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Author Topic: Queston On Quad Tendon Rupture Recovery - Rehab 7 Weeks Post Op  (Read 7842 times)

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Offline alanbk

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Queston On Quad Tendon Rupture Recovery - Rehab 7 Weeks Post Op
« on: November 02, 2013, 01:12:43 PM »
Ruptured left quad tendon 95%, 8 Weeks ago Today,,  Surgery was 7 weeks ago. I was told weight bearing as tolerated on leg with crutches, when leaving hospital. No complications with surgery or recovery to this point except with what I've noticed a click in the knee cap at times. Staples were removed at 2 weeks. Brace was locked in full extension up to 4 week appointment, when ortho asked how much I could bend the knee.  I wasn't sure because I didn't try.  He had me lay on table with leg supported and I was able to bed knee only tried to about 45 deg.  Brace was unlocked to 30 deg, but keep it locked while walking.   By that 4 week apt I was not using the crutches around the house, only when I go out.  Also at the 4 week appt I was allowed to drive since it was my left leg and there was no issues with sitting in front seat of car.  Dr said no pt until more can be done with the knee.  Told me to schedule a appt in 3 weeks (coming up in 4 days), which he said we would be getting a lot more aggressive  the knee. 

After reading a lot on here, and having some movement in the knee, I've been working very carefully, making sure no pain, to get more flexing, not bearing any weight. This has been done with no active knee motion.  Only by using the other leg, or while sitting and using my hands or body.  I'm able to get to about 75 deg.  . I don't go any further because it gets tight. 

What I've noticed is a click on pop in the knee cap, when on occasion there is some active knee motion.    There is no pain what so ever.  I first noticed it when going up or down steps and the brace was not locked at full extension. 

Anyone experience this or have any idea on what it is and if it will go away with rehab?

Thanks
« Last Edit: November 02, 2013, 02:09:14 PM by alanbk »

Offline John42

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Re: Queston On Quad Tendon Rupture Recovery - Rehab 7 Weeks Post Op
« Reply #1 on: November 02, 2013, 01:51:32 PM »
Hi Alan

Welcome to the RQT/RPT thread on KneeGuru.

You seem to be making reasonable progress, nut a long way to go with the rehab - suggest that you click on the undermentioned webpage - contains a number of useful documents which I have compiled together with KneeGuru.  Will enable you to understand your injury and the rehab process.

Read up as much as you can  - PATIENCE is required - ASK questions.

How did you sustain your injury?  Where do you live?

Take care

JohnK/ Manchester UK





https://www.facebook.com/QuadricepsPatellarTendonRupture
Ruptured Patella Tendon January 9 2003
Slipped on black ice.  Manchester UK

Complete Ruptured Tendon

Offline alanbk

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Re: Queston On Quad Tendon Rupture Recovery - Rehab 7 Weeks Post Op
« Reply #2 on: November 02, 2013, 02:07:26 PM »
Thanks John.


Its my left knee, not right. 


I wish there was a great war story behind my injury.  I was walking and didn't see one step up to a different patio level.  My left foot hit the vertical surface of the step causing my left knee to hyperflex with all my body weight rupturing the quad tendon. 


Offline Stuart Rulka

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Re: Queston On Quad Tendon Rupture Recovery - Rehab 7 Weeks Post Op
« Reply #3 on: November 02, 2013, 05:14:40 PM »
Hi Alan. There seems to be a great variety in protocols. In my case I dispensed with crutches completely at 4 days, because my wrists were too weak to support my weight. My PT had me on a bike on my first visit, 2 weeks, to see how far I could move. A week later I managed a full rotation and from then on regularly spent time on the bike. Dispensed with brace at 4 weeks except when hiking which I got back to at 6 weeks, purely as a safety measure. Locked it at 120 max.
   This may not be for you but do be aware that most OS are very conservative and the longer you stay inactive the harder the recovery. My PT was head Therapist at the Vancouver Olympics.
Stuart Rulka
Complete RQT Aug2 2013
Surgery Aug3 2013
Resumed work Aug6 2013

