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Author Topic: Ruptured Quadriceps Tendon  (Read 474344 times)

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Offline 225Champ

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Re: Ruptured Quadriceps Tendon
« Reply #165 on: November 20, 2007, 03:01:19 AM »
Hi All-

Steve I am 6 months out from surgery/recovery/rehab w/ this bi-lateral issue. I was told by active friends that the pool would have been a great place to get in a workout during recovery and my PT agreed. Active in other ways, but I am not a pool person.

Sometimes my OS visits were prior to my PT visits, and I had a long list of questions ready. Whenever the PT reccommended I do a particular exercise, I would always have to say - NOT OS approved. The PT started communicating closer via computer to the OS. Both OS and PT have been extremely supportive - but I questioned everything. They didn't mind.
 
 3 months after surgery, I was given the ok to use the ellipitcal machine at the gym which has helped with the cardio or aerobic of my workouts. I am still careful, even with the gliding of this equipment. I tend to have sporadic muscle spasms after using it.
Also the I've used the recumbent bike at the gym - with my legs out in front, not the regular bike.

The atrophy I've experience has improved w/ leg lifts and quad isometrics. I have come a long way in six months - it's great to be in the  driver's seat again. I 'm not too fond of going up/down the 15 steps in my home, but am thankful that I am able to do so.

I used John's method with the pillows -and my OS reccommended elevating my legs, at the feet - I slept that way for weeks.

It does get better. Keep your spirits up.

Wishing everyone all the best -

Danny / US/ Long Beach California




Offline milkoholicBear

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Re: Ruptured Quadriceps Tendon
« Reply #166 on: November 20, 2007, 05:20:33 AM »
Folks,
I keep reading about these "bilateral" ruptures, and I must admit I don't really understand what it means.
Is it that the tendon broke in both your knees, left and right ?

Offline S53

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Re: Ruptured Quadriceps Tendon
« Reply #167 on: November 20, 2007, 08:08:34 AM »
Yes bi-lateral means a rupture in both legs.

Thanks to all for the answers to my questions.

So far as I've been told my PT works directly for my OS group. Should be coordinated, but I'll always be checking both along the way.

I figured swimming wasn't part of knee PT. I'll be careful on the deck when I'm allowed to go there.

Luckily I haven't heard or felt a "pop" during or after the PT that shouldn't have been. OS felt my anchors were still intact.

Like I said before I'll not have much to report for awhile that will be of any use. I can see this is an inspiring bunch.

Thanks,
Steve
Bi-Lateral Quad Rupture 11/10/07

Offline BTI

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Re: Ruptured Quadriceps Tendon
« Reply #168 on: November 21, 2007, 01:10:48 AM »
Hey All!

61 days post Op for my quad tendon rupture!  Saw my OS today and I have the green light to use a cane and drive my 6 speed Mini-Cooper!!  Wow, I feel whole again!  He also opened my brace up from 50 degrees to 90.  I cannot achieve anything past 60 degrees at this point, but he feels I'll be there in a few weeks with very moderate physical therapy.  I sahred with him my concern of the PT's not always being on the same page as the OS, he reassured me that this would not happen as he closely oversees all activity.  Having heard this, I felt much better.  He also said the last thing he wants to see happen is a re-injury. 

For those of you out there hurting pretty bad right now, it does get better and your life will improve.  Back in September, it felt as if I hit bottom, the pain, the little or no progress, not being able to shower, side effects of the pain meds, loss of appetite...it was horrible.  Now, everyday is a good day and small improvements are made.  I kept telling myself to be patient and not rush anything...

Contined success everyone!

Brandon
Best regards,

Brandon

Pain is nothing but a feeling. It tells us we are trying, we are getting better. We must do what we think we cannot. Success to all...

