Ruptured Quadriceps Tendon

[TurboCoder3000]

Let 8/1/2018 be the day that I hung up my cane for good. No need to carry it after making it 30 days just carrying it per PT's orders.

It sure feels good. It took 2 years to get here. Never thought I'd actually be here.

[Tvh3382]

Well it is 6 months since my bilateral quadricep rupture so thought it was time to give an update.

Still having physio twice a week with ROM in left leg up to about 95/100 degrees but that is hard and it is about 80/85 to be comfortable.  My right leg is only at about 80/85 but again that is uncomfortable and to be comfortable it is about 75/80 degrees.

Now managed to get rid of crutches but need walking stick when out of the house.  Going down slopes is still very difficult and not even attempted to do the walk where I slipped.  Stairs are one at a time both going up and down but still need to use to handrails. Lack of ROM is the main reason for stairs being a problem.

Had a Occupational Health Assessment yesterday to look at getting back to work as 6 months is a long time off work.

Still unsure on how much more ROM when can get but ready for the long slog and keep pushing myself.  Now finding that the more I do my legs are restless in the evening and find it difficult to find a position that is comfortable.  This is mainly with my good knee.  Anybody else have the same problem??

[brisket]

13 month update ...

Haven't been to PT for a while but still working on it at home. Range continues to improve though slowly; I'm guessing I've finally got 120. Gonna get measured soon to assess progress.

I can walk down stairs reasonably well but still doesn't feel normal. On the other hand, going up is 100% like pre-injury days and I'm even trying to "run" up now. I can jog and hop on one leg. Did some short but technical hikes this week including one that had at least a mile down hill at a significant grade. Wasn't as fast as it used to be but wasn't a problem so that's good.

Been doing a lot of cycling; averaging 30 miles a day. The motion still isn't 100% fluid and it takes concentration to fire muscles at the right time and let it bend properly.  There is apparently a device available to adapt crank length - orthopedal. Not sure if I should try it or just push through trying to make it work as-is.

Cheers!

[TurboCoder3000]

2 years post injury/surgery update:

A lot has happened in the past month since I gave up my cane. I continue to regain strength and function, and my ROM is beginning to increase (finally). Increases in ROM before were apparently false positives, because my original PT wanted to verify the new PT's measurements that were +100 and they turned out to be wrong. Anyway...at the very least I have officially HIT 99 degrees ROM. YEAH.

As of Wednesday, for the first time since the day I was injured on 8/28/2016, I can stand and balance on my right knee for TEN SECONDS. It takes a little time to get there initially but once I am there I AM THERE. And, the big thing: I can do it without using any support whatsoever on both soft and hard surfaces.

BOOM.


 

[arnold99]

Good evening, this site has been a great resource to me and I wish I found it sooner.
Ruptured my quad tendon June 16, 2017.  53 years old and have never had a serious injury.  Playing soccer and made a turn and heard a pop and as I fell my knee didn't look right, then it felt like a terrible cramp.  I thought a few minutes of rest and I might resume playing.  I tried to get up and realized I was closer to fainting than standing.
My family drove me to ER and could not do a straight leg lift or bend and ER flipped a coin on XRAY or MRI.  They went with xray and doctor saw visually the indentation above the knee.  Was given a shot of morphine and put in straight leg brace and off to different hospital a few hours later.
At second hospital a resident and surgeon confirmed the quad tendon was almost completely severed " only a few strands left" Was admitted for surgery the following morning.
So from pop to surgery was about 36 hours. 
Because I tried to lay off the pain meds I failed physio so ended up being in the hospital 3 nights.
I went home using a walker and weight bearing on crutches as much as I could tolerate with the straight leg brace.  I was able to ditch the walker in about 3 days. 
Was moved to hinged brace at 6 weeks and wore that at a setting that I was comfortable at for another 6 weeks, typically I wore with full ROM unless I was on a hill or in a crowded space.
I started physio at about 8 weeks and the milestone was when I could finally make a full revolution on the bike, first time I thought I would die.
Fast forward, I was released by surgeon at about 8 months and physio was down to once a month end ended at at 1 year.
I am now 14 months and honestly discouraged.  I still have the elastic band feeling and the occasional anterior weakness where the knee has the buckling feeling.  I can ride the stationery easily but on the treadmill or on the field anything more than a moderate jog for a few yards feels uncomfortable, part of it for sure is mental as the pain of the event and the first few weeks is all too real.  So I have not played soccer or ball hockey since and was told two months ago to be careful with golf before I try swinging normally.
So...any hints or advice?? does the elastic band feeling ever go away? is there a time when going down stairs normally won;t feel tight or hurt?  Stairs are still an issue particularly going down.
Is this my new normal?
Thanks

