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Author Topic: Ruptured Quadriceps Tendon  (Read 473675 times)

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Offline D.S.

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Re: Ruptured Quadriceps Tendon
« Reply #765 on: July 18, 2013, 10:01:55 PM »
Wow. Bearkev, you would be a bit more than 12 weeks post-op now?

Let me go out on a limb. I am not a surgeon or a physiotherapist. And I don't mean to scare you. I may be wrong, but your ROM seems pretty average, near the "norm", according to the anecdotes here and on the epicski forum. I've heard about too many MUA's gone wrong, like separation of the repair, cracked patellas, etc. That just seems so wrong to do an MUA. You seem to be doing fine in regards to ROM. Arthroscopically cleaning up the scar tissue might be good, but I know nothing about it. Your ROM hasn't stalled. If it were me, I would be pretty leery about having the MUA. I am not a doctor. To me, slow and steady wins the race. If you can get 7 to 10 degrees of ROM a week, you'll be fine. IMO. If you were stuck for weeks at say, 120 degrees, maybe then an MUA? Again, IMO. Everyone's mileage may vary.

Today I spun on the stationary bike at home. Seat about an inch higher than normal. Brought up my pace from 25 rpm the other day to 40 rpm today. A hint of tightness in the tendon/muscle at this seat height. With a bit more ROM, seat will be lowered to it's regular height. Next to no resistance right now. I have to resist adding more resistance (pun?), or too much resistance. I have cycled and weight lifted all my life. My body is capable of doing more. I don't believe the tendon/patella injury repair area could stand the strain, nor should it. Paranoid about micro tears. I believe my PT wants me to go really slow. She feels the scar tissue in the tendon/patella repair area is very stretchy and elastic, and wants it to be more like a leather belt in consistency before adding much of a load. I think she said it might be 6 months! Still working the basics. Bodyweight squats, but without very much bend in the knee. Leg raises. Spinning. Walking a lot. Balancing on the bad leg. I'm trying not to worry about atrophy. Strength is good. Knee feels fairly stable. Some swelling. Keeping the brace on in public, against my surgeon's wishes. The brace will come off when my ROM is near normal. Remember, it could take a good year for the injured area to heal. I do not intend to go through this again, or have to have a revision.

My PT won't let me do lunges yet, or bodyweight leg presses, or any weights. I'm not worried about getting my leg and knee back to normal. Just TLC right now, eating well, sleeping well, and supplements.

Bearkev, keep up the good work!
« Last Edit: July 18, 2013, 10:04:48 PM by D.S. »

Offline D.S.

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Re: Ruptured Quadriceps Tendon
« Reply #766 on: July 20, 2013, 06:15:39 PM »
Can't say enough about rehab on the stationary bike. Today I dropped my seat height back down to it's usual lower level. My ROM has progressed enough to allow this. Was also able to wear my comfy cycling shoes w/orthotics, and "clip" into the pedals. Did two sessions, 30 minutes each. Low resistance. So therapeutic! Any general aches and pains I had felt in the knee are gone! I have to work hard to keep myself from adding resistance. So tempting, but I must be patient. I have never wanted to work out so badly in my life.

Went to a major mall yesterday. Wore my brace. For sure, it gives me insurance until I have full ROM and more strength in my knee (just reached 12 weeks post-op). I do not want to stumble or make a sudden move and impact my knee. To all those whose orthopaedic surgeons tell them to ditch the brace at some point, I say, don't! I'm ignoring my surgeon on this matter, and can't tell you how much peace of mind it gives me. I'm giving this knee all the TLC it deserves.

I hope everyone is making progress.
« Last Edit: July 20, 2013, 06:22:21 PM by D.S. »

Offline Bearkev

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Re: Ruptured Quadriceps Tendon
« Reply #767 on: July 21, 2013, 01:55:57 AM »
I agree with you D.S.  About the stationary bike AND wearing the brace.  If I'm going to be on my feet a lot or do a lot of walking, I still wear my brace.  Better safe than sorry.  And the stationary bike does a great job at loosening up my knee.  I need to make more time to do it.  Wish I had one at home but do have access to one at our community clubhouse.

Had another physical therapy session the other day and gained another 4 degrees.  I am up to 118 now.  Gained 14 degrees in the past week.  I guess my Doctor talking about a MUA motivated me to do a lot more stretching at home.  Although they did have me start a new exercise at therapy this week that may have something to do with it.  They have me lay on my stomach with a hot pack under my quad and a belt strapped around my ankle.  Once I feel my quad warm up I bend my knee as far as I can and then pull on the belt to stretch it as far as I can tolerate for one minute.  Then relax the quad and repeat the process a total of 5 times.  Can't argue with the results I've seen this week.  I am 13 weeks post op now and at 188 degrees.  I am also walking upstairs again on both legs.  I feel like I'm a little behind schedule but patience is key with this injury.  I expect to get past 120 degrees this coming week - a big milestone.

Keep up the great work D.S., amberisma and everyone else battling through this.

Offline D.S.