1980 R-ACL
1995 L-ACL
9-20-2007 R Quad Rupture

Offline bill.cochrane

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Re: Ruptured Quadriceps Tendon
« Reply #169 on: November 21, 2007, 06:53:06 AM »
G`Day all,
nothing further to report yet but I see my OS next week and I should begin physio immediately after.I never thought the 6 weeks of immobilisation would ever come but it has.I have one or two worries at the moment,I tried to do a leg raise today and I couldn`t even make my leg move at all I can move it sideways but not vertically lying on my back.Is this normal?The other worry is does the scar tissue affect the ROM and can it be eased by massage?I tried to operate the clutch in my manual car today and if I can get a few more degrees of knee bend I think I will be able to work it after a bit of quad buildup.Can any of you guys give me some good exercises to get started with.My friend is lending me his automatic tomorrow for a month so I will be able to get around and go to physio etc.I start work again on Friday I will see how I go and let you know.Keep up the good work.

Regards,
Bill

Offline nhbob

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Re: Ruptured Quadriceps Tendon
« Reply #170 on: November 21, 2007, 09:56:49 AM »
Hi Bill,

Good to hear from you, hope all is well in recovery.  Let me see if I can give you some of my experiences, since you are a wee bit behind me (I'm  7 weeks post-op today from my 2nd surgery).

I can do the straight leg lifts quite easily now... but it took a lot on concentration in the beginning to get my leg to go.  I started do the leg lifts from a standing position!  When standing with my crutches, I would slowly lift the leg in front of me, keeping it straight, until the leg was out about 60 degrees, it was easier from the standing position because it wasn't all deadweight just being lifted straight up.  Once I started doing them while lying down, in the beginning I had to concentrate, saying to myself, I am going to lift that leg... and believe me... once I did, the lift was just a millimeter, and lasted a second.  Good news, once it started, it came back very quickly... it seems to be true, we need to re-educate those muscles, within a week i was doing champion leg lifts.  You've been locked in for a long time in the immobilizer, those muscles need to "get it" again, and they will!

The massage for the scar tissue... that is something my OS wanted me to do early on, he wanted my massaging the area, almost aggressively from the very beginning.  Each trip to the PT, at the start of the session, they spend 10-15 minutes doing a real hard but controlled massage, I can feel the scar tissue breaking up... it hurts a bit, like someone sticking needles in there, but when they are done (and I get into the real PT), it always feels a bit more free and better.  So from my perspective and experience... the massage is very good!!!

And finally the car... It was very very difficult when I first tried my clutch.  I could not do it.  After renting a car for 2 weeks (I was offered a mini-van by a friend, but I could not get in it), I did go back to my car again... and at first it was very difficult.  It has been a couple of weeks, and it's very easy now, so I think driving the clutch has been a bit of therapy in itself.  But you can ask all this from your OS today!  Good Luck, and don't get discouraged about the leg lifts... it was impossible for me in the beginning, I remember thinking how weird it was to have to concentrate and relearn such a simple task!

Good luck wih the OS today!
Bob
Ruptured Left Quadricep Tendon on 24 September 2007
Surgery 28 Sept 2007 (but suture anchor broke)
Surgery 03 Oct 2007 (OS did not use suture anchor 2nd time around)
Ruptured Disk in Back affecting S1 nerve 11 Dec 2007
Back Surgery 09 Jan 2008 to uncompress S1 nerve

Offline S53

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Re: Ruptured Quadriceps Tendon
« Reply #171 on: November 21, 2007, 05:46:15 PM »
I am almost sure I saw a post inside this thread with a liink to a ROM brace made in Australia. There was even a JPEG photo pasted in. It was blue.

I've spent a few hours searching this site and poring over the web. Can't find it anywhere in my tracks. Can one  of you long timers tell me if such a post was in this thread? If it was here I suspect it was removed.

It's not my intention to divert this into a ROM brace discussion.

BTW am taking heart that people are driving their cars w/manual transmissions within 8-12 weeks.

Thanks,
Steve
Bi-Lateral Quad Rupture 11/10/07

Offline frederico

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Re: Ruptured Quadriceps Tendon
« Reply #172 on: November 22, 2007, 12:52:50 AM »
Hi all,

I have been doing some reading on the net about quad tendon ruptures and can give you some sources to read and hope for the future as well. 

There is a great article by Lyle on Emedicine. 

In section 9 he states:

Several authors advocate immediate postoperative motion to potentially increase ultimate range of motion. Studies also have shown that mobilized tendons heal faster and are stronger than are immobilized tendons. In 2 studies, artificial graft was used to augment the repair and to allow early motion. Konrath and associates reported successful immediate motion without routine augmentation. However, other studies have shown that range of motion is routinely regained after up to 6 weeks of immobilization.