[John42]

Hi arnold99

Welcome to the RQT thread on KneeGuru - firstly you have sustained a very rare and serious injury, and have done well so far following a normal protocol.

A few hints - sleep with a cushion/pillow between your legs - think about purchasing a floor cycle - costs about $50 on Amazon, sit in your comfortable chair and pedal away - carry on reading previous posts on this thread - yep, I  agree, stairs are an ongoing problem, but ill ease with time - avoid grass and wet side walks - avoid some sports activities - and Keep posting - ask questions.

JohnK/ Manchester UK

[arnold99]

Hi arnold99

Welcome to the RQT thread on KneeGuru - firstly you have sustained a very rare and serious injury, and have done well so far following a normal protocol.

A few hints - sleep with a cushion/pillow between your legs - think about purchasing a floor cycle - costs about $50 on Amazon, sit in your comfortable chair and pedal away - carry on reading previous posts on this thread - yep, I  agree, stairs are an ongoing problem, but ill ease with time - avoid grass and wet side walks - avoid some sports activities - and Keep posting - ask questions.

JohnK/ Manchester UK

Thanks John, the little floor cycle I had never seen before.
As I am 14 months when will descending stairs feel normal if ever?
Also I was told at surgery that RQTs might be my thing...so whenever I get a get an ache in the good knee I try to recall what the bad knee felt like the days leading up to the tendon rupture.  I guess there is no way to forecast that.

Anyone on the forum have any advice about resuming golf? my physio was more worried about that than getting on the soccer field to kick the ball about.

Thanks

[John42]

Hi Arnold99

Stairs ..  no consolation,  I am 13 years down the road and have 113 ROM -still taking care going down stairs, and hold onto the banister ( wooden rail affixed to the wall) to hold onto it.
Just take care.

JohnK/ Manchester UK

[brisket]

Hi arnold99, looks like we were injured at around the same time (I was first week of July) and are experiencing similar issues or timeline. Welcome to the "club."

the milestone was when I could finally make a full revolution on the bike, first time I thought I would die.

Haha - I remember when that happened for me; only time I let out a noise at PT.

I am now 14 months and honestly discouraged.  I still have the elastic band feeling and the occasional anterior weakness where the knee has the buckling feeling.  I can ride the stationery easily but on the treadmill or on the field anything more than a moderate jog for a few yards feels uncomfortable, part of it for sure is mental
So...any hints or advice?? does the elastic band feeling ever go away? is there a time when going down stairs normally won;t feel tight or hurt?  Stairs are still an issue particularly going down.
Is this my new normal?
Thanks

Have you been making continuous progress, however gradual? I experienced a lot of trouble regaining ROM but consistently advanced week by week.  My flexion continues to improve to this day.  If you are making progress, and not experiencing significant swelling, I'd say there is no reason to see this as the "new normal" and you will continue to advance. If things have plateaued for a couple of months, then may be worth getting an expert opinion. My reading suggests that a very high percentage of people have good functional outcomes and achieve workable ROM. No reason at this point to worry you won't!

When do you experience the "rubber band" feeling? I still feel tension, more on the patellar tendon side, sometimes when stepping down.

When does the buckling sensation happen? I experience it occasionally, but very infrequently. I've come to suspect it corresponds with small ROM gains and a period of adjustment where my muscles need to learn to fire at a "new normal" position.

Not sure if you had a chance to read my 13th month update above. What might be of interest to you is that only now can I go down stairs with a proper motion and it definitely doesn't feel normal yet. It does seem to be getting better but hard to judge day to day.

