Ruptured Quadriceps Tendon

[John42]

Hi Vic

Welcome to the RQT/RPT exclusive club - Yep, it`s going to be a long haul to recovery with lots of PATIENCE -  I see that you have read some of the previous posts and we are rooting for you.

Just go ahead and ask questions.

Take care

JohnK/ Manchester UK

[Juny]

Hello John,

I've seen that you've been sending several documents regarding rehab. I'm not at that point yet but I'd like to read up on what I can.

Questions:

I've read on some of the posts that a few have had a bit of pain to the inside of the knee or in my case  to the left of the incision low end of the kneecap. I get this a few times a day it almost feels like bone on bone. Those that have had this does it go away after some time?

Has anyone experienced some pain near the hip flexor?

How long do the restless nights last?

At what ROM can I drive an automatic? I'm not worried about getting into the car just the sitting down part. Just before the surgery I was dragging myself into the car and once I adjusted my leg with my hands I was able to depress the brake and gas with ease.

Will my quad strength be so diminished that I won't be able to depress the pedals? Thanks. Wish everyone a speedy recovery.

VIC

[Stuart Rulka]

Juny. The issue with driving is not about your physical ability to depress pedals but rather how your Insurance carrier would react were you to be involved in an accident. You could be ruled Negligent!  That being said I myself was driving an automatic two weeks post surgery ( surprised anyone?) ? My alternative was continuing to drag my wife out of bed at 5am to drive me into work (40 mins each way) and having her fight rush hour traffic  (an hour each way) to pick me up at 5pm. Preferred to take my chances driving myself!
 Warning! Do not try this yourself , trained driving instructor - as they say in the commercials!
Point is you are not really using your quads, just flexing your ankle.

Good luck

[SE27Eagle]

Very sorry we're acquiring new members so fast, but on the other hand, you're both proving the rule that this is an injury which occurs to especially nice people.  One of those is Frank, who probably knows precisely the legal position on driving.  But for benchmarking purposes (Stuart is a bit of an outlier in terms of rehab speed), I was negligently driving about 6 weeks after surgery, and when I say negligently, I mean I was cautiously driving a right hand drive automatic around the corner first with just my left foot, then both and then finally with the right.  But obviously the question is whether you can control the car safely, including being able to brake hard enough to perform an emergency stop. 

[Stuart Rulka]

Has certainly been quiet on this thread!
With regard to driving I too was using an automatic, using my right foot on the accelerator, or gas pedal over here, and left foot braking with my good leg. Must emphasize  that this in an acquired skill and is probably best not tried if you aren't experienced in it!
 Just had a personal setback having been diagnosed with Pyriformis Syndrome. A side effect has been a change of gait resulting in bursitis and renewed swelling in the damaged knee.
   Here we go again!

[Juny]

I thought the thread was quiet as well. I haven't tried getting behind the wheel yet but it seems as though I'd have to push the seat back far enough to keep my leg at 0 degree. I think I'll try it soon. I'm so anxious to get even 10 to 15 degrees ROM but that won't be for another 10 days for a total of 4 weeks 4 days with 0 degrees ROM.

Stuart sorry to hear about the Pyriformis Syndrome you've developed. I wasn't sure what that was and just looked it up. I may have the same thing. The pain I've felt at the hip is radiating from my buttock down the back of my leg almost to the back of the knee. It feels like when you do a hamstring stretch only it is constant and for me worsens when I'm in the process of sitting down leaning to my good side with my bad leg fully extended. I've been chalking it up to a strain on the hamstring from having the leg extended for three weeks now. Like I need another medical ailment to go with the RQT and my diabetes. TC everyone.

Juny

[fishy]

Has certainly been quiet on this thread!
With regard to driving I too was using an automatic, using my right foot on the accelerator, or gas pedal over here, and left foot braking with my good leg. Must emphasize  that this in an acquired skill and is probably best not tried if you aren't experienced in it!
 Just had a personal setback having been diagnosed with Pyriformis Syndrome. A side effect has been a change of gait resulting in bursitis and renewed swelling in the damaged knee.
   Here we go again!

Fishy here, and AW FUDGE, Man am I sorry.  A definite bummer...I will keep you in my prayers....you take care of the problems so you can get past this situation.  Keep us informed so we can use your experience to guide us.  Good luck....  Bob

[Stuart Rulka]

Juny. As a former driving instructor I would have to counsel against trying to drive with one leg stuck at 0 deg. The mechanics of trying to brake in an emergency, even with the other leg are not in your favour! On the other  hand  my PT had me ditch my brace completely at 4 weeks at home and during therapy. The longer you stay at 0deg  the tougher the rehab of your quads.
 Bob ,  thanks I can use all the help I can get !  As stated before my mental health depends on exercise, however honesty compels me to admit that my current ailment may well be due to hypertrophy of the Pyriphormis muscle and it's impingement on the Sciatic nerve. In other words an overuse injury. Prevailing wisdom seems to be that this is age related and I need to adopt an exercise program more in keeping with my advanced years (66).  Perhaps you can relate!

