Ruptured Quadriceps Tendon

[vince99frc]

Thanks for responding..  I have been out of the brace since the 8th week.  I am 12 weeks now and I have slight extensor lag.  I still have pain and tightness when trying to fully extend. 

Vince99, I ruptured my both patellar tendons and I am 6 weeks post op and still can not do a leg lift, nor does my OS want me doing them.  When standing with the crutches, I do standing leg lifts where I swing my legs, one at a time forward.  I started doing them per my PT without flexing my quad after the third weeks and now do them flexing my quad as much as I can.  I have a PT protocol from my OS that is titled Quadriceps tendon repair that he wrote over the words Patella, so think he is being lazy, but my injury is rare, per him.  I checked on 7 week workout and it says that you should be doing straight leg raises, flexing while increasing ROM from 95-100 and then to 105 and then 115 by week 10 post op.  Hope that helps.

Are you still in a brace, or are you out?

Tom

[vince99frc]

Hello there...  I am located in Tampa, Florida, USA..  I am going to look at your undermentioned thread now..

Thanks,

Vince

Hi Vince

Welcome to the RQT?RPT thread on KneeGuru - you will have realised that you have sustained a very rare and serious injury, with a long rehab.

Months ahead of you for rehab.

Suggest that you click on the undermentioned thread, which shows a collection of documents which I have compiled together with KneeGuru over the years.

PATIENCE will be rewarded.  Where do you live?

Take care
JohnK/ Manchester UK


://www.facebook.com/QuadricepsPatellarTendonRupture

[Stuart Rulka]

65 year old male(active) ten weeks post surgery for complete rupture. No pain at time of injury or since. Dispensed with crutches 5days post-op because of arthritic wrists. Started on bike 3weeks post- op and set aside brace 4weeks post-op. started hiking Vancouver's Grouse Grind 6 weeks PO. How long should I expect swelling to remain and how long should Physical Therapy continue, currently 3 times per week, hiking4 times weekly?

[John42]

Hi Stuart Rulka

Welcome to the RPT thread on KneeGuru

You have sustained a very serious injury, with a long rehab in front of you. The tenon has not yet healed 100% and suggest that you go easy on outdoor activities. The swelling can continue for quite some time - but listen to your knee.

Suggest that you ask your OS/PT have you seen this type of injury before, as you should not be on a bike 3 weeks after surgery, as there is the danger of rerupture.

How did you sustain your injury?   

Suggest that you look at the undermentioned webpage - it contains a set of documents which I have put together with KneeGuru.

Keep posting - ASK questions.

Take care

JohnK/ Manchester UK


://www.facebook.com/QuadricepsPatellarTendonRupture

[John42]

Forgot to ask you ---

Did you rupture your patella tendon or your quadricep tendon???

Best

JohnK/ Manchester UK

[Stuart Rulka]

John42. Injury sustained in fall descending an embankment, rescued by Canadian Coast Guard hovercraft and underwent surgery for complete rupture of quad tendon 15 hours later. Returned to work 3 days post-op and started Physio 2 weeks later. Have known this practitioner for 25 years; he was in London with the Canadian Olympic team, was Chief Therapist at the Vancouver Olympics and works primarily with athletes. Thank you for your response

[Stuart Rulka]

Posted my history primarily because most postings re this injury seem to focus on the downside. I think it is important for others with recent surgeries to know that properly supervised, recovery need not be as traumatic as I  was led to expect. I was diagnosed with Depression 5 years ago and chose strenuous exercise as an alternative to drugs. My first reaction on hearing the diagnosis and recovery period,(No hard exercise for 12 months) was that it amounted to almost a death sentence! Exaggerated I admit but at my age I would never have been able to regain my level of cardio-vascular endurance or recoup the muscle loss. As it is My right quad is still 2cm smaller than my left. Had I waited a year I would have become an "Old Man".

[Frank550]

Oh how I wish your surgeon and team had looked after me! I am flabbergasted at the speed you appear to be recovering!

All I can say is please be careful and don't tempt fate and have a re-rupture.

(Must book a move to Canada!)

[Stuart Rulka]

Frank550. I should mention that I was fortunate to be taken to an almost rural District Hospital in Duncan B.C. Where I received wonderful treatment even though it was our August holiday weekend . My PT is treating a patient who suffered the same injury on the same weekend in Metro Vancouver and he waited 4 days for Surgery! My PT is the top knee man in Canada (Marc Rizzardo) who sat me on a bike on my first visit, 2 weeks, and told me to see how far I could move ,forward and back. By the 4th visit I made a full revolution and never looked back! The Grouse Grind I hike (try Google ) is a perfect challenge, 30pct grade but with a tram down, downhill travel being expressly prohibited! Still tentative going down stairs so this is perfect. Even with a6 week layoff my cardio went to hell and I lost 2cm off my right quad. Can't overstate my good fortune!

