Ruptured Patellar Tendon Surgery

[bballkingofnba]

Hi vonlehmd, I would say short arc quads were def helpful and you should be able to do them 8 weeks out. They help restore full active extension to the knee which is essential when we walk. Also the bike is a great tool to loosen up the stiffness. I used to bike for about 30 mins everyday starting at week 8. Started with no resistance and added a little bit each time

[TomG23]

Hi Tom,

welcome.....

I just wanted to add to what Sella has stated. Ice. Its a great friend. Heat and swelling are an enemy in healing, as I have found out, ice can help you not form so much scar tissue.

My advice would be dont push it too far or too hard, but do keep moving and patella manipulation is very good for stopping the adhesions.

Good luck with everything and keep us up to date on how youre getting on.

Cheers

Frank

ps....if you can avoid crowds I would, any sideways knock could put you down and cause more damage at this early stage. The hustle and bustle of tube and crowded trains sends shivers down my spine, even now, and im 7 months down the road!! Thankfully Im an early pensioner at 52!!!

Thanks for all your replies and advise.  Finding it very hard at the moment just getting around the house on crutches using one leg. It's zaps so much energy.

It's a week post op tomorrow and I feel helpless and a prisoner in my home.  Boredom is really setting in.  Going to be tough getting through 7 more weeks of being non weight bearing but I'm sure the resources and people on this site will really help.

[vonlehmd]

Tom,

One thing that helped me the last 8 weeks was watching the entire "Breaking Bad" series.  I watched most of it on my IPad (streaming through NetFlix).  This is one time in my life where limiting TV watching was not in play. 

I have also spent hours on end reading through posts from this site.  It really helps to learn from those who have already been through this.  Some of the storylines could also be a mini-series themselves.

[vonlehmd]

Tom,

Shortly, you will also be keen to some other observations out of this experience.

You will start to:

Really appreciate some of the smaller things in life and not sweat the things in life that used to bother you.

Start to look forward to basic things like a shower, someone stopping by to say hello, or a smile from a stranger.

People will go out of their way to lend a hand, and you will have a new appreciation of people.

You will feel more sympathy for people who are living with any kind of challenge.

You will look forward to doing even mundane tasks that you used to procrastinate over.

In short, you will come out of it a bigger and better person in the end. 

Keep your eye on the prize....

[carkeltom]

Welcome to another Tom.  Yeah, boredom definitely kicks in.  It is a good time to get the smallest of things done.  You will get to the point where you can bear weight and not be dependent upon the crutches and you will feel much better about the situation, even though it is a horrible one to be in.

So, a short 15 week update.  PT continues to go well, even though I have pain the next day on the sides of my knees and my quad tendon area.  Plus, I have been having some numbness in my legs whether I am walking or standing for long periods of time.  It is not the numbness where the OS severed the nerve on top of the knee, but almost like my leg is falling asleep.  It has happened while riding the stationary bike and while doing leg presses.

And just when doing simple no-weight squats was getting easier, the PT gets me doing squats on a half-ball type balance board.  My legs were quivering like a bowl of jelly.

So, I go back to the OS tomorrow and hopefully he will like the progress, as I can only do what I can do.  Just doing my best to bet better. 

Take care all and good luck.

Tom

[vonlehmd]

8 week post op update:

I was in to see the doc today, and he released me to PT. 
Start with my first PT session Thursday (3 per week).
Also OK to unlock brace and stop using when I want to.
It feel great to be able to walk without them locked at 0 degrees.
Takes a lot of pressure from the knee joint when walking with a little flex.

I have been working hard on the Quads (SLRs) and ROM. 
At 90 degrees flex.
 
Will start on the floor pedaler (cycle) tonight. 

Will post update after first PT session.

