Ruptured Quadriceps Tendon

[TurboCoder3000]

Eboh,

I too am a long way from full recovery. Here's my timeline:

8/28/2016: I suffered a complete tear of my right leg quadriceps tendon at the bowling alley. I was bowling for the first time in a very long while (about a year). I didn't even make it past the 3rd frame of my first game. I was sliding with my left foot, and it stopped for a brief millisecond. Then, my left foot kept going. Sensing this, my right tried to automatically save me by putting itself down (big mistake). I lost my balance, fell completely flat on my back, both knees fully bent. At some point on the way down I twisted my knee. No big deal, I thought, until I got up. I fell flat on my face three times.

I tried getting up to go to the chairs. No go. The ground just rushed up to my chin faster than anything I had ever seen before. So, I crawled back to the chairs and somehow managed to use my remaining good knee to get myself back into the chairs. Put my regular shoes back on, and tried to get my bowling balls so I could go home. Probably a severe sprain, I thought. Nope. Ground comes rushing up to my chin again. Had to call my step dad to help me. I figured the third time this happened that something was seriously wrong and decided to go to the emergency room.

At the emergency room, from the x-ray, they said everything in my knee was fine, that it was likely just a severe sprain. They sent me home with nothing more than motrin, a brace, and crutches.

It took two weeks for the swelling to go down, with zero improvement in function. At this point my primary doc sent me to get an MRI (we couldn't get one until the swelling went down) and to see an orthopedic specialist. I was diagnosed with a completely torn quad tendon.

Surgery was 9/21. Everything was healing fine until around 10/05, when my surgery wound turned necrotic in the middle. I developed necrotic skin the size of two dollar coins. After about two months of no improvement in the necrotic skin, I was finally sent to wound care on 11/22, where they cut off the necrotic skin completely. I started PT on 2/5 when my wound finally healed enough to where it wouldn't be impacted by PT.

My wound has reached the last 5% of healing, and has thus started being stubborn. It went from improving every week at wound care to improving every other week. So one week there would be some improvement, next week no improvement despite me taking all of my vitamins/medications necessary and keeping up on my nutrition.

This past week at wound care was no improvement. Then, during my surgeon appointment yesterday, something miraculous happened. Over night my wound healed itself. It's just a very tiny scab now. After months of this nightmare, it is finally over.

I can now go forth full force on my PT and get it over with. My surgeon says my quad tendon repair is now rock-solid, and I can get aggressive with bending my knee in PT. One nice piece of info I learned as well: he thinks I will only need 2-3 weeks of PT now that everything is rock-solid.

Soon I will finally be able to return to my normal life activities. But no bowling. I am never bowling again after this one!

[Chiropractor2001]

Great job turbo
It is great news.. good luck on rehab.
Keep us informed on your rehab journey...

[Eboh]

Thank you for your responses, TurboCoder3000 and Barrjoe!

Barrjoe - my first surgery was 11/8 and my first physio appointment was 12/21. 
I wasn't allowed to put weight on other than straight leg until 3 months post-op, so I'm a bit shocked that your re-rupture happened that way!
Did I read that you experienced a lot of pain after the cast was removed? Uh-oh! 
What a great progress you've made in such a short period of time! Well done!
BTW, my re-rupture happened just after physio!
Good thing you don't live in my house, with 6 semi-levels...my left hip is exhausted.

TurboCoder - I'm so sorry for your experience with the wound!
My first thought after the first fall was "I have to get the patella into the right position so that I can walk back to the car and get home".
But then it turned out to be absolutely impossible to get back on my feet, no matter how many times I tried. I recognize your story!
I couldn't call for an ambulance, either, until I got hold of someone who could pick up the dog and the car, so I stayed there on the ground for an hour... At least the weather was nice! 

Kind of a funny story, though: This happened when I had dropped my husband off for a beer festival, just outside the venue. The location is pretty, and I wanted to take the dog for a quick walk before I drove home. Neither hubby or his mate heard their phones because of the noise inside. I got hold of my daughter, who took a taxi to come to my rescue, but it was a long wait: She had misunderstood what I said, took a taxi to our home, and then - when the misunderstanding was cleared up - ran all across town to get to me.
All while smoking participants of the festival watched me from the terrace of the venue, without anybody calling out to ask if I needed help...
A representant for an Italian brewery caught sight of me and kept me company until my daughter, hubby and mate, and the ambulance showed up all at once.
Although I don't drink beer, Loverbeer will always hold a special place in my heart! 

