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Author Topic: Patellar Tendon Repair-following full rupture -52yo male  (Read 83 times)

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Offline bcullimo

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Patellar Tendon Repair-following full rupture -52yo male
« on: July 23, 2021, 02:26:59 PM »
Background
Moderate to high active male 5'8" 180lbs. Active hike/walk/run/ski. 52 years old, married with 12 and 9 yo children.
Organization of diary Newest to oldest ( read from bottom to top) by date.  I work from home. A note on listening to ones body.  I noted I have mentioned this a few time in my entries.  I think this is challenging but important.  For myself I have a background in backcountry skiing and climbing and hiking, as well as sailing. Nothing worth writing an adventure about, but I have been doing it long enough to know when I have pushed my body hard enough and it needs a break. I am hoping and must believe this experience and subsequent knowledge will position me well for a full recovery with minimum setbacks and no reinjury.  I recognize that mental strengthening will be a critical leg to my three legged stool of healing, strengthening, and mental health to get past this injury.

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9/14/21=I have been at Full ROM +/- 4 deg nearly since last check in. No pain, some popping here and there as to be expected. Moved to short brace and then only on uneven terrain, woods, beach, etc.  I finally started strength training this past week with PT.  I have upped my training at home as well.  In terms of use use. Going up stairs is basically normal, I can not quite run the stairs, but very close, I can skip stairs if I choose.  Going down has normalized, but mentally still feels awkward so I am working on that. I am trying to be gentle as I have a lot of muscle mass too rebuild. I expect normal muscle mass is still targeting around Feb /March 2022, though I have been slightly ahead of my targets. My dr and PT confirmed that for every week of atrophy it will take 4 weeks to build back muscle. In my book 6 weeks in full leg brace relates to 6 months. My expectations are still to be skiing in January 2022 and gentle hiking (with poles) Nov/Dec 2021.  I bought a fitter pro and spend 10 to 15 minutes a day in five minute sessions on it. I am going to ask my PT guy about swimming, I will probably start hitting the bike harder too.  Trying not to rush things interms of shock on the tendon, but build lot of associative and direct muscle for support. I still stretch and do gravity excercises 2x a day.



8/14/201- Very little pain mild discomfort. Walking around house without knee brace (ok'd by PT/Dr). Flexibility at 121 deg (after warm up/ not assisted). I walked a mile each of last two days outside no pain, leg still remains modestly tight upon initial use. Bending to over 100deg without assist is very easy at this point. Surgical entry wounds completely closed and not scabbing over, just a modest scar.  Internal swelling still exists and knee remains warm to the touch and some redness as healing continues. PT has me doing squats, and on a bike for ten minutes.  No issues to report.  Next Dr appointment 8/24. Continue to stretch knee and exercise at least twice daily.


7/26/21-pain 2/10, tightness 6/10 at peak, 3/10 at trough-Meds/workout no change. ROM peak 83deg (assist) 74deg (no assist) start 53deg ( no assist). ROM routine. Measure @start ROM no assist. Massage 5 min, Heel slides no assist (3x10), Heel slides assist (3x10), Hold at peak 2m (3x) end peak ROM measure. I am measuring using the iphone angle tool. It seems to be pretty close to PT measurements. I have not purchased an app, just using apple free tool.  Post workout ROM excer, I do 5 min mediation body scan.   

7/23/21-pain 2/10 tightness 6/10. - LPTA had me in mid to high ROM in 70 deg range. Says i am a week ahead of schedule, and that is good.  He was concerned about pushing to hard and gapping in the tendon. He said as long as you stay under 90 deg you should be ok. But listen to your body.

7/22/21-pain 2/10, tightness 6/10, my measurement of ROM seems to be getting into 70 deg range

7/20/21-Pain 2/10 tightness 7/10- LPTA today measured ROM at 62 deg no change in regime

7/19/21 Pain 2/10, tightness 7/10, meds no change, sleep no change, exercise no change 2-3 times daily. My wife says I am nuts working out 2hrs and 15 minutes daily.  It not who I am really, but since I can not do a lot of the things I normally do, working out seems like a good alternative, I am also reading 4 books,
Tides by Jonathan White
Apollo by Rick Riordan ( my sons summer reading)
A history of Salem,MA
A biography on Nathaniel Bowditch

7/17/21 pain 2/10 my regime 3x/day about 45 minutes (timed)
upper
Curls 3x10
shoulders 3x10
tris 3x10
Lower
situps 50
calf raise 3x10 (brace on)
leg raise 3x10 "
hip abduction 3x10 "
hip extension 3x10 "
quad set 3x10"
heel slide 3x10"
calf stretch
Heel angle by my measurement ~57-62 deg  I measure last set of heel slide using iphone angle measurement

