Ruptured Patellar Tendon Surgery

[manttila]

I heard a comment about arthritic wrists and crutches.  I have a similar issue about 15 years ago when I had ACL surgery and I was able to get "forearm?" crutches which work fine.  Except that after RPT surgery they would not let me use then when I left the surgical center.  They felt regular crutches were more stable.  Needless to say once I got home I went back to my forearm crutches.

Since then I am able to put full pressure on my knee and the convention crutches are more convenient.

Just wanted to share some experience if it might help.

[kajacos16]

Hi John,

 Thank you for the link. I live in California. I injured it running the bases in softball. Real cool story I know, I wish it was at least a good story. I heard the pop and knew it was bad.

[John42]

Hi Kajacos 16

What is known as a typical sports injury - feel for you, just listen to your knee - watch out for wet leaves, keep posting

Take care

JohnK/ Manchester UK

[kresh]

In no way or form am I comparing my situation to anybody but here is my story:

Professional Footballer
21 yrs
Partial tear left patellar tendon (May 2014)

I continued to play with the tear for about 3 weeks before I got an MRI scan; I've copleted my rehabilitation with some of the best surgeons and physiotherapts in the world and will explain steps to take after surgery and advice to never get PT ever again.

Firstly, the main reason for overloading in the patellar tendon is due to weak quadriceps(including VMO) and tightness of the ITB band/hamstrings/Glutes all coinciding with a poor warm-up/stretching regime. A poor core structure will put greater pressure on the surrounding muscles around the knee, thus leading to greater tension on the patellar tendon (Q-Angle). The biggest factor of PT IS DUE TO A WEAK SACROILIAC JOINT you must strengthen the iliac joint. A simple test is to stand straight and bend one knee up to 90 degrees. The good leg will smoothly complete the action at 90 degrees with activation of the Glutes. The bad (injured) leg will come outwards when bending to 90 degrees instead of a smooth perpendicular motion, the glutes will fail to activate due to weakness of the iliac joint.


Rehab will be frustrating and annoying but the main concept for any tendinopathy is to stop any exercises if in your eyes you feel a greater than a 2/10 in pain. For the first 6-8 weeks you should be undergoing proper Physio treatment whilst incorporating decline squats for eccentric loading 3 x 15 reps every second day. Patience is key tendon collagen rebuilds over a 90 - day period.. A very slow process.

Post 10 weeks (Every day)

Bike 30 mins
Foam roll each muscle group 2 mins
A drill with theraband (TB)             3 x 10
Groin squeeze with TB                   3 x 10
Lunge extension and twist with TB  3 x 10

Leg raises (body weight) 3 x 15
Wall squats                    3 x 15
Decline squats .              3 x 15
Calf Raises.                    2 x 15
Swiss Ball iliac exercise   2 x 20
Bird dog                         2 x 20
Plank (Front/side)           45 secs x 2
 
I have begun jogging recently and I'm reaching the final phase of recovery.. A cheat way to get back quicker is to wear a SIJ belt this acts a replacement for your core and tricks your mind into thinking your core is activated until you build enough strength.

Remember smash your core exercises if you can avoid surgery I recommend trying PRP injections I had 4 injections and noticed significant improvements

[John42]

Hi Kresh

Welcome to the RPT thread on KneeGuru- As you have stated, nobody on this thread could follow the unusual treatment which you have received - What ROM have you reached today?

Where do you live?  Keep posting

Take care

JohnK/ Manchester UK

[kresh]

John42

Today I'm still battling the injury I can jog at a slow pace with some stability, I completed the dynamometer knee strength test a few days ago
Right knee 41.9
Left knee (injured) 40.3

On Tuesday I will be doing my 5th PRP injection to help promote further healing and reduce scar tissue, but I still struggle when sitting down for long periods. Look it's a tough injury but positivity can play a major role I felt better after two PRP injections and was told the third would do wonders, however I felt worse after three and felt like a hit a plateau.

Sydney, Australia

[manttila]

It has been about 1 month since I had my surgery and I think it is going well  but was looking to gather some of your experiences.

-The Velcro knee brace they gave me is always slipping down even  though I use one of my old knee brace socks.  Normally just pull it back up and tighten.  At times I don't mind it going down some even though it still prevents my knee from flexing too far.  Don't know if this is the right explanation but when it is down it feels comfortable to bend the knee slightly when walking in my home.  I am very careful that my leg is straight when I plant it.
-Around my house (all one level) I have started to walk around carefully with out my brace or crutches.  Verrrryyyyy slowly.  Is this OK or is it too risky?
-Until this happened I never appreciated the value of those electric carts at some stores.  By the way in my area the ones at Loews are better than Home Depot Home Improvement stores! 

Not experiencing any major pain in the joints just gets achy when I am on my feet to long.  I am not one to sit for long.  Not taking anything regularly for pain just advil on occasion 1-2 nights a week when I do too much during the day.

Look forward to what experiences you have had at this point in the process (1 month in).
 

[John42]

Hi Manttila


Bear in mind that your tendon has not healed and will remain weak for about another 6/8 weeks - so my advice is not to take any risks - use just one crutch or cane - listen to your knee, but take it slowly

Best

JohnK/ Manchester UK 

[manttila]

Thanks for the advice.  I don't want to get overconfident and cause other problems!

I will be more cautious.

[Kaddydee]

Hi guys,

A quick question for those who've been there and done that.....
Did any of you experience a really tight/sore calf after your PT reconstruction?
I'm 11 days post op and the last 3 days my calf has been really sore to touch, very tight and what has scared me is that I can't put my heel on the ground when standing (or flex my ankle up) because of the tightness in my calf.  Had an ultrasound yesterday and there is no blood clot just a large haematoma which isn't related to the tightness.

Any ideas???

I see the surgeon on Thursday so I'm sure I'll get some answers then but I thought I'd ask here first.

Thanks,
Kath

[manttila]

This is wild.  I might actually be able to share some of that "been there done that" with some newby's.  I am sure other people will comment but your best response below is you have an appointment with your doctor.  My thoughts.

-Prior to my first appointment (2-3 weeks) I had been getting some pain more in my Achilles area than my calf but I could not sleep.  My doctor also checked it and could not find anything but he did say I could do some calf stretching and I have not had any issues since.
-My doctor also has a an opportunity to email them for questions.  Since this is new to me also I did not hesitate to email any questions as I was going thru the recovery as minor as it may seem.
-This forum is great!!

Good luck.

[manttila]

This might be more of a survey type question but just curious.

About 6 weeks in and no therapy yet.  When my leg is relaxed to me it looks my ROM is about 45 degrees.  What is typical.  I hear a lot of people suggesting 30 degrees.

[John42]

Hi Manttila


Once out of a plaster cast or brace after six weeks, the ROM is normally 30/45 and the next milestone is 90ROM within 12 weeks, so keep fighting, but take care on wet roads, leaves and snow/ice.

JohnK/Manchester UK

[manttila]

Thanks John.  I was a little confused by my angles.    My knee is actually around 90 degress when relaxed and I have not started any PT yet.  It has only been 5-6 weeks since surgery with my second visit next Monday.  That is probably when he will actually check the ROM and I can ask him then if it is normal.  Maybe I will be released to drive if the ROM is that high! 

[John42]

Hi Manttila

I would delay driving for at least another six weeks or so - ask yourself - can I do an emergency stop?

Don`t rush it or you might suffer a re rupture, and we don`t want this.  I know it`s hard. but your knee is such an important limb....

Keep posting - listen to your knee

JohnK/ Manchester UK