[JC55]

9 week post-op.  Saw OS in morning and he unlocked brace to 120 degrees.  Shared with him my concerns about swelling, tendinitis, etc and he said all is normal and for PT to begin ultrasound on affected area.  He wants me in brace for two more weeks when not working on max ROM.  He said more intensive weight training will begin shortly.  Saw PT in the afternoon and did a few new things.  Rode stationary bike for 5 minutes following by walking backwards on treadmill for another five minutes.  I did not have a good nights sleep (some unrelated business stress that really saps my energy) so I felt a little sluggish but powered through the rest of my PT session ending with heel slides (got to 119 degrees so PT said no reason to stretch further since was at 90 degrees...her motto is "slow and steady" but she'll push me if she thinks I'm not doing enough) and some ultrasound treatment.  Took a little walk to get some fresh air and then rested knee.  A little sore...but in a good way. 
Glad to read everyone's progressing...stay strong my friends!

PS:vonlehmd I think you are correct in saying that we may very well come out of this bigger and better people.  I consider myself a nice guy...but this injury has really made me be more sympathetic for others with physical challenges.  I think I'm more thankful for all the small things and for the people in my life, especially my wife.  Peace to all of you as you go through whatever challenges you are experiencing...I hold all of you in my thoughts.

[vonlehmd]

9 week post-op.  Saw OS in morning and he unlocked brace to 120 degrees.  Shared with him my concerns about swelling, tendinitis, etc and he said all is normal and for PT to begin ultrasound on affected area.  He wants me in brace for two more weeks when not working on max ROM.  He said more intensive weight training will begin shortly.  Saw PT in the afternoon and did a few new things.  Rode stationary bike for 5 minutes following by walking backwards on treadmill for another five minutes.  I did not have a good nights sleep (some unrelated business stress that really saps my energy) so I felt a little sluggish but powered through the rest of my PT session ending with heel slides (got to 119 degrees so PT said no reason to stretch further since was at 90 degrees...her motto is "slow and steady" but she'll push me if she thinks I'm not doing enough) and some ultrasound treatment.  Took a little walk to get some fresh air and then rested knee.  A little sore...but in a good way. 
Glad to read everyone's progressing...stay strong my friends!

PS:vonlehmd I think you are correct in saying that we may very well come out of this bigger and better people.  I consider myself a nice guy...but this injury has really made me be more sympathetic for others with physical challenges.  I think I'm more thankful for all the small things and for the people in my life, especially my wife.  Peace to all of you as you go through whatever challenges you are experiencing...I hold all of you in my thoughts.

Thanks for sharing Jerry.

Seems my ROM is improving with the use of the floor pedaler. 
I find it easiest to use from my recliner (versus sitting on the floor).

I have various aches and pains thoughout the day and while doing exercises.  I just back off a little when feeling it.  Seems I have to cautiously push through it a little at a time, reminding myself that the pain is there for a reason.  My brain/nervous system is reminding me that the injury is still present. 

Having a hard time finding confidence, now that I have unlocked the braces, while walking.  It feels good to allow the flex but I have fear that knees will buckle, so I walk very slowly.  Assume confidence will go up over time allowing a quicker pace. 

[carkeltom]

Dan, I felt the same thing with the braces unlocked and doing exercises.  I still get an uneasy feeling of the knees buckling at times.  I had to teach myself to walk heel to toe again since I was pretty much walking on my toes when I was in both braces and using the crutches and then afterwards when I was just using the braces.  I had a few instances where I forgot to pick up my feet and sort of dragged my toes on carpet and caught my toe and stumbled.  When doing wall squats and squats on the bars at PT, my thighs would quiver and the feeling of the knees buckling I had to overcome and you will too.  And, I walked very slowly also with the braces.  I live in Missouri and the winters are hit and miss and I think that once the first ice or snow event is here, I will walk even slower.

Some good news though to share.  I went down some stairs, sort of forwards/sideways and one at a time, but I have to remember to bend the non stepping down knee to bend so my toes reach step.  And, I went up some steps one foot per step, which is pretty good for me.   

OS appointment in about an hour and a half, so hopefully maybe we can go for at least another three months before the next visit.  Knees hurt this morning from using the floor pedaler for about 8 miles last night.  Go me!

Tom

[John42]

Hi

Glad to hear that you are getting good use of the floor cycle - but don`t over do it.

Snow/Ice and wet surfaces are a nightmare - so take extra care.

