patient rehab I saw many people who were in a much worse place than me.  It's just that the OS and the PT gave me the impression that I would make a full recovery.  There is no pain to speak of and just occasional stiffness.  The worst part is than I can no longer bowl (American bowling) properly.  If this never comes back I will be one sad person.  I will also be wondering if I wasted all this time at the gym in an attempt to get to a point that isn't realistic.

Thanks for the kind thoughts.  Good luck with your recoveries.
Title: Re: Weakness and atrophy after quad tendon repair
Post by: Stuart Rulka on December 25, 2014, 06:20:19 PM
Destroyedbothtendons. Merry Christmas, remember time spent at the Gym is never wasted, even if you never quite regain your old form. You will always be the better for it.
   Good luck.
Title: Re: Weakness and atrophy after quad tendon repair
Post by: mojocpa on December 26, 2014, 11:36:34 PM
Destroyed, a lot of it is mental in my opinion. I had one instance where I was backing up and almost stepped on someone else's foot, the reaction was one of that knee mentally buckling - every one around me was asking if I was okay. I also think that we are more cognizant of our knees now and don't take them for granted. As far as full recovery goes, I think everyone is different as far as the amount of recovery.  If you think about bowling, it depends a lot on your knees. Things do get better, it is just everybody heals differently. Stuart was doing his Grouse Grind shortly after his surgery. I believe that is mostly uphill, though. I will be happy to get to the point of walking down stairs with something in my hands "normally". But if it does not happen, then so be it, I will go on with my life.
Title: Re: Weakness and atrophy after quad tendon repair
Post by: destroyedbothtendons on January 09, 2015, 05:03:23 PM
So last night I informed my teammates I will no longer be bowling.  It just wasn't worth the aggravation to be that bad at something that I used to really enjoy.  Hopefully someday I will get back there. 

Thanks for the moral support.  Maybe I just expected too much too soon.
Title: Re: Weakness and atrophy after quad tendon repair
Post by: Thomas99 on January 10, 2015, 02:12:00 AM
I feel your frustration destroyedbothtendons, I also used to play ten pin bowling with a quite respectable average of 190. I'm also Worried that I won't be able to bowl again. Just the thought of putting all my weight on my injured knee, gives me the nightmares of collapsing in a heap. I may now never get my elusive 300 game ( came close with a 298).

Is there anyone else out there that has been able to play ten pin bowling after rupturing their bowling leg tendon ???

Less than 2 weeks for my second surgery attempt to fix my left patellar tendon.
Title: Re: Weakness and atrophy after quad tendon repair
Post by: destroyedbothtendons on January 23, 2015, 06:44:04 PM
So last week I went back to the OS to discuss my issues with my left leg.  After taking a look and showing him what I could(n't) do he gave me a script for an MRI.  Since most of the script was written in the usual "Dr. Handwriting" I couldn't really make out most of what it says.  The word "RETEAR" was pretty clear though.  The MRI was last night but I have to wait until my appointment of Feb 3 for the details.  Hopefully I will get some answers to put my mind at ease.  I will update with the news.

Thanks again for all of the support.
Title: Re: Weakness and atrophy after quad tendon repair
Post by: Thomas99 on January 23, 2015, 10:27:12 PM
Wishing you all the best destroyed both tendons, hopping you have not got a retear, like i had, which was re-operated on 2 days ago.
Title: Re: Weakness and atrophy after quad tendon repair
Post by: destroyedbothtendons on February 03, 2015, 06:10:38 PM
My MRI showed that the quadriceps tendon in my left leg did not heal properly.  The choices are to have another surgery or have limited use of my left leg for the rest of my life.  I chose the surgery because I have to get back to bowling again.  This basically means starting from scratch (but only 1 leg this time and not 2).  Same recovery procedure.  4 weeks in an immobilizer & 4 to 6 weeks in a bledsoe brace.  At least I get to do this on my terms this time.
Title: Re: Weakness and atrophy after quad tendon repair
Post by: Thomas99 on February 04, 2015, 12:48:54 AM
Sorry to hear about needing further surgery, but like you said you don't really have a choice but to go with surgery again. At least it will be easier this time around, due to prior experience.