Imagine how many times the doctors asked me if I had been drinking, when they heard where it happened.

I've found three major advantages with going this second round:
 
1) This time I'm not panicky about falling!
In the 17 days between the first injury and the surgery, the knee was so unstable it felt like nothing but skin held the leg together. After my second fall at home - you know, the day after I was discharged from hospital with no proper examination, no treatment, no brace, no restrictions  - I was so fearful I cried several times a day. And I've been around the block a few times, I'm a tough woman who's not easily scared.

2) I know what excercises will be important when the cast is removed, and what was problem areas the last time. I keep tightening the muscles all the time, and - imagine this! - I am now able to properly tighten the vastus medialis, which I'd only just started to "get hold of" in physio before the second rupture! Yay me! 
The cast is rather wide, and I'm therefore able to sneak my hand inside it to get a better feeling of how the muscles are responding.

3) When I was home on a temporary leave from hospital last Saturday, my dog fell ill and had to be put down the same evening. Although it's sad and empty (we've been together almost 24/7 for 11 years, travelled a lot together through several countries, trained a lot together, she was my motivator and my mental crutch!), it also means I don't need to worry about finding help to take care of her while I'm unable to. She was old with quite a few ailments, and we were expecting it, although not just yet.
It actually feels ok, though, and her timing couldn't have been better!

So, although my prognosis is sh*tty according to the doctors, I feel there's a lot of advantages this time. The second time around is supposed to be easier concerning all matters, right? 
I've even become better at taking one day and one problem at a time, which will be pretty useful, particularly as it seems I've developed a heart problem, as well.  (Waiting for cardiac appointment)

Oh, the joy of growing old...   

[Barrjoe]

Eboh, 

The first day after the cast came off was horrible, but mostly because of stiffness which went away within a few days. Kinda felt like I was dragging a log along.  So, don't let that scare you! It passes quick.

Wow, uncanny timing we have injury wise, huh?

[Barrjoe]

Less than great news here.  Yesterday noticed a divot, for lack of a better word, above my right knee cap. Didn't really hurt , but felt squishy, almost like a soft piece of fruit. Anyway, went to pt today, and the therapist didn't want to touch me and sent me to the Ortho  clinic  right then. Naturally , I can't get in until tommorrow, plus I'm seeing a PA that I probably know more than.

The way the pt is acting, I'm thinking I retore it again. Which if true, would be the 3rd time in 4 and a half months. I have absolutely no unusual pain. Put there are a few things I can't do like leg lifts for example. Anyone else ran into this? And if it is tore again what other possible options do I have?

Thanks

[Chiropractor2001]

Oh no... I hope it is nothing . And I hope it is just fluid accumulation  around the muscle. Let us know what happens...

[Eboh]

I'm terribly sorry for you, Barrjoe! 
I really hope it's not another rupture - holding my thumbs for you and hope you'll get back to us with news soon! 
I didn't have much pain with my re-rupture, after the initial few minutes it was painfree. I heard it happen though, the knee immediately swelled up, and the ability to stretch the leg out disappeared completely.
I was told there was one other option but surgery: Wearing a brace for the rest of my life.
I might go for that if it happens again, I've had too many complications with the anesthesia and pain medication.

[Barrjoe]

Hey gang,
Getting mixed answers about what's going on. Went and saw 2 PA 's yesterday and they think the quad is  still together.  X-rays and  the physical things they had me do seemed to confirm this. However, the pt girl think that maybe one of the sutures might have came loose. I have a divot about the size of a golf ball just above the middle of my knee cap.

So, guess I really don't know anything for sure at this time. Don't have a clue how it could have come undone. Also don't have any pain. The fact that I havent achieved any improvement doing a leg lift concerns her. Seeing the Ortho who did the surgery next Friday so find out then for sure. My gut feeling is the pt girl is right and I have a partial re tear. I also don't want to go thru this again. Keeping my fingers crossed until then......

[TurboCoder3000]

Hey gang,
Getting mixed answers about what's going on. Went and saw 2 PA 's yesterday and they think the quad is  still together.  X-rays and  the physical things they had me do seemed to confirm this. However, the pt girl think that maybe one of the sutures might have came loose. I have a divot about the size of a golf ball just above the middle of my knee cap.

