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Author Topic: Ruptured Patellar Tendon Surgery  (Read 1248653 times)

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Offline madvillain

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Re: Ruptured Patellar Tendon Surgery
« Reply #5535 on: February 17, 2015, 09:04:57 PM »
Jeez is there an RPT virus going around!?  Hate to see new posters but also it's beneficial for everyone to chat and compare experiences.

Lots of questions about how best to rehab and I think you just have to trust your body and the process whatever method you take.  I was talking to a older woman at the gym last night who was there trying to rehab a knee replacement.  I saw her struggling on the bike and I asked her if she did heel slides and she said "the surgeon told me I could stop doing those".

I immediately suggested that in fact, NO!  She should keep doing them.  Every.Single.Day until she can complete a full revolution on the bike! 

Your surgeon has one really, really, really good skill and that is stitching your knee back together.  She (or he) doesn't follow you home and monitor your progress with the tenacity of of a football coach.  That's up to you and if you need help, your PT.

Their have probably been 3 times in my recovery where I felt maybe I had "over done it".  The first was at day 6 when I was walking without the walker to my car (mom was driving!) and slipped on a bit of wet grass.  Luckily I had the braces locked.  Well not luckily, smartly, I had them locked.  Keep your braces locked.

Second time was around week 3 when I did straight leg raises and then read in a PT guide from the Univeristy of Wisconsin: NO STRAIGHT LEG RAISES.  Well what do you know my tendon didn't rip out.

Third time was at week 8, before I left for my New Orleans trip, after a hard gym session I stupidly sprinted up the stairs on the way out two at a time and was left with pain for the remainder of the evening.  A rest day and lots of ice and I'm no worse for where.

Point is, even if you're ambitious, you can be smart, and if you do "over do it" once or twice don't worry, just rest and ice, and get back on it soon enough.

I'm lucky as I'm the sort that loves to google and already had a foundation of training knowledge to build my recovery program on, but if you need guidance I would suggest (with prudence of course) to follow the advice of your PT and your body moreso than that of your surgeon.

I'm hardly saying go out and just plain ignore his advice.  What I am saying is to tailor his advice to your needs.  I do heel slides every single morning before I take a shower.  It limbers me up and sets a foundation for going down the steps to my car, and walking to and from my office and so on throughout the day.

My surgeon, if I asked him, would probably say "you can stop doing the heel slides".  Well, ok, but I like them and will continue to do them.

In general, I think there are three very real obstacles in a RPT recovery that need to be addressed in weeks 4 through 12:

1) regain quad control (this is related to point 2)
2) regain walking ergonomics and step control
3) push past normal pain and stiffness in your workouts and know when to stop

Regaining quad control is difficult.  I worked tremendously hard, not to brag, but probably harder than the vast majority of RPT patients, to arrest quad atrophy in weeks 1-6. 

Worked, but not that well.  It wasn't until week 6 or 7 that I was really able to realize how much I had lost and how to gain it back. 

There are dozens of exercises you can do, and I suggest picking 3-4 and doing them 4 times a week, to regain quad control, and specifically VMO control, which is needed for curbs, steps, inclines and eventually jogging.  Ask your PT to give you 3-4 you can do.  Most of them don't involve anything more than body weight or a step.

Here's a typical VMO day for me at weeks 6-10

1) stepups (at first using the littlest step no weights, now I am up to the 3ft step and use 15lbs weights)
2) wall squat (good luck getting much further than maybe 60 degrees bend, but that's ok, go as far as you can, a little pain and stiffness is normal, anything past 3 on the pain scale stop and re-evaluate.
3) high knee and butt kick drill (ask your PT they will know what I mean)
4) light weight deadlifts and/or smith machine squat

I do those in succession x3.  Usually takes about 30-45 minutes.  If you do them quickly, you will get your heart beating, which I recommend.

At week 9 I added the following:
15 degree incline 5 minutes on treadmill
-3 degree incline 5 minutes on treademill
10 minutes on bike resistance at 7-10
10 minutes on rowing machine

At week 10 I added:
Jog, 4.5 mph, 5 minutes on treadmill
jump rope lightly

And so on... You can see that you want to build a foundation for returning to explosive movements.  You literally have to re-learn how to jog, how to jump, how to even bend your leg at times.