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Re: Ruptured Quadriceps Tendon
« Reply #768 on: July 21, 2013, 02:11:52 PM »
Excellent Bearkev. You are doing well. My PT and I are now discussing my rehab protocol after my physio ends. I only have a few sessions of physio left. It's covered by the government, but it's for a limited time. It appears that my protocol will be quite conservative. Parts of it will be similar to the Massachusetts General Hospital Protocol:

http://www.massgeneral.org/ortho/services/sports/rehab/Quadriceps%20and%20Patellar%20tendon%20repair%20rehabilitation.pdf


Offline D.S.

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Re: Ruptured Quadriceps Tendon
« Reply #769 on: July 24, 2013, 12:49:17 AM »
In 2 days, it will be 13 weeks post-op for me. Measured 120 degrees of ROM today at physio. So I only progressed by 5 degrees in 7 days, but hey, she told me to slow it down last week anyway so it's all good.

More exercises have been added. I like the step-up/step-down progressions, on a 3" step. Both forwards, and sideways versions (subtle difference on the effect on the hips). I have never wanted to work out so badly in my life, but I must show restraint.

Best regards to all!

Offline amberisma

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Re: Ruptured Quadriceps Tendon
« Reply #770 on: July 26, 2013, 11:34:09 PM »
D.S.  I also completely agree with the stationary bike.  I've only been permitted to use it for 8 days, but I absolutely love it!

Anyway, some quick updates.  Today is 6 weeks since my surgery, and I took my first steps without my brace (shhh don't tell my doctor).  Last Thursday was the first day that I didn't use a CPM machine to loosen my knee up.  My PT took me to a airdyne bike and I did that for 10 minutes.  I have been able to increase my ROM greatly over the past 8 days.

7/18 - 99 degrees
7/22 - 112 degrees
7/23 - 117 degrees
7/25 - 122 degrees

I am extremely happy about that and really hope that I am able to get full flexion back.  My OS said that there is a good chance that I may not, but I would like to prove him wrong!

I am also up to singe-leg leg press of 50% of my body weight and I feel like I can do more.

One thing I've also been dealing with... pain along my joint line when I sit with my knee bent for too long.  My pre-op MRI said there was internal derangement and dysplastic fissures of my medial meniscus so I'm hoping that doesn't give me issues.  When my knee swells, most of the swelling is also on the bottom left of my knee where the sutures were tied on the outside of my kneecap.

Anyone else have a similar pain or swelling pattern?
« Last Edit: July 27, 2013, 04:04:12 AM by amberisma »

Offline carkeltom

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Re: Ruptured Quadriceps Tendon
« Reply #771 on: July 28, 2013, 04:34:25 AM »
Ruptured both patellar/tendons below the knee cap at the same time.  happend on 7/19/13, surgery on 7/21/13 and now in rehab since 7/23.  immobilizers on both legs, using CPM on both legs but only one at a time, 0-30 degrees only.  Have been weight bearing but wondering about projected progress and possible exeercises which would help strengthen the quads.

Tom
Bilateral patellar tendon rupture 7/19/13

Offline D.S.

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Re: Ruptured Quadriceps Tendon
« Reply #772 on: July 30, 2013, 07:24:42 PM »
Tom, all I can say is ouch and wish you a healthy recovery.

Today was a great day. Measured 130 degrees of ROM at physio. This is approximately at 14 weeks. So getting close to the ROM of the good leg.

I wish everyone the best!

Offline fishy

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Re: Ruptured Quadriceps Tendon
« Reply #773 on: July 31, 2013, 04:53:45 PM »
I am a newbie.  66 year old male, 5' 10", 195 pounds (20 pounds over my normal running weight at time of event), have run 60+ half/full marathons, strength training at the gym three times a week. I fell down two stair steps on to concrete floor while carrying a 30 pound box landing squarely on both knees.  Immediately went to ER and Dr. thought I had only bruised knees and suggested rest for a day and a light workout. I followed suggestion and hit the wading pool for water aerobics and walked for about an hour, showered, and was walking towards my car when BOTH legs gave out!!  May 27th (Memorial day in the US) I had surgery to repair my left leg repairing a fully separated RQT and torn quad tendon in the right leg.  Awoke to IROM braces on both legs.  8 weeks post surgery and Doctor said I was doing great with ROM of 120 both legs....he suggested I could wean myself off of braces.  Week 9 now and I have completely "weaned" myself off the braces.  I occasionally use a cane, but prefer walking without any support.  I have read all 52 pages of postings....amazing read.  I am older than every other poster, other than that I am experiencing pretty much the same pains and complaints as everyone else.  I walk a mile or so a day, hit the gym and Jacuzzi to loosen my quads (and it just plain feels good), stationary bike for 30 minutes with zero resistance, work on ROM, and I hope to reincorporate upper body strength training soon. I plan on dancing at a wedding on August 24th (I promised my doctor that I will not "bust a move" that would "bust my knees"....).  Getting ready to hit the gym now...keep the faith my new family of "walking wounded"....and keep posting!
« Last Edit: July 31, 2013, 05:45:42 PM by fishy »

Offline Bearkev

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Re: Ruptured Quadriceps Tendon
« Reply #774 on: August 01, 2013, 12:25:10 AM »
Just got back from therapy and finally reached 130 degrees.  I've gained 26 degrees in the last 2-1/2 weeks.  I am also riding the stationary bike for 30 or more minutes with no pain.  I am also walking upstairs normally again.  I finally feel like there's an end to the tunnel.  Unfortunately, workman's comp is cutting me off from physical therapy soon.  I have 3 sessions next week & that's it.  I would like to have at least another week but don't think I can win that battle.  I am confident though that I'll be able to handle strengthening myself.  To those who are earlier in the process, keep your chin up, be patient and stay positive.  Before you know it you'll be past the pain.