Rougraff and colleagues found that nearly all patients (including patients with delayed repairs) regained motion to within 2 of their uninjured leg. Additionally, their study provided the only comparison of immobilization and immediate motion in the literature to date; however, but the immediate motion group was very small. No significant difference existed in ultimate range of motion between the groups. Future research comparing larger groups of patients treated with immobilization and early motion is needed to help resolve this issue.


I would encourage you all to read the whole article at:

http://www.emedicine.com/orthoped/topic274.htm

Another article I came across by a group in Ireland states: 

Symptomatic outcome following surgical repair was excellent with a mean symptom score generated of 22.7 out of a maximum of 25. 18/19 patients returned to their premorbid level of activity on average 18.1 weeks following injury. There was no difference in quadriceps girth comparing affected and unaffected limbs. Less than 5 degrees deficit in range of motion existed between affected and unaffected limbs. Approximately two-thirds of patients were the same or better when comparing peak torque/body weight, average power, maximum average peak torque and total work/body weight in affected and unaffected limbs.

This was a rather small group study.  But at least it gives one some hope!

I find it interesting that many of the posters on here had a very active pre-injury life. Does this mean that more active people are prone to this injury?  That would be an interesting study. 

Everyone have great Thanksgiving! 

Best regards,

Fred

Offline milkoholicBear

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Re: Ruptured Quadriceps Tendon
« Reply #173 on: November 22, 2007, 06:21:57 AM »
I remember reading somewhere that if age is not a factor (< 60), then the "weekend warrior" types are the most exposed to this king of accident.
If none of the above, then most certainly a nasty combination of stairs and gravity are involved (this happened to Bill Clinton).
In my case, I was riding my recumbent bicycle about 25 km daily to and back from work (12.5 each way).
Then one hot and sunny day, when I got to the parking lot where my car was waiting, I put my left foot down, heard a loud pop, and you all know the rest.

Offline John42

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Re: Ruptured Quadriceps Tendon
« Reply #174 on: November 22, 2007, 01:39:20 PM »
Hi Fred


My Consultant states that a Ruptured Tendon is in most cases due to a sportsman injury or
a Trauma, i e an accident.

Baseball, volleyball, football, rugby etc cause the greatest number of ruptured tendons.  In some cases, in can be proved that the tendond get weak if you have been taking steroids.

JohnK/ Manchester UK
Ruptured Patella Tendon January 9 2003
Slipped on black ice.  Manchester UK

Complete Ruptured Tendon

Offline frederico

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Re: Ruptured Quadriceps Tendon
« Reply #175 on: November 22, 2007, 06:45:03 PM »
John and Bear -

Really what I meant to say was that despite being in decent shape athletically, from what I'm reading on the board, most people sustained their injury while doing something routine and commonplace. (i.e., slipping on steps)   For example, I was in great shape from biking and my quads were strong.  However, I sustained my injury when I slipped on some wet grass.  I think there is someone else who posted a similar cause.  My point is that we weren't doing a overhead scissors soccer kick or an extreme jump to make a dunk shot in basketball.

You can't strengthen tendons, however, you can strengthen or keep the muscles strong that attach to them.  My impression from my accident, (and I have gotten the impression from some other posters)  is that if I hadn't been in good shape when I slipped, I would have just fallen and maybe bruised my butt (and ego).  However, because my quads were strong and I reflexively attempted to "catch" myself, tightening the quad on the supporting leg, which then overpowered the tendon and resulted in the rupture.     

I haven't seen any studies with regards to that, but it would be interesting to know whether others feel similarly about their injury. 

Of course the extension of that train of thought is can it or will it happen again?  My tentative conclusion is that it can....mainly because of the reflexive tendency which happens so fast you can't override it.  Why can't we just relax and fall like we did when we were kids? 

Just some Thanksgiving day musings.  It is 60 degrees here and I went out for a nice ride on my road bike! 

Fred

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Re: Ruptured Quadriceps Tendon
« Reply #176 on: November 22, 2007, 07:06:25 PM »
Hi Fred

So you fall in the catogory of a trauma rupture - could happen again - so take care - just let the tendon heal properly - could take some time.