Hang in there, I know it can be quite devastating being told you need to have the surgery redone, look on the positive side of healing fully and getting back to bowling.

I'm 2 weeks post op from my own revision surgery and things are a little easier 2nd time around.

At least you can plan and organise before the upcoming surgery. I bought heaps of groceries, drinks, non perishable stuff to stock up prior to my revision surgery. Felt like I was one of those doomsday preppers you see on tv.

Do you have a date for your new surgery ?
Title: Re: Weakness and atrophy after quad tendon repair
Post by: destroyedbothtendons on February 04, 2015, 01:40:19 PM
April 2nd.  Doctor said I am no more likely to hurt myself than if I was never injured in the first place.  Already scheduled some vacation time and the ability to work from home for the month of April.  Fortunately it is my left leg so I should be driving as soon as I get the immobilizer off.  Knowing what to expect is certainly a relief.
Title: Re: Weakness and atrophy after quad tendon repair
Post by: destroyedbothtendons on February 25, 2015, 07:31:09 PM
Yesterday I went to a different orthopedic to get a 2nd opinion.  He basically confirmed what the surgeon told me.  I don't "need" a 2nd surgery but if I "want" to do certain activities (Bowling...) I will "want" to get the surgery.  His description of the issue was pretty much identical to the surgeons and when I asked about the tendon not attaching properly he said it does occasionally happen. 

So the surgery for April 2nd is still a go...
Title: Re: Weakness and atrophy after quad tendon repair
Post by: destroyedbothtendons on March 31, 2015, 04:24:13 PM
So tomorrow I am having a 2nd surgery to repair the left tendon that didn't heal properly.  This is the primary reason the strength in that leg was just not coming back.  They drilled 3 holes to attached the tendon in 3 spots and the center one didn't take (or I tore it, I don't think I'll ever know for sure).  The MRI shows a big white spot where that part of the tendon was supposed to heal.  This is basically starting from scratch but with only 1 leg instead of both.  No wheelchair but crutches for a month while the leg is completely immobilized.  Then back to braces, PT and all of that other fun stuff.  This does mean shorts and no underwear (TMI?) for a month which is a small plus.  Hoping all goes well.

Thanks for all of the support since I found this group.

Good Luck to all of you who are still going through this.

Take Care.
Title: Re: Weakness and atrophy after quad tendon repair
Post by: jcolarelli on April 03, 2015, 02:33:55 PM
Hope all went well yesterday, destroyed.

Good luck and godspeed with the recovery.  Maybe I'll see you at PT soon  :)
Title: Re: Weakness and atrophy after quad tendon repair
Post by: destroyedbothtendons on April 11, 2015, 09:09:05 PM
According to the Dr. the surgery went very well.  He was able to rescue the original tendon and attach it.  I am already able to straighten the left leg better than before the 2nd surgery.  I now longer need to use crutches but I am wearing the braces fully locked in case I fall.  I am allowed to take it off to shower/bath.  According to the Dr. I will be getting rid of the brace completely on May 4th and be able to start PT.  The only "pain" I get is later in the day my leg gets tired from dragging around the brace all day. 

On another note for anyone in the Southern NJ (USA) area:  My 2nd surgery was done by a Dr. at the Rothman Institute and the 1st surgery was not.  This original Dr. was going to cut my tendon and basically start from scratch.  I don't know if he still would have done that after he got in there but I am glad the new Dr. didn't as this appears to allow for a much quicker recovery time frame.


Thanks for listening.

Title: Re: Weakness and atrophy after quad tendon repair
Post by: jcolarelli on April 13, 2015, 01:42:55 PM
Great update, glad to hear it all went well.  My Dr. is from Rothman too, we should compare notes.   :D

I like the Dr but truly hate his PA....

Here's hoping for a speedy recovery this time!  Best of luck with PT.  My insurance has me capitated to Novacare. I use the Moorestown location (for the 2nd time, torn menisucs in 2013) and have had good experinces there if that means anything for you, not sure what coverage that you have.
Title: Re: Weakness and atrophy after quad tendon repair
Post by: destroyedbothtendons on May 05, 2015, 05:38:52 PM
P.T. starts today after seeing the Dr. last Thursday.  I have to break in a new therapist as my previous one is about 9 months pregnant. 