7/16/21-Pain 2/10- meds aspirin, Eval with PT. He indicated less than typical swelling at this stage, and range of motion ok, Gave me series of exercises to add to what i am doing. including ROM exercise. Dr/PT goal is ROM 90deg by 8/7/21- this seems challenging given how tight my tendon currently is. Also PT thinks skiing and hiking is achievable before 2022

7/9/21-Day 14-pain 3/10- Follow up with surgeon, All surgical dressings came off. Dr happy with healing, swelling levels, discuss procedure and says it went well no surprises.  He said he upgraded the anchors he put in the leg as we discussed my active lifestyle and desire to return to skiing and hiking this year if feasible. He said all things equal he did not see a problem, not bumps and jumps in skiing, he said the most difficult part will be the mental part.  We scheduled my phyical therapy session through October. PT in my case are a part of the sports medicine practice that did surgery.  Also discussed Platlett Rich Therapy with Dr.  He indicated in my case for the level of invasiveness it would probably only get me a week, so not really worth the effort. He worked closely with a  doctor for the NFL team Giants who was an early adopter of this therapy, he indicated it was rare that it was used on knee injuries of this type. Also discussed massage therapy as I have a close friend who is a licensed massage therapist. Dr agreed with therapist that massage will help once we start strength training and quad is firing, but right now will add very limited value. Also discussed electrodes and compression stockings- nothing of any great significance, I am not changing my regiment.  He was very comfortable with my exercises, he said be prudent and listen to you body.  He cleared me to drive (my left leg is injured and I drive  a truck with a lot of space.)

7/6/21-Day 11- pain 3/10, swelling very minor, but visible compared to other knee, surgical scar healing as expected, no inflammation etc. meds aspirin, sleep same, exercise same, mediation same. Exercise before work at lunch and after dinner, massage leg and to bed by 10pm.

7/5/21-Day 10 post surgery-pain 3/10, meds aspirin, sleep same as usual, excer curls etc, toe lifts, mediation breathing and body scan 1m and 5 min

7/4/21-Pain 3/10, Day 9 post surgery- Meds Aspirin only, Started doing a basic upper body work out, curls etc etc, added toe lift and stretching my calf muscles.

7/3/21-Pain 3/10- no acetaminphen only aspirin. Swelling and related pain continues to subside. getting around pretty easily at this point. I keep the brace on at all times. Except when I take it off and massage my leg for about 30 minutes before bed. I have started trying to do some basic meditation breathing and body scan excercises 2x a day more if I can

7/2/21- Pain 2/10- Primary swelling of surgery has largely subsided. I have not needed oxy, reduced acetaminophen to once daily and aspirin 2x a day as prescribed. Sleep remains awkward, but not unusual.

6/26/21-Medication regiment- 500mg acetaminophen (as needed) and baby aprirn in AM and evening, Oxy as needed for pain. Pain is so far associated primarily with post op swelling, other than that I would describe it as a very low grade headache in the knee.

6/25/21-Surgery at 2pm, 1 1/2 hours, out of post op around 6pm walking on own (crutches). Full brace locked at 0 deg.  Expectation of Dr. is 8 weeks like this, but expects 100% recovery.  6 months to full recovery. Goal-skiing by Jan 1 2022

6/23/2021-Initial evaluation confirms injury, schedule surgery

6/20/2021-Emergency room- same day, complete rupture of patella tendon.  Pain 5/10 with no movement, 9/10 with movement. Made appoint with knee dr at that time.

6/20/2021 -playing basketball, taking a simple lay up, defender kicks me in the knee. Hit ground patella rolls up into quad like a window shade being let go
« Last Edit: September 14, 2021, 11:37:07 AM by bcullimo, Reason: update »

Offline jgardner

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Re: Patellar Tendon Repair-following full rupture -52yo male
« Reply #1 on: July 23, 2021, 03:52:45 PM »
bcullimo,

Sorry to hear about your injury...that's a tough one. Thanks for sharing your story. That's a bold goal you have, but I like it. I hope you get there!

Jim
12/2018: MRI: Rt Knee Lateral Trochlear Chondral Defect
1/2019: PT and continued running (100-mile race in 6/2019)
11/2020: MRI: Rt Med. Meniscus tear; small chondral defect on med. condyle
12/2020: Mosaicplasty and Partial Meniscectomy
6/2021: Partial Synovectomy, Patella Release, Fat pad resection

Online John42

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Re: Patellar Tendon Repair-following full rupture -52yo male
« Reply #2 on: July 23, 2021, 08:37:07 PM »
Hi - welcome to the RpT club - sorry that you have landed yourself in this unique club - however a long haul to reasonable recovery, but you  will not be on the ski slopes a long while.

You would do well, by reading some of the recent posts - drum up some questions as we are here to help you.   

One tip is to sleep with a cushion/ pillow between your knee - listen to your knee - don`t attempt to drive until youhave the all clear from your OS.

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

Complete Ruptured Tendon