Ruptured Quadriceps Tendon

[millimob]

Hi Everyone
Last Saturday 24th April 2010 I ruptured my Quadriceps tendon, I am 70 and very active DIY etc,It was a simple stupid accident my foot slipped off a step as I was going down, and my weight was put suddendly on my Right leg, which buckled and I heard a "POP" I realised that my knee was injured but had no pain, I could not straighten my right leg without pushing it straight with my left leg, then I could bend it OK again.
My wife called an ambulance, and the paramedics diagnosed a possible tendon rupture and a trip to A&E dept at Selly Oak Birmingham.
After much ado and waiting,xrays and diagnosis I was full leg plastercasted and admitted to ward S4 for the orthopedic team to decide what to do.
I was consulted and an operation to repair the tendon which had ripped from my kneecap was planned for Sunday am. This was not possible due to the truma schedule. S4 is the military ward and some of the injuries I saw to our soldiers for outweighed mine.
So I was operated on Monday am some 30 hrs after the accident, the kneecap has been drilled in several places and the tendon sewn back to it, I have 29 clips in the wound.
I was discharged from hospital onTuesday,and I am managing on elbow crutches trying not to put any weight on the right leg (this is difficult however)
I dont know what to expect from here other than, I have the clips removed on 14th May and will have my leg immobilised in a brace for total of 6 weeks, then I am told I will have a variable knee brace to gradually get a restored angle of movement.
I just wondered what the process is from there with physiotherepy and exercise etc.
From what I have read on this site it would appear to be along job.
Thanks for reading my tale of woe

Today 11th June 2010 6 weeks and 4 days post op I had brace replaced with a hinged brace adjusted to 40 deg and given some exercises by the physiotherapist 1. lying on bed or flat surface press knee down using muscles and hold for 5 secs repeat 10 times 3 times daily or until uncomforable I found this easily repeated. 2 clench buttocks as if cracking a walnut he quoted, again repeating as other exercise, also moving leg in stiff mode outwards to side of body.
I have found the flex brace initially more comfortable and walking with some flex of leg is more natural.
I then went out for a walk along my road about 500 yards gradual slope upwards which was fine then back again, but found downhill walking a bit more difficult for some reason, but felt pleased with progress will continue excercises as advised and see physio again in 2 weeks for 60 deg setting, I will try not to overdo things as advised.

[John42]

Welcome to Amen and Millimob - both newcomers to the Ruptured Quadriceps tendon thread.

I have sent both of you a set of documements by e-mail which cover the rehab procedure for a ruptured Patella tendon - the rehab process is very similar.

Read as many of the previous thread as possible - ask questions - and a good tip is to sleep with a pillow/cushion between your knees.

A tip to Millimob, there is no reason why you should not apply for a car disability badge, it`s useful in the future, but dont attempt to drive until such time as you can depress the brake pedal, otherwise you may invalidate your car insurance policy.

Best wishes

JohnK/ Manchester UK

[mistertonite]

Hello to everyone,

Just wanted to give an update and more information on my injury.  I tore my left quad tendon and broke my patella playing baseball on 5/02/2010 (another player ran right into my knee and tore the tendon completely off).  Had surgery to repair the tendon on 5/13/2010.  I was on a straight leg immobilizer for  4 weeks and was told not to bend my knee.  My OS wanted to make sure my patella was healed before any type of ROM.  During the 4 weeks, I was able to put weight on the leg using crutches to move around.  Went to my OS on 6/10/2010 and the patella is healed according to xrays.  I am now off the crutches and able to walk with just a cane.  OS told me I can begin ROM and set my leg brace to 70 degrees ROM.  I thought that was too much too soon as I am only 4 weeks post op and can only bend my knee to 20 degrees.  I also don't want to be too aggressive on my recently healed patella.  I have the classic pain on the patella tendon and still very stiff.  Should I even attempt to get more ROM?  I still have not been to a PT but I am doing some light exercise (slight leg raises, calf raises and quad tension).  This is a great forum and thanks to all for your posts.

[frederico]

I would err on the side of caution.  I gradually increased my brace about 5 degrees every three days.  If I felt to much burning in the patella tendon, I would back off and wait a day or two more.  Slow but steady wins the race with this. So, if you can bend your knee 20 degrees now, I would set the brace at 25 and see how it goes for a few days. If all is well, bump it up from there.  You'll be up to 70 degrees in about 1 month, (45 degrees / 5= 9 periods X 3 days per period = 27 days) which will be about 2 months post-surgery. That's pretty good. 

