Ruptured Patellar Tendon Surgery

[John42]

HI RPT chums

Just walked home through a terrific snow storm - even after ten years since I had my RPT injury on black ice, it was very scary - must be very cautious - scared stiff.

JohnK/ Manchester UK

[madvillain]

Stay positive everyone!  John makes a great point and that is that the mental barrier to re-injury or even rehabbing your injury after surgery is perhaps the toughest, even moreso than the lack of mobility, isolation from your work or friends, or even the immediate pain after surgery.

Surround yourself with positive people and don't let yourself get discouraged if you are not progressing as fast as you'd like.  Safety is critical in everything you do and I had to remove myself last night from a X-Mas party about 5 drinks before I usually would, simply because I cannot let myself get too intoxicated at this point in my recovery.  It was hard to leave my friends after a long time stuck in my apt (I'm now moving pretty damn well in the braces, it's pretty neat) but my recovery is 100% the most important thing in my life currently and I treat it as such.

Had a really great PT / general workout this morning, put myself through the ringer for about 80 minutes and worked on all aspects of fitness, including some pretty great leg / core stuff on the balance ball.  I can now use the ball safely, which is awesome as it's such a great tool to get in a good workout at home.  That and the free weight set is critical IMO to help you rehab.

My knees are feeling great although I am sick and tired of the braces, almost like you get sick of your significant other even though they are your muse/movivation/etc!  They are my best friend currently but damn if they don't get a little itchy and heavy from time to time!

Happy holidays everyone stay strong in the new year and one day at a time...

[Thomas99]

6 and half month update after my first failed patellar tendon repair.

After seeing my new OS, I have my new surgery date of 22nd January 2015 to fix my patellar tendon. Looking forward to the surgery so I can move out of the current waiting game. Although not looking forward to restarting the rehab again.

Never thought when originally hurting knee the recovery would take so long, let alone re-rupturing the tendon again with a major partial tear that will require the original surgical repair to be repeated. I have had extreme knee and leg swelling and continued significant pain requiring pain tablets and trouble sleeping. I have not slept all the way through a single night in the last 6.5 months, with pain waking me up multiple times during the night. The limited mobility, pain and sleeplessness has taken a toll, particularly due to the such extended time period. It has been pretty hard on the wife as well, so a thanks goes out to all those partners out there helping their partners recover.

Please note that my poor recovery and adverse issues/re-rupture is not normal and most people can expect a better and quicker recovery than I am experiencing. Don't want to unduly scare the newbies out there.

On a positive note, my new surgery is scheduled and I'm moving forward in my planned recovery.

[madvillain]

Man even though I have had bilateral which is obviously tougher than single rupture,  what Thomas is going through sounds awful.  My thoughts and prayers are with you Thomas and bless your wife.  Help of others is so important for us and it really can strengthen your ties to others if you let it (imo).

Not sure if this is the place for this but does anyone have any good disinfectant products to use on the braces they are starting to smell like a gym locker.

 I've been advised not to place them in water but surely there is a something like a lysol spray I could use?  I could google something on amazon but figured the veterans here might have a go to product that's safe on skin as well.  Thanks for any help.

Read some University of Wisconsin rehab procedure stuff and they recommend giving non active (hip not flexed) heel pulls a go from weeks 3-6 so tried some (further than I've gone before) tonight and got to about 45 degrees before...it's a very weird feeling to describe.  It's almost like the ultimate case of stiffness.  Feels like the body has almost forgotten how to bend the knee past that far.  I guess it's good I can go to 45 degrees but at the same time def a dose of reality and how far I have to go still.  Neuromuscular effects are real, that's for sure.  Surgeon wants me to schedule some PT starting in a couple weeks.  I do a lot at home but I guess you need a pro to really help you push the ROM stuff initially.

It's now day 24 from injury and 23 from surgery...anxious energy hit me today, just frustrated at work as I run my own business and even though it's a "desk job" it does involve quite a bit of in chair out of chair, standing at work bench, not standing at work bench, answering phone, putting out sandwich board, stuff like that.  Just blessed to set my own hours and have extra time around the holidays.