To sum up my recent experience - with continuously pushing myself and staying active, rom improvements are still coming.  I'm finding  that most of my other issues are resolved by focusing on using and firing muscles the right way, aka normally, and unlearning the protective/adaptive habits I've learned in the last year.

Stay in positive and keep working!

[arnold99]

Thanks Brisket, I feel like I have hit a plateu for sure.
The buckling is only occaisionally especially if I am out somewhere and on a longer walk.  Like you I think as I healed I changed my gait or adapted to protect the leg.
I would say going downstairs my ROM is normal but it is tight and uncomfortable. 
Rubber band feeling is jist how describe the area right around my knee cap, it doesn't feel normal.
Another thing, do you have any problem kneeling? If I try to put the bad knee down it is torture until it settles, right at the point of injury.

[brisket]

I would say going downstairs my ROM is normal but it is tight and uncomfortable. 

Okay, sounds similar to my current status, in which I'd say the feeling of tightness is going away but very, very gradually.  This might sound counter-intuitive but check that you are moving the other leg properly and landing / bending it normally instead of tending to straight leg it or shift weight quickly. I had a friend observe and provide this feedback recently and paying attention to the "good leg" has helped.

Rubber band feeling is how to describe the area right around my knee cap, it doesn't feel normal.

Is this when you move it; or manipulate your knee-cap; or just all the time? My knee cap is not quite as movable as my other side but pretty loose and no unusual sensations.

Another thing, do you have any problem kneeling? If I try to put the bad knee down it is torture until it settles, right at the point of injury.

Guess I'm lucky with this - no pain at all kneeling! Can't sit back on my heels yet though. The only sensitive area I have is if I press firmly on the area just above and on outside side of my kneecap. Earlier, there was definitely a little bump / sensitive area around what I think was the site of the repair. This seems to have gone away - either due to time or my constant and obsessive massaging of the region

[arnold99]

Thanks Brisket, the tightness I would say has been the same for months and it more noticeable when walking and of course stairs.  When sitting at work at 90 degrees it is a bit tight but okay.

Right now with it feeling tight and having physio end I kind of feel like it is also a mental thing and I am tentative to push it on my own, I have scared myself on the treadmill by not having  the safety string attached.  I am good the first 5-6 steps at a good speed then I go into limp mode.

[Jlguthrie]

Glad to hear of everyone's success. 9 month update, had my last visit with surgeon. Was told every thing looked good and at the one year mark should be as good as it gets. Knee cap still tight and uncomfortable  but liveable. Full day excursions which in the beginning  were unimaginable, are now tolerable. To any future readers, stretch continually  once allowed.At about the 5-6 month mark using ems and going to the gym have made all of the diffrence.Focussing on hamstring,hip flexors, and quad (slooooooowly) exercises were extremely beneficial.

[TurboCoder3000]

This is so frustrating. I don't understand this phenomenon. For those just tuning in I completely tore my right knee's quadriceps tendon on 8/28/2016. Had surgery 9/21/2016. Suffered necrotic skin over the entire surgery wound as a complication, forcing me to spend every day, 24/7 in recliner, in an immobilizer brace for 8 months until the surgery wound healed. This included twice weekly wound care visits for debridement. Anyway.

25 months out from surgery and my knees get weak as hell. Today was one of the worst. It's like I've lost all progress I've gained over the past 8 months. After I get up from sitting for long periods (I do internet marketing work for a living) I walk stiff-legged, and can really only walk like I just came out of an immobilizer brace.

Why does this happen? This never happened when I was normal. How can I make sure that once I reach a real level of competence in my walking it stays there?

And how can I grow muscle faster? Waiting 6 weeks for strength to change doesn't seem practical (or friendly). I just want this to be over, dammit.

[Jlguthrie]

Turbo, sorry to hear you've had a setback. I too have moments of weakness . I'm doing a lot of leg work at the gym and using ems and I'm still only about 60- 70% of where I was. Still have some rough  days but overall still improving. 8 months of atrophy is going to take a lot of time and hard work to overcome. Maybe a good strength coach whose familiar with injuries could help? Oddly enough after a leg workout where my legs should be really fatigued and shaky is when I walk normal including steps. Then the next day it's like starting over. Keep pushing.