The OS "strongly" recommended that I keep the braces on most of the time.  It will take the sutures about 3 months to completely attach and that stress could cause them to tear.

Jcolarelli - I went to see Dr. Marchetto at the Rothman Institute.   My prior therapist is familiar with him and had good things to say.

Let's see how P.T. goes....
Title: Re: Weakness and atrophy after quad tendon repair
Post by: jcolarelli on May 05, 2015, 10:29:27 PM
Only 9 months?  No excuses, your rehab is at stake, haha.

Glad to hear everything went well.  I'm seeing Dr. Pepe at Rothman.  He did my meniscus repair in 2013, so I went back to him when this occurred.

Good luck with PT!
Title: Re: Weakness and atrophy after quad tendon repair
Post by: destroyedbothtendons on May 15, 2015, 10:09:49 PM
I survived my 1st week of P.T..  I actually feel pretty good other than some fatigue from the exercises.  Only really need to go twice a week as opposed to three for my last injury.  Only 1 leg so the exercises take 1/2 the time.  I am also about 1/2 way thru my 12 weeks of the brace.  This I can't wait to get for it to be gone. 

Good Luck to you all.

Thanks

Title: Re: Weakness and atrophy after quad tendon repair
Post by: bowlermk on August 06, 2015, 02:02:24 PM
Hello all. As you can see from my screen name I am also a bowler. I am a member of the Professional Bowlers Association and used to a pretty decent bowler. I had my "mishap" on April 12 and the surgery the next day. I can now walk normally on flat surfaces, but stairs are still a problem. I live in NJ and commute to NY to work so I go up and down A LOT of stairs each day. It is getting easier but not fast enough for my taste. As for my bowling - I have started bowling again and will be bowling in the fall leagues. I am not 100% but at least I am able to throw the ball. The biggest problem is my left knee, the knee I slide on. I have bad arthritis in that knee and since I am using it to compensate for the injured knee, it is now giving me lots of pain. I take Advil and Tramadol and wear braces on both knees but I'm bowling. My PT was actually tailored toward getting me back on the lanes. I just wish someone would tell me when I will be 100%
Title: Re: Weakness and atrophy after quad tendon repair
Post by: Stuart Rulka on August 06, 2015, 04:42:22 PM
Bowlermk, like you I suffer from arthritis, and similarly have been suffering in the non injured knee, also hips, probably from change in gait. Don't know your age, but definitely a factor. I was 65 at time of injury.
   Good news is, even at my age, I was at one extreme end of the scale. Returned to work four days after surgery and resumed hiking at 6 weeks, uphill only. I was obviously very fortunate, but listen to your body, and your PT, and all is not doom and gloom.
  You can follow individuals stories by tapping on their names. :D
Title: Re: Weakness and atrophy after quad tendon repair
Post by: jcolarelli on August 06, 2015, 05:15:17 PM
Hi Bowlermk - i'm just over 6 months post-op and I still have the same issues that you're having.  Steps are the worst for me still.  I can walk mostly normal, but the pain/popping in my knee are bad going up and down stairs (inclines/ramps can be a challenge too depending on the pitch).  Not sure if that's related to the cartilage damage that was sustained that went unrepaired, but it could be.  I was released from PT and by the original OS in early June, and it isn't getting any better.  So I plan to seek out a second medical opinion with a different Orthopedic in the coming weeks.  Thanks to insurance, I'll have to go the route via my primary care doctor for tests until that can happen though.  Ahhhhh fun fun fun....

Where in NJ are you located?  There are at least 2 of us on the board here in the South Jersey area.  Good luck!
Title: Re: Weakness and atrophy after quad tendon repair
Post by: bowlermk on August 06, 2015, 10:55:43 PM
I am in Manalapan. I'll be 58 soon but I feel like I'm 80. My OS kept me immobile for about 6 1/2 weeks post-op, then therapy. the bad news is that because I work in NY I don't have the time to go to therapy 3 times a week any more. The good news is that during the commute I do more walking and climbing and descending stairs than I did during the therapy. I have been back at work for 3 weeks but I have not been able to do the commute 5 days straight yet.