Ruptured Quadriceps Tendon

[bill.cochrane]

Bob,Brandon & other fellow wounded,
I am 16 days post op now and I go and see the os tomorrow,I think everything is coming along fine I can put full weight on my leg and can walk albeit slowly without my crutches.The scar is drying out and it joins my collection of others picked up as 35 years as a paratrooper.I am going to get 30 degrees or more of knee bend tomorrow to allow me to sit in a plane seat as I am going home to Brisbane on Tuesday.One of my worries is how to keep of unwanted weight gain due to enforced inactivity do you have any suggestions on how to stop this happening?I have yet to do any real physio, what sort of exercises are we able to do when we can?Yes Bob at least I will be able to get into my pool when I get home as the weather in Queensland is getting warmer with summer approaching.Anyway thanks for providing a sounding board during this time I hope you are progressing well.
Regards,
Bill

[BTI]

Bob & Bill,

Your updates are much appreciated, I look forward to them.  I am at day 38 post op.  This Tuesday is my 6 week post op follow-up where I will be placed in the Bledsoe Hinge brace and hopefully get the go-ahead to begin physical therapy.  My leg feels like it wants to do more than just sit idle in this full leg immobilizer!
Bob, you sound like you are making progress, don't be so hard on yourself when you don't feel as if you are making gains...lots of damage in there, takes time. 
My wife and son went on a road rally race today with 270 other Mini-Coopers!  I sat comfortable in the front passenger seat for over 3 hours!  I can't wait to drive...I feel like I can however, but the wife says NO!  Bob, I can't get over how much you are doing so quiclkly...GOOD FOR YOU! 

Bill: 16 days and you are standing AND walking a bit!  WOW!  You are an animal...be careful...don't get cocky and think you can do it all...Oh, lay off the junk food! Ha!

I'll send another update on Tuesday to let you know what the OS advises regarding rehab and range of motion.  I feel like I can do leg raises, walk with a cane...but I am very cautious, fearing I will do additional damage. (some of the posts really freak me out!)

Be well guys...stay positive!

Brandon

[sjdean]

I would recommend isometric exercises

One thing I've learnt, is that different OS have different approaches. The second time around, my physio wanted me doing all sorts of stuff (as the doctor never gave any advice to her). It was only when I caused a stink and spoke to the doctor that I was told good god no, under no circumstances should I be doing the exercises proposed.

I think it's useful to discuss what treatment regimes we all had and give the victim, er, patient something to go back to the doctor with and ask.

Your doctor should be telling you what to do. If he isn't, he isn't doing his job IMHO.

Cya
Simon

[sjdean]

Sounds like you are coming along quite well, boy the different ways that different OS's treat this surgery (or any other at that), seems to be totally different!  I am only 13 days post-op, and for the past 2 days I've been using the 30 degree lockout immobilizer, and been slight weightbearing (they told me that OK once I had that huge cast off, which was just 6 days post-op).

Unfortunately, one can never be sure what technique they used inside, whether it was a straight join and sewing back together, or some more elaborate move involving drilling holes in your kneecap. Sadly as I've realised, all injuries and all repairs are sadly not equal.  Though six days post op seems ridiculously early. I mean, if you twist your knee in some way (accidents are common), you could do that repair quite a bit of damage - unless they've gone and repaired it incredibly strong.

It's every patients duty to enquire, and every doctors duty to tell you what they've put inside you and what their reasons are.

Hopefully both you and I will do just fine, and come out of this with just a scar on a leg!  The process is so slow sometimes, the inability to even carry a glass of water to the table is so foreign to me!  If I have to go through this whole process again, I swear I could not do it.

You could. You definitely could. You've been through it once, you're an expert. You know how to hold the crutches, you'll be back on your feet in no time. The only thing that will get to you, is why different surgeons have different protocols and why have they given you no explanations as to what they're doing or expect.

First time I went through the process, I struggled like anything. I couldn't use the crutches or anything properly. I didn't know how. I broke down in tears in the hospital because I felt so helpless and useless.

Second time around, I whipped the crutches to my side and got straight up and about. I had already figured out how to sit down, how to get into bed, get around the house, get out of the house, how to get in the car (to be driven), how to get up and down the stairs, how to wash. All those things you had to learn before, you know them now.

Next time, it'll be easier.

But one word of advice.

Don't do it again.

Cya
Simon

[nhbob]

Hi guys,

Simon, I think it is true, everyone seems to have different approaches and speeds for recovery.  Bill, I think it's fantastic that you are weight bearing, sounds like you are well on the way to recovery.  I feel like I am somewhere between Brandon and Bill as far as the aggresive (or conservative) approaches to this recovery!