You guys know how it goes, even if it's not painful it's just a PAIN IN THE BUTT sometimes to have this rehab and injury. 

Anyways, cheers as always hang in there Thomas you will get through this surgery is going to go great.  Hell, you're a grizzled vet!

[rideandshoot]

First I’ll confess I haven’t read every single post.  A few hundred but not every single one☺.   Here is my story.   Sorry it’s so long but it is complicated

Story…
First demographics.  53 years old, fairly athletic, Mountain Bike Racing, Road cycling, trail running, trekking, strength training, archery.

Friday Sept 12, 2014…  hiking down into a steep ravine a rock dislodged under my left foot.  Ended up sitting on my left foot with my toes pointed backward.  I can’t remember how it got there.  When I unraveled myself my kneecap was… well you know.  We splinted my leg with branches and some duct tape from my survival kit and I hobbled out.

Sept 13, 2014… lying around the house waiting to see the Surgeon on Monday.  I had my left leg in a ‘immobilizer’ purchased from a medical supply store.  I got up to get some water and when I turned the corner I collapsed.  The way I remember it my left leg started it.  The ‘immobilizer’ didn’t hold (it folded in half).  This really hurt.  I pealed of the Immobilizer Velcro straps then I realized that I couldn’t move my RIGHT leg either!  Unbelievably there is my right patella up in my quad. 

Sept 14th… Bi lateral patellar tendon repair by the on call Trauma Surgeon.  By all accounts she does and did excellent work

Both ruptures were the same.  Right at the kneecap.

Bi Lateral Risk factors completely absent, no previous knee issues
•   No cortisone injections   
•   2 Medrol injections a year for bronchitis
•   No regular use of corticosteroid inhalers
•   No testosterone supplementation

Post Surgery
•   6 weeks total immobilization with only isometric, core, glute strength stuff
•   At 9 weeks had 100% ROM (therapy 3x per week)
•   16 weeks…  general quad strength is on track, cycling and elliptical are good.  But,  I’m struggling to walk normally.  The 6 weeks ambulating in the immobilizers with my knees locked out has stuck. My PT thinks that my gait is causing the general tendon and joint pain I’m experiencing.  I am also still experiencing an occasional buckling events

Questions for the Patellar Tendon rupture fraternity out there:
•   At 16 weeks were/are your knees stiff and sore after being on your feet a few hours?
•   Any suggestions on getting a normal gait back.  I lock out my knee as I plant my heal and then again as I roll forward on my rear foot.  PT says I have to keep a slight bend in my knee or there are other problems in my future.
•   Has anyone had a similar experience and found a particular exercise that targets the right element of quad strength.  I’ve been focused on my VMOs and they seem to be coming along but?
•   What about braces or supports?  Something that might help me with my gait.

I should conclude by saying the you are an inspiration.  It is great to read real life examples of people who have made it back and the info I have gleaned from the threads has indeed been very helpful


 

[John42]

Hi  Ride and shoot

By now, you will have realised that you belong to a very exclusive club.  A double RPT will take a very long rehab process.  There are a number of fellow double RPT who have recently gone through the same trauma as yourself.

Read some of the previous posts - ASK questions - we are all here to help you -

Remember PATIENCE is a must - don`t push it ...

Suggest you read the undermentioned thread - contains documents which I have together with KneeGuru - explanation about your injury and the rehab process -

Keep posting - Where do you live??

Best

JohnK/ Manchester UK

https://www.facebook.com/QuadricepsPatellarTendonRupture

[jbouchard24]

Hello,

When working on range of motion and breaking through the scar tissue, how far should you go?  Do you bend the knee until it feels tight and then return to zero degrees or do you bend it to pain and then return to the start?  The doc wants me to increase my range of motion to 60 degrees and I have been working on it at home but do not know how far to push it.  Also, how often should you perform the range of motion exercises at home?