Offline Stuart Rulka

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Re: Queston On Quad Tendon Rupture Recovery - Rehab 7 Weeks Post Op
« Reply #4 on: November 02, 2013, 10:53:34 PM »
Alan. I should mention that my OS had said "No hiking" for 6 months, very conservative as I mentioned. My Physio  however was okay with it as long as there was no downhill involved. He does have 2 other quad tendon ruptures he is treating right now, so he has experience. As to the click, when I questioned it in my knee his response was "get used to it!"
Stuart Rulka
Complete RQT Aug2 2013
Surgery Aug3 2013
Resumed work Aug6 2013

Offline alanbk

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Re: Queston On Quad Tendon Rupture Recovery - Rehab 7 Weeks Post Op
« Reply #5 on: November 03, 2013, 01:59:02 PM »
Stuart,


Thanks for the reply.  The click just has me concerned,  its very bothersome but not painful.  Did anyone have an idea what the cause could be?  When I out put my hand on the knee cap i can feel lt.  Im really hoping it goes away with more rom. Im just a lil concerned that ive been too aggressive too early.  Have not been to any pt yet.  I expect that will change on Wednesday.  They say the tendon takes 8 - 12 weeks to heal.  Just also concerned that being  too aggressive will hamper healing.  From the sounds if your rehabilitation it does not.

Offline John42

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Re: Queston On Quad Tendon Rupture Recovery - Rehab 7 Weeks Post Op
« Reply #6 on: November 03, 2013, 03:20:29 PM »
The tendon take a bit more than 12 weeks to heal - PATIENCE is required - listen to your knee - DON`T push it


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

Complete Ruptured Tendon

Offline SellaVee

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Re: Queston On Quad Tendon Rupture Recovery - Rehab 7 Weeks Post Op
« Reply #7 on: November 03, 2013, 04:19:36 PM »
Hi alanbk

Several people on the RPT thread have mentioned this popping and clicking and the consensus of opinion seems to be that it's due to the patella maltracking because the muscles on one side of your leg are stronger than those on the other.  I know my physiotherapist has been working hard at getting my patella "into the groove".  She showed me how it should work on a plastic model.  The groove is like the shape you get when you make a fist and look at where your fingers and thumb meet.  The patella is sort of cone shaped so it should drop into the space.  If the muscles are stronger on one side it will be off centre and cause the clicking and popping.

Have a word with your physiotherapist when your appointment comes round.  Strengthening the quad muscles, and in particular the VMO, which is the muscles just up from your kneecap on the inside of your leg, seems to be the way to go.

I have no medical training so this is just my opinion.  Sella
Ruptured patellar tendon (avulsion fracture) 11 June 2013
Surgical repair with wire 5 July 2013
Wire removed 28 January 2015

Offline Stuart Rulka

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Re: Queston On Quad Tendon Rupture Recovery - Rehab 7 Weeks Post Op
« Reply #8 on: November 03, 2013, 07:29:57 PM »
Hi Alan. I get the impression that there is a school of thought that says you do not do serious rehab till the tendon has healed .my PT seems of the opinion that the tendon can sustain a reasonable degree of stress early on, which allows you to work on building the quads back up.in support of SellaVee's theory my clicking has diminished as my quads have grown stronger. My surgery was 13 weeks yesterday.
Stuart Rulka
Complete RQT Aug2 2013
Surgery Aug3 2013
Resumed work Aug6 2013

Offline alanbk

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Re: Queston On Quad Tendon Rupture Recovery - Rehab 7 Weeks Post Op
« Reply #9 on: November 04, 2013, 01:00:03 AM »
Wow, everyone is really great and helpful on here!!!   