[mistertonite]

I would err on the side of caution.  I gradually increased my brace about 5 degrees every three days.  If I felt to much burning in the patella tendon, I would back off and wait a day or two more.  Slow but steady wins the race with this. So, if you can bend your knee 20 degrees now, I would set the brace at 25 and see how it goes for a few days. If all is well, bump it up from there.  You'll be up to 70 degrees in about 1 month, (45 degrees / 5= 9 periods X 3 days per period = 27 days) which will be about 2 months post-surgery. That's pretty good. 

Sounds like great advice Federico.  I will err on side of caution and the pain stops me from becoming too aggressive anyways.  I'd figure it would take at least a month or so to get close to 70 degrees.  I'll keep posting my progress as it comes.  Thanks a bunch.

[readinggal]

hi everyone - this is a great website and im still trying to find my way around it - how helpful it is that other people have experienced this horrible injury and can support each other in the process.
I had a nasty twist/fall on may 20th 2010 experienced the most excruiating burning pain in my knee- was taken to A&E and put in a cricket pad splint for a week (and crutches) the following week following an ultra sound i was booked in on 29 may for an operation to repair a total tear of my quadrecep tendon  on my right knee
came out of hospital after 5 days. 14 days later had staples removed and put into a different splint for a further 4 weeks. On tuesday i have physio for first time and over the course of next 6 weeks they will be adjusting the splint to 30\60 then 90 degrees - has anyone had similar experience of the recovery?  i have lots of questions - i know everyones recovery is unique but would really like to hear - and any tips would be most welcome

[John42]

Hi

Welcome to the RQT thread - you will have realised that you have sustained a serious injury, and it will take quite a time to recover.

Please let me have your e-mail address, and I will let you have three documents, which will give you an indication of the rehab procedure.  The documents refer to a Ruptured Patella Tendon, but the rehab is similar.

Important that you read some of the previous posts on this thread and prepare a list of questions for your next meeting with the PT/OS.

Be free to ask as many questions as you like, we are here to help and give you guidence.

Take care
JohnK/ Manchester UK
[email protected]

p.s.  where do you live??

[readinggal]

Thanks John email address winging its way to you

I realise its going to be a long rehab - i'm 56 so no spring chicken - and obviously its early days (4 weeks post op) anyones experience and tips for recovery will be gratefully received

I am in Reading Berkshire.

[John42]

Hi Sue in Reading ( because we have several Sue`s on KneeGuru )

You have meanwhile received three e-mails from me - read with care, compile questions for your pt and don`t forget to ask questions.

Should mention, that you should apply for a car disability badge, and in case you do drive, don`t attempt to drive until you can debress the brake pedal, otherwise, you will invalidate your car insurance policy.

Please do keep in touch

JohnK/ Manchester UK 

[readinggal]

49 days since accident
31 days since operation
Day 1 of physio  : splint now locked at 30 degrees: feels weird as if my leg want to give way - little pain but i took painkillers 2 hours before appointment - good thinking but really should have topped them up 4 hours later when i started getting twinges.

bit tearful again this evening - purely out of frustration as my other half is doing everything -bless him ~ but not always with a smile i wish i could do more..............


John : i rang our local council re disabled badge and they seemed to think that because this is a ''temporary'' disability then not entitled.....

however - i shop in sainsburys and wrote to their head office asking if they give out temp. disabled parking permits for their disabled bays in their car park and yes they have agreed and have given me a disabled pass for 6 months (extended if needed) they said its a good idea for their customer care policy
so thank you sainsburys.

[stylabull]

Updating my situation, MRI scan showed that I didn't have bone flakes in the knee but a large tear in the meniscal cartilage, got to have arthroscopy in a few weeks to hopefully clear it up. Must have happened when I ruptured the quads but didn't show up as I didn't have an MRI at the time, don't get any pain from it when walking but feels uncomfortable when I try to run, have had to write off this cricket season!!