Thanks.

- Bouch

[John42]

Hi Bouch

In order to increase your range of movement, suggest you look on Amazon and purchase a floor cycle - not expensive, but you can sit in your chair at home and gradually pedal away as and when you feel like it. 

It takes time, PATIENCE

JohnK/ Manchester UK 

[rideandshoot]

John42...  I live in Phoenix, AZ.  First injury occurred in the Mountains about 100 miles north of here.

Thanks for asking and for the link.

[jbouchard24]

Thanks JohnK.  I just ordered one from Amazon. 

-Bouch

[rideandshoot]

Hello,

When working on range of motion and breaking through the scar tissue, how far should you go?  Do you bend the knee until it feels tight and then return to zero degrees or do you bend it to pain and then return to the start?  The doc wants me to increase my range of motion to 60 degrees and I have been working on it at home but do not know how far to push it.  Also, how often should you perform the range of motion exercises at home?

Thanks.

- Bouch

I relied on my PT to know how far to push.  The primary stretch was me flat on my back and the PT pushing my foot toward my glute as far a I could tolerate.  Then she had me pump my foot (like letting off the gas) pedal which stretched things more.  I did this 4 to 6 times a day as soon as my braces were off.

[carkeltom]

Rideandshoot,

Questions for the Patellar Tendon rupture fraternity out there:
•   At 16 weeks were/are your knees stiff and sore after being on your feet a few hours?
•   Any suggestions on getting a normal gait back.  I lock out my knee as I plant my heal and then again as I roll forward on my rear foot.  PT says I have to keep a slight bend in my knee or there are other problems in my future.
•   Has anyone had a similar experience and found a particular exercise that targets the right element of quad strength.  I’ve been focused on my VMOs and they seem to be coming along but?
•   What about braces or supports?  Something that might help me with my gait.

I should conclude by saying the you are an inspiration.  It is great to read real life examples of people who have made it back and the info I have gleaned from the threads has indeed been very helpful

Good questions.  I am a double RPT just like yourself.  I am 18 months out from injury on 1/19/14.  I feel your pain.  With regards to the questions you posed:

Yeah, my knees were very sore after a day at work and I have a semi-desk job.  I was icing for at least 6 months on a regular basis and I used some over the counter simple neoprene knee braces, especially in the mid western winter as cold days seemed to be the worst for pain and stiffness.

Normal gait:  That will come with time.  I am a pretty big fella, 6-3 and 275 and it took me up until at least a year post that I "felt" normal walking like everyone else.

I had the occasional stumble or buckle, but nothing that made me fall, in fact I had one about two weeks ago.  The worst feeling is the second before your knee and brain catch it before it goes too far, so I know what you mean.  The proprioception/nerves have to have a chance to heal and then your brain has to get that impulse back to catch.  I think a big part goes back to the fact you had two ruptures.  I had one knee with more collateral damage as I had tried to stand up three times before the left one ruptured and new I had really done a number.

I have not been able to take off at full speed running yet, but I get on my elliptical about 45 minutes per day and by spring softball with my daughters, I hope to be able to teach stealing and running again without issue.

Make sure you keep a bend in your knee when you walk.  I was told it can lead to "Frankenstein" type gait, but single RPTers, and I am not bad mouthing them, but we have a different skill set to learn without a good leg to stand on and depend on.  I had braces on for 16 weeks, mainly for safety, but once I was out, I was moving.  Sort of like Forrest Gump. 

Exercises:  If you have access to a pool, use it.  Taking the load off does great.  No fear of falling.  I used a local hotel pool for a few months and when PT was over and I was ready for a gym, I used theirs about twice per week.  The floor pedal machine was good too, but I found the resistance to not be ther greatest in the model I had.  I also had a muscle stim machine.  I used that at work and home, 20 min each leg twice a day, as I did not want to spend my PT time doing something I could do at home.  I think it cost me about $75.