So, guess I really don't know anything for sure at this time. Don't have a clue how it could have come undone. Also don't have any pain. The fact that I havent achieved any improvement doing a leg lift concerns her. Seeing the Ortho who did the surgery next Friday so find out then for sure. My gut feeling is the pt girl is right and I have a partial re tear. I also don't want to go thru this again. Keeping my fingers crossed until then......

Geeeeze barrjoe, I hope you don't have to have another surgery. That would be awful!

[TurboCoder3000]

Well, finally: my surgery wound as of Thursday is down to a teeny tiny pin hole.

Wound care believes it will be about one more week and it will be fully healed.

FINALLY!!!!

I am working on transitioining to a walker now. Once I am fully comfortable with the walker and I rebuild my muscle function I should be walking normally again.

Surgeon believes my repair to be rock solid now and that I should only need 2-3 more weeks of physical therapy.

[Eboh]

TurboCoder: I'm really happy for you!   
I don't quite get the short period of pt, here they expect you to have at least 6 months of treatment to achieve adequate strength and proper gait.


Barrjoe: I keep holding my thumbs for you, and wish you accurate and good news!


I am scheduled to have cast and stitches removed on Tuesday. Not looking forward to it, and prepare myself for more negativity from the OS. The cast feels so safe and comfortable, and right now I'd wish to keep it on for a year. Or maybe two. 
First post-hospital pt appointment on Wednesday.

[Barrjoe]

Know what you mean about the cast Eboh. As much as a pain it was getting around and doing even the simplistic tasks, you knew you weren't gonna get hurt. Good luck!

Great things are going good for you Turbo. Glad to hear

[TurboCoder3000]

TurboCoder: I'm really happy for you!   
I don't quite get the short period of pt, here they expect you to have at least 6 months of treatment to achieve adequate strength and proper gait.


Barrjoe: I keep holding my thumbs for you, and wish you accurate and good news!


I am scheduled to have cast and stitches removed on Tuesday. Not looking forward to it, and prepare myself for more negativity from the OS. The cast feels so safe and comfortable, and right now I'd wish to keep it on for a year. Or maybe two. 
First post-hospital pt appointment on Wednesday.

Eboh: I have heard two different things. PT says it will take at least four months of physical therapy. My surgeon says I should only need 2-3 weeks PT otherwise I will need another procedure to manipulate my knee if there is no improvement in my knee function (extremely painful from what I hear). He has been wrong before; for example, he wanted to do a skin graft on my wound but it ended up healing just fine with the assistance of wound care. It just took a bit longer.

So, I don't know. Sigh.

For me, staple removal was quick and relatively painless. I had 32 staples put in during my surgery.

[Eboh]

TurboCoder: It's not the removal itself I worry about! 
I can happily remove stitches myself if convenient.
I've been given a poor prognosis due to the fact that this is a re-rupture, and that it was very hard to repair because of the inferior quality of the tendon. I worry that they wont be satisfied with the result, which is impossible to know anything about with the cast on.
And then, what Barrjoe says - he got what I meant! 

Hubby took me out on adventures yesterday, we even had a restaurant lunch outside in the sun! I hadn't been outside for a week.
Although I walked too much it was wonderful, and spring is coming - fast!   

[TurboCoder3000]

TurboCoder: It's not the removal itself I worry about! 
I can happily remove stitches myself if convenient.
I've been given a poor prognosis due to the fact that this is a re-rupture, and that it was very hard to repair because of the inferior quality of the tendon. I worry that they wont be satisfied with the result, which is impossible to know anything about with the cast on.
And then, what Barrjoe says - he got what I meant! 

Hubby took me out on adventures yesterday, we even had a restaurant lunch outside in the sun! I hadn't been outside for a week.
Although I walked too much it was wonderful, and spring is coming - fast!   

Gotcha Eboh- my bad on that one!

I'm glad you're able to get out. The only time I can really get out is to my appointments. I don't have a wheel chair but I am improving in knee strength and function little by little almost daily.

Other than appointments I haven't really been outside going on 6 months now. Other than that, I am really just stuck to my chair 24/7.

My surgery wound should be fully healed come this Thursday. We hope!!!!! *keeping fingers crossed*