Best wishes

JohnK/ Manchester Uk
Ruptured Patella Tendon January 9 2003
Slipped on black ice.  Manchester UK

Complete Ruptured Tendon

Offline S53

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Re: Ruptured Quadriceps Tendon
« Reply #177 on: November 22, 2007, 08:34:46 PM »
Fred,

Your incident sounds similar to mine. Slipped in my yard, wet, poor footwear. OS said my quads were so strong from years of cycling and running that tendons had little chance.

I think when we were kids we naturally, tumbled. We didn't try to protect or prevent.

I will pay religious attention to stretching in the future. Got fairly lax in last few years when it was probably far more important.

BTW I presume you ride clipped into your pedals. Think how many times you walked around in cycling shoes, even for a few steps. Like skates.

Steve
Bi-Lateral Quad Rupture 11/10/07

Offline nhbob

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Re: Ruptured Quadriceps Tendon
« Reply #178 on: November 22, 2007, 09:42:18 PM »
Well Fred,

I do agree with you wholeheartedly with your points.
and also now that I look back, I can see the things I did (or failed to do) could have contributed to my injury.

I also was in very good shape, especially aerobic and lower body.  As you probably know by my postings, I am an avid hiker and cyclist.  When I hike, there are two mountains that I hike non-stop to the top for exercise... the one I ruptured my quad on was one of them.  I never have really stretched in my life to any great degree... so my legs have always been very tight, but they have always worked very well, with the transient aches and pains... but never anything like this has ever come close to happening to me.

My injury, like others here, was the result of a fall, the result of twisting the ankle on the right leg, and trying to "save myself" at a high velocity fall to a steep downhill, I manged to get the left leg out to stop myself. I even remember thinking for a second, "Whew, I caught myself"... but the "pop" came so fast from the left knee and I collapsed like a ton of bricks to the ground, I was dumbfounded! 

My OS, who is a young guy (like me, he's in his 50's... that's young, right!), he only does knee surgery, and he said it was just a bad situation of the angle my leg hit the ground, bent just right, the foot hitting the ground, and the most critical firing of the quad at the same time... it was the firing of the quad that really did me in.

It was explained to me, imagine you have some strong packing tape, that can hold 1000 pounds suspended, or even dropped straight down... now imagine that same packing tape over the edge of a table with the tape bent at 90 degrees or so.... you then drop a weight of 250 pounds off one end of the tape, and as it heads to the floor, you violently pull the end of the tape above the table horizontally with another 250 pounds of pull... the tape would likely break, because of the force in two directions violently at the same time, even though it's just a total of 500 pounds, but it's the bend at the table's edge (read patella there), that put a force on the tape (tendon), that it just snapped! 

If only we could have read the future! 

So I do agree, I think a lot of folks had a certain degree of fitness, but (as in my case), I think I knew I should have been stretching (I think it would have given me a little bit more leeway), I should have been looking where I was going (why I twisted my ankle in the first place), I guess I'm paying for it now.  just like everyone, I just hope I can get back at least to 90% of what I had, I know that at 55 years old, I will most likely always be aware of this injury... I'm not sure if I will be over-cautious now.  Will it always be in the back of my head that I'll back off from doing things... maybe I should be backing off at 55, I don't know.

Bob
Ruptured Left Quadricep Tendon on 24 September 2007
Surgery 28 Sept 2007 (but suture anchor broke)
Surgery 03 Oct 2007 (OS did not use suture anchor 2nd time around)
Ruptured Disk in Back affecting S1 nerve 11 Dec 2007
Back Surgery 09 Jan 2008 to uncompress S1 nerve

Offline bill.cochrane

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Re: Ruptured Quadriceps Tendon
« Reply #179 on: November 23, 2007, 08:47:35 AM »
G`day all,
well did my first day back at work today without any dramas,drove my mate`s jeep it sure feels good to back back some sort of control again.I still have nil to report re physio but that will change next week after I see the OS.I will keep you all informed.I think the thread about well developed quads having something to do with these ruptures rings true,my injury was similar.I will post again next week.

REgards,
Bill















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