And again, as for braces, there is not much on the market designed for patellar tendon ruptures.  I do have a set of knee braces designed for ligament damage in the knee, but they set me back about $600 each and I only got them out of fear or reinjury.  I only use them during activities on that have some uneven ground or slippery floor (softball fields where I feel at home and the rubber basketball court at my kid's school where we practice softball in the winter).  McDavid sells some simple Neoprene braces with hinges but like the simple neoprene ones myself.

If you have any more questions or comments, there are, like John42 said several more doubles out here.  DanV would probably have to be the most athletic of all the doubles I have heard of.  He is really into exercise and he uses some braces, but can not remember the exact kind.

Everyone else, if you find someone who's story piques your interest, you can read all their posts by clicking on their name.  I took me awhile to find a double who had a similar injury and we seem to be multiplying.  I think Jerry from KY is a double also.

Take care everyone and Happy New Year and better healing to us all.

Tom

[fishy]

Fishy here, welcome to the double club rideandshoot.  I am a 67 yo male, multiple marathoner, living the dream in Alaska.  May 24, 2013 I missed two steps down into the garage  after hauling boxes down from a 2nd story all day.  Went immediately to ER and doc said no bad tears....just rest and light activity.  Next day I went to a local pool and did some water aerobics followed by a half hour in the pool.  After exercising and walking towards my car my right leg just gave way....and I immediately sat down with my butt lower than my foot (sloped walkway)....and I watched (amazed) as my left quad separated from my knee.  The rest is history.  Surgery was done at the VA hospital, PT was also at VA and it was interesting healing with a group of military "20 somethings" with various rehab issues... I have posted my journey and I hope it provides some info that helps.....  Stay positive, you will recover, others will follow in your footsteps so journal your journey.... and John42 is our cheerleader and mentor.....and to the rest of my RPTers stay strong and you are in my prayers.....  Bob

[madvillain]

Thanks for the post carl.  I must say that I feel my gait is pretty damn normal for 4 weeks out out double RPT.  I think I'm just lucky that I hardly spent any time bedridden and/or off my feet.  I was back to work 6 days out of surgery and since then I have slowly progressed to be able to work a full 9 hour work day at my office with very little pain or fatigue now 4 weeks out of surgery.

Seattle has so many hills and I am starting to let my knees flex just the slightest going up and down and that's a very positive development for me.  Starting to trust it just a little bit and I know the braces won't allow me to buckle.  I don't mess with wet grass though and I also don't mess with sh*tty shoes anymore.  Def have to have good traction.

I do PT religiously, and I say that in all seriousness.  I have not missed a single day of leg lifts, iso sets, situps, etc since I got out of the hospital.  I have no pain, so why not? Better than wasting time on the Internet before work.   On day 14 I gave up the straps, that was an awesome day and haven't looked back.  At the two week followup the surgeon was very surprised to see me enter his exam room in braces, sans crutches and moving rather well in and out of chairs.

He told me if I'm pain free to walk, so I walk, and stand as much as I can.

I get discouraged sometimes when I realize I'm only on "lap 1" of a 8 lap race but hey, 1 down, 7 to go!

Tremendous respect to everyone that has had this injury. I offer up my rather "rapid" progress not to brag but simply to encourage others to put the work in and take agency of your own recovery.  Good surgeons help, good PT guides help, but a positive attitude and work are the most important things IMO.  Not to compare us mere mortals to pro athletes but pro athletes have come back to their sport from this surgery, it's not easy and it takes a tremendous amount of work but if they can return to the elite in their field, surely we can return to 100% daily mobility and even our sports / activities of choice.  I probably won't ever play basketball or maybe even tennis again, but I will def look forward to hiking and jogging again.

Ah who am I kidding.  In 18 months I want to be back on the tennis court.

[bballkingofnba]

You will definitely play again lol. I told myself the same thing but when I see other 20 year olds like myself on the field I cant stop myself despite my patellar pain from the fracture. The surgeon says I am not doing any damage by playing though pain so its worth it. Nothing like sweating on the basketball court.