Well today I had my first PT appt.  It was great, they seem to understand the seriousness of the QTR, and my OS, even though he had me in a 30 degree locked brace from just a couple of weeks post-op, he wants me to stay at that 30 degrees for now.  I am now able to hit the 30 degree lockout easily... just becomes uncomfortable if I have to keep it at that 30 for a long time (like sitting in an uncomfortable chair at a restaurant... that happened today).  But as I said, it will remain at 30 degrees until at least Wednesday of next week (which will be 5 weeks post-op).

The PT was mostly evaluation, but Pam (excellent and very understanding of what was going on, and being conservative)... basically has me continuing to massage around the surgery area to break up scar tissue, and showed me how to push some pressure left/right and up/down on the patella to help break down scar tissue... all part of the "aggresive massage" to the surgery area that the OS had me start once I got the cast off.  The last part of the PT involved electrical stimulation (I don't know the exact name of the machine) of the inner quad muscle... it was a 20nminute session of stimulation for about 5 seconds, with 12 second intervals between contractions.  I would work along with the contractions the best I could... I guess this is all to reteach my muscles on what they are supposed to do.  It seemed to be productive, like working out without working to hard on my part.  I have two more appointments this week, Wednesday and Thursday, then the OS next week.

Even though it seems very slow, I guess I am making progress once I think about where I was a week ago.  One thing though (and Bill, I'm jealous), I still can't go without the crutches... I can get buy with one crutch for a bit... but my bad knee will seems to not support my weight yet.  And that brings this wordy response to the most visible and positive outcome for me so far:  For the longest time, it seemed I could not even begin to do any type of straight leg lift... even after the surgery it seemed my muscles were just not attached (I was beginning to think I had ruptured my patella tendon too... it really concerned me).  Well anyone that is going thru this type of recovery, I'm happy to report that I am finally able to lift my leg of the ground, but I have to concentrate on how to do it, it's almost surreal that I just cannot pop that leg right up into a lift like my good leg does... so I guess this is the point of the PT right now, is let those muscles get their brains back!

On the life quality side... I drove today for the first time in 5 weeks!  I was going to borrow my boss's Dodge Caravan, but I could not get into the Caravan, the seat was too high and the door just does not open enough.  I can fit great into my Subaru, but I can't operate the clutch pedal, so I bit the bullet and rented a car today, and I can drive!!! Which brings me to my first day of work, which will be tomorrow (Tuesday).  I hope it goes OK, sometimes keeping the brace on for a long time bothers me, especially an uncomfortable angle in an uncomfortable chair, tomorrow will tell all.

Sorry for being so wordy!

Bob 

[BTI]

Bob,

I can tell your sprits have been lifted!  Congratulations on your progress, way to go!  Good luck on your first day of work, get comfortable and don't move around too much.  I'll send an update after my OS appointment tomorrow-going to a new brace after 6 weeks!  I can do a straight leg lift...but I won't due to strict OS orders.
Like Simon said...we really don't know unless we ask our Dr. to expalin in detail what procedure was performed.  So, we will have different plateaus of development and recovery.  I belive the most important area to pay attention to: Do Not Re-Injure Yourself!  Simon went through HELL!

Take care all,

Brandon

[bill.cochrane]

G`day all,
I am pleased to see we all seem to be progressing.I saw my OS on Monday and he got me to sit on the bed and with him supporting my ankle see how much the leg could bend before it became uncomfortable I think it was about 40 - 50 degrees when I became anxious as the top of my quad was becoming very tight.He let me have 30 degrees which seems quite comfortable using the special brace, so I could fly home,he is also happy for me to walk as long as it is even ground and obviously with the brace on.The flight went well but I almost went arse up getting on the fast moving down elevator steps at the airport,I led with my good leg and as I cannot bend my crook one the good one was on the way down the elevator and my other wouldn`t bend so I nearly fell.Bob I wouldn`t be jealous of me I am green with envy that you are driving,we sold our automatic recently and now have 2 manuals so unless I do as you have done and hire a car it`s up to my wife to get me around.Also I am yet to do any physio so you go for it.Well guys it has been great reading your reports and for you allowing me into your club,will email when there is something of interest to pass on.

Cheers,
Bill

[binkeyhb]

Hi Bill,
I'm 5 months post-op with bilateral quad rupture. Drove manual after 3mos. Jogging but real slow. Scars keep getting bigger(more scar tissue). No ROM below a 90degree squat. not sure I'll ever get that back. Surgeon wants me in the pool. Been a jogger for 45 yrs+. Hang in there!
Good wishes,
Bink

[bill.cochrane]

G`Day all,
thanks for all your encouragement it`s 3 weeks today since my operation and everyhing seems to be settling down.The scar is almost dry and I am putting some ointment on it to stop it becoming too tight.I was allowed to bend the knee 30 degrees to allow me to travel by air but I didn`t ask my OS if I should leave it at 30 degrees or straighten it again (I did) and can I continue to bend the knee when I get into the car and sit at a table or should it still be immobilised until the initial 6 weeks period is over.Thoughts?Hope you are all progressing well.