Best

JohnK/ Manchester UK

[bballkingofnba]

Hi all, hope all is going well! JC 55 you were able to go from 90 to 119 in one session? That means your tendon was prob healed enough to get some ROM earlier but your OS is playing it safe which is good! I am very curious to know how the tendons heal in the knee and there isnt much literature out there. Your progress seems pretty close to mine as I started riding the bike at 8 weeks as well and i think the bike is great to build the quad. One thing I used to do was press the VMO with my finger as I biked to make sure it was firing. This is known as bio feedback. Try it out. Also a few ppl also in the past asked me to post a pic so here is what my knee looks like 18 months post op. My recovery has been slower than normal in terms of strengthening because my kneecap took a vicious hit as well leading to chondromalacia and a fracture so I still have pain doing some of the functional activities and functional activities are what bring the muscle mass back. Overtime my OS thinks the pain will subside and I will stop thinking about my knee. I would love to see pics of other knees to see how they look so post any pics if possible

[vonlehmd]

Hi all, hope all is going well! JC 55 you were able to go from 90 to 119 in one session? That means your tendon was prob healed enough to get some ROM earlier but your OS is playing it safe which is good! I am very curious to know how the tendons heal in the knee and there isnt much literature out there. Your progress seems pretty close to mine as I started riding the bike at 8 weeks as well and i think the bike is great to build the quad. One thing I used to do was press the VMO with my finger as I biked to make sure it was firing. This is known as bio feedback. Try it out. Also a few ppl also in the past asked me to post a pic so here is what my knee looks like 18 months post op. My recovery has been slower than normal in terms of strengthening because my kneecap took a vicious hit as well leading to chondromalacia and a fracture so I still have pain doing some of the functional activities and functional activities are what bring the muscle mass back. Overtime my OS thinks the pain will subside and I will stop thinking about my knee. I would love to see pics of other knees to see how they look so post any pics if possible

Tried to post a picture but says file too large.
Any suggestions?

[vonlehmd]

Feedback request.

A little scheduling snafu created a delay in my PT, to my dismay, of a week or more.

My question to myself is do I really need it?

I am already working the ROM, cycling, and am aware of other exercises recommended at my stage.
I am thinking of going it alone.
Anyone else have thoughts/comments?

I have been involved in working out (bodybuilding and powerlifting) routines most of my adult life.
So I am accustomed with technique, fatigue, pain thresholds, etc.

I also wonder if they will really add anything to what I am already doing based on protocols (I.e. Mass General) that many of us are aware of.

A little of this is anger regarding incompetent office staff and a little impatience. 

I should probably do what i can on my own and get the PT in when they can schedule me. 

There, that felt better.  Just needed to vent a little.

[bballkingofnba]

To be honest I felt that PT was useless after week 8. Initially they help with the electric strim and ultrasound but after that you are just paying someone to do exercises on your own.... Also very few PTs know enough about injuries to answer my questions and I end up seeing the doctor anyway. But just check with your surgeon first.

Also when you guys bend to get that initial ROM did it feel like your tendon stretch like a rubber band? Like bending at first felt really weird compared to my good leg. Anyone else get that feeling?

[vonlehmd]

To be honest I felt that PT was useless after week 8. Initially they help with the electric strim and ultrasound but after that you are just paying someone to do exercises on your own.... Also very few PTs know enough about injuries to answer my questions and I end up seeing the doctor anyway. But just check with your surgeon first.

Also when you guys bend to get that initial ROM did it feel like your tendon stretch like a rubber band? Like bending at first felt really weird compared to my good leg. Anyone else get that feeling?

Thanks, great feedback.  I was unimpressed with even the equipment at this place when I saw it.  Seems I can go it on my own.

As to my feeling, I am getting a little beyond 90 degrees.  Since I have it in both (bilateral) can't compare to a good leg.  But I don't think it is much of a stretch as compared to a rubber band.  I feel slight pain at points as I work it back to 90 degrees, and then it locks.  I then apply slight force to lower leg to nudge it back to a point where it stretches with a little discomfort (good pain).  I then back off and stretch back a time or two.  Then massage knee and go at the other leg.  Both are surprisingly at the same degree of flex, a little over 90 degrees. 

In my case, it was a clean tear off the bone (patella).  Can't recall your repair.  Seems that if it was a central tear a different sensation would be expected.