Offline John42

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Re: Ruptured Quadriceps Tendon
« Reply #775 on: August 05, 2013, 05:27:40 PM »
Hi Folks

Suggest that you have a look at the new thread, which covers a RPT/RQT injury ...

Go to the BULLETIN board, and click onto Ruptured Patella Tendon/Ruptured Quadricep Tendon, if you follow it through, click onto the button on the right hand of the screen.

This is a brand new site, which contains lots of upto date informationon your injury and rehab information.

Ask questions if you so wish, and will try to respond to them.

Take care

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

Complete Ruptured Tendon

Offline fishy

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Re: Ruptured Quadriceps Tendon
« Reply #776 on: August 05, 2013, 05:51:27 PM »
Week 10....took both leg braces off and begin walking one week ago.  The braces gave support and security in the event of a fall or muscle failure, but sacrificing circulation didn't seem to be worth the trade off.  My doctor gave me the option of weaning off the braces slowly or removing completely (with no risky behavior, i.e., stick to pavement and avoid graveled slopes)... I can report less leg pains at night and I slept on my stomach without pain.  My legs feel stronger and I can walk with a more "normal" gait.  My course of rehab isn't for everyone, but it is working for me.  I will hit the Jacuzzi tonight (to warm up my leg muscles) then 30 minutes on the bike, then back to the Jacuzzi, then steam room.  I will sleep great tonite.... Keep your spirits up my fellow RQT, keep posting and I will do the same....

Offline D.S.

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Re: Ruptured Quadriceps Tendon
« Reply #777 on: August 07, 2013, 01:19:39 PM »
15 weeks post-op

I measured 135 degrees of ROM at my physio session. Good leg measures 145. One more physio session left.
 
I saw my surgeon last week, and he says I am doing well and don't need to come see him anymore.
 
I hopped on my road bike and went around the neighbourhood yesterday. For safety, I wore running shoes, instead of cycling shoes in conjunction with the clipless pedals. I kept it in an easy gear, and the neighbourhood is flat. I did not stand up on the pedals. It felt great. I will do this more often, to augment my training on the stationary bike.
 
I think I will hold off on returning to the gym until mid October, which will be about 6 months post-op.
 
I cycle on my stationary bike for about 45 minutes a session, almost every day. I keep the resistance fairly low, and vary the RPM between 70 to 85. I increase the resistance a little bit each time. At 6 months post-op I will train more aggressively on the stationary bike than I am now. I've always found the bike to be the ultimate leg trainer for me. It will help a lot to increase the size of my quads and calves.
 
I concentrate on the core stuff right now. Straight leg raises. Quad setting. Terminal knee extensions (like quad setting, but standing, using a Thera-Band for resistance). Hip exercises (adduction, abduction, flexion, using Thera-Bands). Step-ups (forwards and sideways). I do some work on stairs in my house. Lunges. Body weight squats. And I walk in parks, on grass (uneven surfaces) and I ascend and descend gentle to moderate grades.
 
Of course I stretch for ROM everyday, and I will probably make stretching my Quad a regular thing even when I reach full ROM.
 
I am working hard on nutrition, eating from every food group I can, going out of my way to get variety, and supplementing with vitamins, etc.
 
Finally, I rest a lot through the day, and sleep more than I ever have. I need to lose weight, but that will be looked after in a couple of months when I increase the intensity of my stationary bike workouts.
 
I wish everyone the best!

Offline John42

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Re: Ruptured Quadriceps Tendon
« Reply #778 on: August 07, 2013, 04:04:36 PM »
Hi D S

This is the new thread created by KneeGuru

https://www.facebook.com/QuadricepsPatellarTendonRupture

Click on the links - to the various documents which together with KneeGuru, have been compiled over the years.

Some good reading about your injury and rehab advice.

Would appreciate your comments

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

Complete Ruptured Tendon

Offline Bearkev

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Re: Ruptured Quadriceps Tendon
« Reply #779 on: August 10, 2013, 12:22:57 AM »
I am now 16 weeks post op and had my last physical therapy session today.  I measured at 134 degrees.  I still have a long way to go as far as strengthening and wish I could get at least another two weeks of therapy.  But workman's comp feels I've had enough.  But at least I'm another step closer to normal.  I plan on working out 3 to 4 days a week incorporating most of the exercises I've been doing at therapy.  Hopefully I can get to 100% by the time the ice & snow returns.

I hope everyone else is doing great.