[Jeff59]

About nine weeks ago, I became a member of the dubious ruptured quad club. Here's my story to date:

April 24 -- I wish I had a glamorous story about how I tore my tendon, but it was a Saturday night and we had just run the dishwasher, which for some reason leaked all over the floor. I slipped on the wet tile with my left leg and jammed my right leg, attempting to recover. At least I think that's what happened. I went from standing to being on the floor really, really quickly. I grew up on ice and snow, but I've never fell so fast or hard before. At any rate, I suddenly found my 50-year-old body on the floor with a knee that no longer worked.

At the emergency room, the doc thought it might be a displaced patella, put my leg in an immobilizer brace and sent me home wih the instruction to see an orthopedic surgeon if it wasn't feeling better by the middle of the week.

April 28 -- Obviously, it wasn't better by the middle of the week. I saw a surgeon who sent me for an MRI to confirm what he suspected from the gap above my kneecap -- that I had torn my right quad tendon. The MRI did show just that, I had a 100% tear.

May 4 -- I had surgery, drilling the holes in the kneecap, much pain for a day, pretty much what everyone else has experienced.

May 7 -- Saw the surgeon for the first follow up. He put me in an adjustable brace and set it at 30 degrees.

4 Week Follow up -- He had me adjust the brace to 45 degrees and told me to add 15 degrees every ten days. When I asked about physical therapy, he said it was way too soon, the tendon needed to heal.

Late in the fifth week, I stopped using the brace around the house because I felt stable and had decent range of motion. I haven't really used the brace since.

Tuesday, I saw my surgeon for the 8-week follow up. He had me do a leg lift, had me walk a few steps back and forth across the exam room and told me that unless I had problems, I didn't need to come back. He turned to leave the room and I stopped him to ask about physical therapy. He said that I had full range of motion and that all therapy would do would be to strengthen the muscle and I could do that on my own.

At the time, I wasn't really thinking beyond, "Wow! I'm cured!" But of course I'm not really all better and now I'm wondering how I'm going to do this on my own. I do have decent range of motion, over 90 degrees, but I have no way to measure exactly what it is. It's certainly not "full range of motion." I can walk fairly well, and I've been working on my exercise bike, which I've been able to turn complete revolutions for about a week, but my leg is still very weak. I can't climb stairs. I still have those scary moments where the knee feels unstable and I'm afraid it's going to buckle. I know it's going to be a long time before I'm back to normal.

So, now I'm wondering if I'm going to be okay rehabbing on my own. I don't really know where to begin beyond the exercise bike. I feel like I've been cut loose way too soon.

[John42]

Hi Jeff

Welcome to the RQT club - regardless of what advice you have received so far, you will require a lot more physio and PATIENCE.....

I have sent you three documents, from which you can learn a great deal of the rehab procedure...

It`s going to take quite some months to get near 100% mobility.

Please continue to ask questions

Take care

JohnK/ Manchester UK

[Ian B]

Hi Jeff,

Everyone is different, however I have healed very well with no PT.

I am now 10 months post injury, and I am basically back to normal.  The leg is still a little weaker than the right leg, however I have no limp, and I am not limited in anything I do.  I am more careful than I used to be.  I stooped with the brace after 6 or 7 weeks.  I went to one PT sesiion and concluded it was a waste of time.

Over the months, I gradually gained with regard to range of motion, and the leg got stronger.  I am now pain free.

I found that the improvement was just a gradual change over the months.  I was back at work partime within a couple of weeks and was back fulltime after 5 or 6 weeks.  I found walking to be good exercise, and did as much of it as I could.

I know when I read the posts how fortunate I was.  I also had a total rupture, but my surgery was less than 48 hours after the injury.  I spent 1 night in the hospital post op, and was on my own.  I was injured while travelling, so I never saw the surgeon again.  I saw a local surgeon about 11 weeks post op.  He said everything looked good, just keep doing what you are doing.

I am not sure when the tendon is back to its original strength as far as attachment goes.  I am always careful when I am doing anything where a risk of fall is present.  I probably will be careful forever, as the last thing I want to do is go through another injury like this.

Ian

[subail]

Jeff59  I think I would insist on some physio. I know that it was helpful from the point of view of progress...getting measurements and advice on strengthening.

I just had knee replacement on my other knee and a lot of the exercises that I am doing I could do at home, yes. However, I still think i am benefitting from their expertise.

I don't think I've ever heard of an OS who would not recommend at least a few sessions of physio     ...in fact, I find that odd!

Good luck!     Sue