Regards
Bill

[nhbob]

Hi Bill,

This is where OS's seem to have different approaches.  But for me I have been in a 30 degree brace since a little less than 3 weeks post-op. I am now 4.5 weeks post-op, the OS wanted me to stay at 30 degrees until my next appt (6 Nov next week), where he said he would most likely increase the ROM.

It was very difficult to even come close to bending my knee a couple of weeks ago, but now I can bang right up to the 30 degrees with the brace with no pain (because of the stretch of the velcro/material I am maybe even doing 35 degrees.  But anything after that is very tight (when I take the brace off and try to bend, it seems I hit a real tightness right away),  He did want me to try to increase a little under controlled conditions without the brace... but not to force anything uncomfortable.  So to answer your question, I think you are fine doing 30 degrees at the point you're at.

I have done PT three times this week, and have made great strides into the straight leg raise, I can do 10 at a time quite easily now... just 2  weeks ago the leg felt like it wasn't even connected, so that's some progress for sure.  They have me massaging the area quite hard (but controlled) to break up scar tissue though.  My knee is very "bulky" shall we say, it looks to be all aligned but "bulky", but I am told it has scar tissue and that's why it's a bit deformed looking.

Hope everyone is doing great with their progress.... boy this takes a long time!  Life changing for sure.

Bob

[philt]

Hi all, it's been a few weeks since my last post and sorry to see some new names on the board - you have my sympathy!  There have been some great words of wisdom from Frederico and co and so I'll simply let you know my experience to date to help with your expectations.    I'm now 6 months post-op following a complete rupture of the tendon at the start of May.  Surgery 18 hours later and in a leg brace with no ROM for 6 weeks until PT started.  I'm now fully mobile, and have full ROM (am probably more flexible than before!) and working on re-building lost muscle.  Like others, I have lost weight (between 16 and 20lbs) which I can only put down to having the same concerns about weight gain post-op and my current exercise regime.

I'm guess by now that you all realise that recovery is a a slow process - the only thing I'd say is stick with the excercise and PT - I was told that the biggest risk I'd face was easing off once I became mobile.  I'm glad I didn't and my goal of being able to ski by January now looks like becoming reality.  I'm currently hitting the gym for an hour at least 5 times a week for intense work on my leg to rebuild the lost muscle - must look a bit of a plonker doing loads of one legged exercises but I don't care 'cos no-one's going to do them for me!  Today I managed several reps of 25kg on the quad leg raise machine with my bad leg and for the first time didn't feel any pain under my kneecap - my next appointment with the PT is Tuesday and I'm facing the dreaded cybex machine for a stength test.  I'll let you know how it goes.  Take care all.  Phil T

[nhbob]

Hi Phil,

Thank you for the positive news.... those are the kind of outcomes I think we all want to hear... even though it is a long slow crappy road to travel to where you are, the good thing is there is some happiness at the end of the tunnel.  Thanks again.

Bob

[milkoholicBear]

Hello everyone,
I am 15 days out of surgery for a torn left quad tendon. I couldn't add anything that has not been written in this thread. Even my knee looks very much like Bill Cochrane's (with quite a few less staple marks though, I only had 12 or 13).
Not having any kind of flex yet, my brace is locked into 0 degrees. 
On Tuesday, I am meeting the OS and might have some news then.

[bill.cochrane]

G`Day all,
sorry to see a new name appear as I wouldn`t wish this injury on my worst enemy.Went to my new OS yesterday,another Army doctor reputedly very good.Told me to begin quad contractions to at least keep my quads doing something.He also said I could continue bending my knee 30 degrees and basically another 3 weeks in the leg brace followed by physio.The doctor who did the op told me I could be jumping again in 3 months, this guy is much more conservative he reckons possibly 12 months I have news for him! The most frustrating thing for me so far is not being able to drive,I can`t wait.I will keep in touch continue getting well all.

Regards,
Bill

[BTI]

Hey Folks,

It is good to see everyone making progress.  I had my 7 week post op appointment yesterday for my ruptured quad tendon, the OS is very pleased with my current condition.  He believes it is healing very well and moved me into a hinge brace with a lockout of 30 degrees (which I can achieve).  He is a careful and cautious OS, as he doesn't want me to start putting full weight on my injured leg as I continue to walk with the crutches.

I am not that comfortable in the hinge brace, the straps tighten just above and below my kneecap which causes it swell.  I will see if there is a better fitting brace available. Has Anyone Experienced This Problem?   I still do not have the go ahead to drive, it is strange how you can miss certain things so much more than others. 

My follow-up will be in two more weeks where he feels I will be able to drive and begin physical therapy.  The atrophy I experienced is quite depressing, need to get in the gym and start rebuilding some muscle mass. 

Looking forward to reading your updates, good luck everyone...

Brandon