I really have been protective of the knee, I'm just  doing a lot more with it than my OS told me to do. After reading the horror stories of those who basically did not used their quads for 3 months, I really wanted to start working the leg more that what the OS said. From what I've read on here, a lot of you are much more aggressive than I have been.    I've not pushed it to the point where there is pain.  Actually it feel good to walk on it, no pain at all.  I have not put any real load on the leg with the knee bent other than ordinary walking with the brace locked at 30%. Again at the last apt. the OS unlocked the brace to 30, and said keep it locked when walking.  Also when out of the brace I've  been working the knee with no really active knee effort to about 80 deg after that it's really tight.  I'm actually looking forward to seeing the process of how PT will work with it to get more ROM.     Prior to this injury I worked out daily, normally 30 - 45 minutes a day, mainly running, cycling or the stepper.  I've been doing this type of workout since 1998, over 15 years.   All of which is working the legs.  So needless to say my quad and calf muscles are huge, well they use to be.  Thanks for the explanation on the clicking and popping, it sounds very normal.  The next appointment is this Wednesday, I hope the OS wont get on me too much when he sees I've been doing more that he wanted.

On another note I've ordered some Cissus tables, all natural, they should be here Tuesday.

Thanks again,

-Alan 





« Last Edit: November 04, 2013, 01:02:36 AM by alanbk »

Offline Stuart Rulka

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Re: Queston On Quad Tendon Rupture Recovery - Rehab 7 Weeks Post Op
« Reply #10 on: November 04, 2013, 04:33:13 PM »
Alan. You haven't mentioned your age, which for most of us is over 50. Your fitness level will definitely be an asset in your recovery. Just hope they let you use it!
Stuart Rulka
Complete RQT Aug2 2013
Surgery Aug3 2013
Resumed work Aug6 2013

Offline alanbk

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Re: Queston On Quad Tendon Rupture Recovery - Rehab 7 Weeks Post Op
« Reply #11 on: November 04, 2013, 11:46:02 PM »
Stuart,

I am 53.  Well I have already started using it.  The week of surgery I was back on the exercise bike.  The bike we have at home is an older aerodyne type.  I've been doing 30-45 minutes with arms only, with my legs resting on the foot rests. 

I have done the stepper at the gym after the brace was unlocked to 30.  If you keep high on the stepper you knees don't have to bend much at all, and no pressure on the left leg when it is not straight with your arms helping to support.  Again there has been no pain at all, I have not stressed the tendon in the least bit.  The best part is the quad still gets a decent work out.

-Alan 
« Last Edit: November 04, 2013, 11:48:59 PM by alanbk »

Offline Stuart Rulka

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Re: Queston On Quad Tendon Rupture Recovery - Rehab 7 Weeks Post Op
« Reply #12 on: November 05, 2013, 03:25:17 PM »
Alan. My experience was that at seven weeks I was able to behave almost normally, with the exception of going downhill, but you are so close now to your PT you might as well wait. My point is you may not have to baby it too much at this juncture.
Stuart Rulka
Complete RQT Aug2 2013
Surgery Aug3 2013
Resumed work Aug6 2013

Offline alanbk

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Re: Queston On Quad Tendon Rupture Recovery - Rehab 7 Weeks Post Op
« Reply #13 on: November 06, 2013, 06:10:15 PM »
Just came from OS.  He's very pleased with progres, didn't think twice on that I've been using the stepper.  Unlocked brace fully and said it's optional, wear it for protection.  Says that tendon is healing nicely, and doesn't want me to baby the knee any longer.  I'm to start PT  @ 3X per week.  No limitations! 

Offline Stuart Rulka

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Re: Queston On Quad Tendon Rupture Recovery - Rehab 7 Weeks Post Op
« Reply #14 on: November 06, 2013, 07:13:50 PM »
Alan. Go for it and good luck. I do still wear the brace locked at120deg. as you say just for protection whilst hiking, especially as the snow has arrived on our local mountains!
Stuart Rulka
Complete RQT Aug2 2013
Surgery Aug3 2013
Resumed work Aug6 2013