[John42]

Hi Stuart

May I suggest that you get a floor cycle - Amazon - about £30 or $45 - you just sit in your chair and pedal away - it is a godsend

JohnK/ Manchester UK

[Stuart Rulka]

Thanks John. Do have access to stationary bikes in our complex but prefer to get outdoors after working 10hour days. Hike all winter in the dark using headlamps and crampons when necessary!

[SellaVee]

Hi Stuart

I'm delighted to hear of your progress and I'm sure it will be an inspiration to other readers.  The thing that really surprised me was that you felt no pain at the time of the accident or since.  I was in absolute agony when I fell, and I remember being in pain when I came round from surgery.  I'm guessing you're not on pain medication.

John, Frank and I are all in the UK where the rehab protocol tends to be much more conservative than in Canada and the physiotherapy not so good.  I also suspect you had a much higher level of fitness.  I'd just recovered from foot surgery when I fell so my fitness was poor.  I aim to be fitter when I'm recovered than I was before I fell, as I learned from seeing some of my fellow patients in hospital that it's very much use it or lose it when I comes to mobility.

I also agree that you'll benefit from being outdoors.  When I first came out of hospital I hired a wheelchair and my husband would push me up the road to our local pub garden.  Just sitting outside in the sun cheered me up.

Do you use knee sleeves/braces and hiking poles when your on the trail?  I'm relieved that you're still tentative going downstairs, otherwise I'd have had to ask you to change you're username to Superman Rulka.

I Googled the Grouse Grind and learned that it was one of the 10 most dangerous hikes on earth and that last month a man had a heart attack while climbing.  "Let's be careful out there" .......  on the Hill.

To answer your original questions, I think swelling could continue for up to a year, depending on how hard you're working it, and I'd ask your physiotherapist how long he or she expects you to continue.

[Frank550]

Superman seems quite appropriate!! (In a nice way)

I think the UK lags behind many parts of the world in its medical aftercare, I'm sure the surgeons do good work but the post op care is flooded with patients and not enough practitioners.

As for going downstairs etc....stairs are a pain going up or down, its inclines I cant deal with, I'm ok going up but going down is a problem where I feel I'm going to topple forward, add a 50kg dog to that equation who sometimes wants to move faster than I am capable......

Fitness...I think you've hit it on the head, I used to be Mr superfit when I was a cop, but arthritis and I have to admit a bit of laziness, put paid to my sporting activities, I have also promised myself to rectify that situation as soon as I can (we should start a post op quad tendon fitness group!!)

onwards and upwards

[mojocpa]

I did the double RQT going down my stairs at home. I caught a heel with brand new shoes and ruptured the left quad and the right one went trying to get up. This happened the evening of October 1, 2013. I had surgery the next morning and PT had me in a walker with locking braces that  afteroon. I was released from the hospital on October 6th. I have an appointment with the OS this afternoon. I have kept a positive attitude and follow the medical specialists orders.

[Stuart Rulka]

SV. After my fall I landed on my back with my leg doubled underneath me. One look at the position of my kneecap told me I was in trouble. I was really surprised to feel no pain but was frankly terrified that any movement might precipitate agony. Had to stay calm to coach my wife to launch our rubber dinghy from the shore of the isolated islet we were on ,explain how to lower and start the outboard and send her back to our sailboat to radio for help. Lesson is that disaster strikes at the most inopportune  times, and if venturing afield be sure all parties have an awareness of what to do in an emergency! Had I been writhing in incoherent agony things could have become ugly!
  I suspect the lack of pain could have been because my injury may have been less of a rupture of the tendon than a tearing of the periosteum to which the tendon attaches. My only basis for this theory is the lack of pain and the fact my surgeon said my powerful quads were partly responsible. Fitness can be a double edged sword! No post surgical pain either although my OS pressed a prescription for 40 Oxycodone on me at discharge. Tore it up, and was back at work 3 days later, which I could not have done on drugs. Being self employed is a great motivator, and motivation, or desire, plus fitness is key to recovery.
 The Grind is not as dangerous as the media suggest, I suspect the deaths (understated actually) are commonly due to middle aged men trying to keep up with younger ladies! I am no hero and now use my brace and one hiking pole, taking much shorter steps than is my wont. Tonight will be my 18th time up the hill since my injury August2nd but I have been climbing 3-4 times a week, year round since 1996 .