[SE27Eagle]

Stuart, I am really sorry to read this news a second time and actually understand it (on FB I interpreted it as "if only he knows what I do every day" as opposed to "I need to lay off the exercise now").  Indeed, I just stopped short of a like.  Anyway, you are just going to have to build the Sofa Sprawl into your routine in order to protect your access to the Grouse Grind.  And swimming, perhaps? 

Juny, your question about driving at 0 degrees is the first proper challenge to my proud record of Dangerous Practice Seeking Endorsement on this board when I (this isn't a joke) was seriously asking whether it was a good idea to be coming down the stairs on both crutches rather than the approved method of handrail and one crutch.  And to reinforce Stuart's point about acquired habits, I was trying my dodgy wrong foot/two feet technique with 80-85 degrees of movement.  Actually I think it helped ease it out a bit further but I never quite had the chutzpah to admit to the PT that this (rather than my studied neglect of the exercises) might have accounted for a spurt of ROM progress.

[Juny]

SE27Eagle, I thought it was funny coming down the stairs on both crutches (probably because I also tried it a few times.) 80 - 85 degrees that kind of blows for me since I'm still at 0 degrees and according to what I've read 10 - 15 degrees from week to week after I start PT which won't be for another 2 weeks then doing the math I should be at 80 - 85 between the first week and the second week of June.

Stuart I'm pretty sure I have Piriformis Syndrome. I think it's a result of the RQT and keeping my leg at 0 degrees for over a month and during this time changing my body mechanics. What have you done for this? The pain from this is worse than the knee, which is pretty much pain free. TC everyone.

VIC

[Stuart Rulka]

Juny, I agree with you  regarding the pain, and sympathise with your situation , given that the only advice I have been given is to rest it combined with using a roller and tennis ball and stretching. This would be tough at 0deg ROM !
 Saw my own Physician today, for the first time since my surgery, he feels my issues may be more to do with the joint capsule of my right hip which has a history of arthritic degeneration. This has been aggravated by gait changes following the rupture .
  Everything snowballs!  Bob , envy you your countdown to Hawaii !

[SE27Eagle]

I am beginning to wonder whether the standard practice in - say - 10 years' time will be to build in pilates or yoga into the rehab schedule so that anyone who's been immobilised and lost muscle bulk in the leg gets to work on core strength and posture as well as the simple mechanical power of the primary muscle groups.  It's funny how some things start popping up over and over again reading through our mighty thread and remembering my own experiences in two episodes.  As Stuart says, things snowball - or to put it another way, you can be blindsided by the original injury not to realise that what will really screw you up is prolonged immobilisation or biomechanical strain from compensation. 

I am also painfully aware of what one of my colleagues said (who used to be a hospital doctor) and that is that in a perfect world, you would train for surgery like you train for a major sports event - you would do aerobic training for cardiac and vascular fitness (and indirectly, immune system health) and manage your weight to reduce strain and load.  But of course injuries and sudden diagnoses don't give you notice.

[Stuart Rulka]

OK. Just received the faxed report of my knee radiographs taken an hour ago. The report on both knees is the same with one exception. On the right knee ( the damaged one.)  ""There are multiple suspected loose bodies within the suprapatellar recess, largest 6mm in diameter."
 Anybody else experienced this ?  Knee functions normally, just feels swollen, something I attribute to my hip issues and temporarily abnormal gait.

[Egatsby]

Just stumbled upon this message board. Ruptured my left PT 4/28/14 having surgery 5/7/14. I ruptured my right 8 years ago so I know the torture I have to look forward to. I ruptured them both playing basketball I'm officially retired now eff basketball. I will have matching scars on my knees so I guess that's kinda cool

Edit: wrong forum sorry I don't know how to delete

[SE27Eagle]

Hey Egatsby, welcome to our exclusive club of two scar members.  It is oddly cool, actually, except that you made me look at them more critically and for the first time I realise the one on the right is well to the side.  For a proper matching pair you want them both to be down the centre, I'd say.  And best of luck on Wednesday.  I know that going round the second time is wearing to say the least.  Knowing for sure you will come out the other end doesn't fully compensate for knowing how long it will take.

Stuart, I'm not sure what has been in there both times with the knee's slow return to normal size.  There isn't anything discernable in the left now, but that's 7 years post injury and surgery.  It took a long time to get back to normal appearance; if I remember correctly, about a year.  The right is still a fair bit bigger than the left but shrinking.  In both cases, the "extra" knee has always been above the patella, so I guess that's what is meant by suprapatellar recess.  What are these loose bodies likely to be and would they yield to massage?

Was signed off by my OS last week.  Much mutual congratulation and a last look together at the original MRI scan, which showed how impressively I'd made a mess of myself.  As have we all, of course.