Anyways, that's my two cents hope everyone is well.

« Last Edit: February 17, 2015, 09:25:17 PM by madvillain »

Offline alexws

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Re: Ruptured Patellar Tendon Surgery
« Reply #5536 on: February 18, 2015, 12:02:37 AM »
The best way for me to get the ROM to start coming back is to put a towel under your heel and hold the ends of it.  Using your arms to pull the towel towards you bend your knee up. I have set my brace at the goal degree of flexation and do it at least 2x a day for who knows how many reps.  You will feel super stiff doing it, but for me you can feel it getting stiffer and mechanically your knee will want to stop before any pain.  Stop BEFORE it starts to hurt from bending.  Eventually it will loosen up for you.

Offline JC55

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Re: Ruptured Patellar Tendon Surgery
« Reply #5537 on: February 18, 2015, 04:56:13 AM »
Lots of activity. Welcome to all the new peeps.  My two cents:
Dan, don't compare your recovery to Alex. We are all different with different docs but not a race...patience.
Someone asked about Elliptical...my PT had me walking backward on a treadmill and told me RPT recovery techniques are different from RQT and ACL due to mechanics.
NO leg raises til 6 weeks (if I remember correctly) due to stress point below patella.
I really liked the Univ. of Wisconsin protocol...made sense to me and my PT agreed. Like STUART, when you and your PT are on the same page I think you OWN it more and recovery benefits.
SELLA, so glad all appears to have gone well. Gave me a smile when you said you got tea and cake after surgery...so Downton Abbey...think I'll call you Lady Sella from now on.
Sorry been a little delinquent in checking in but in midst of basketball season and my team is a contender.  Very busy with work, practice, games and travel but I'll never complain since I recall the time after surgery when I couldn't do anything. Life needs to be treated like a beautiful garden (sorry Tom, didn't mean to bring back bad memories regarding the site of your injury), it must be tended to everyday to reap the rewards!
« Last Edit: February 18, 2015, 04:59:18 AM by JC55 »
Jerry, Kentucky, USA
Complete tear of left patella tendon, Sept 8, 2013
Surgery Sept 9, 2013, no wire

Offline BustedWheel

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Re: Ruptured Patellar Tendon Surgery
« Reply #5538 on: February 18, 2015, 01:21:48 PM »
Dan, I think I got the hinged brace at the 2-3 week mark after surgery, locked in full extension, when I went to get my stitches out.  My 2 week anniversary of surgery was the Friday after Thanksgiving, so I didn't have the first appointment after surgery until the next week.  At the 6-7 week mark, the hinged brace was unlocked to 90 degrees and I started PT.  By week 12 post surgery, the brace was completely done with.  In between the 6-7 week and 12 week marks, I tapered off with the brace, as I got better with the PT.

Now I am pretty much in my comfort zone, I can go to gym and work out fully, not just upper body, albeit with pathetically low leg resistance compared to what I did before.  However, as the doc and PT told me, this is the strength training phase, ROM is pretty much back, swelling is pretty much gone, pain (other than annoying aches and twinges) is pretty much gone.

I didn't have a wire or anything, so I didn't need any other procedures after the initial surgery.  There is a protective stitch they put in around the knee to take the strain off the repair, but it relaxes/breaks over time (4-6 weeks) and is, I believe, absorbable or just stays in. 

Doc thinks the last time she has to see me is at the 18-19 week mark, and at that time I will be done with formal PT.

I took a pretty middle of the road approach.  I kind of followed the Wisconsin rehab protocol you can find on the web, and pretty much tracked a little ahead of the milestones on it as far as my recovery.  I know my way around exercise and the gym, so I think this helped being in tune with what I could do and could not do. 

The docs are very cautious.  The PTs are a little more aggressive.  The research seems to be that immobilization for 2-4 weeks may be OK, but after that you have to start moving or it will affect your recovery and, ultimately, tendon strength.  After about 2 weeks, I avoided pain meds like NSAIDs, as some research seems to say that anti-inflammatory meds actual hinder healing, your body needs the inflammatory response to get all the healing building blocks to the injury.  It may be BS, I don't know, but I read some scientific articles on it.  I've also heard that with respect to weight lifting, that NSAIDs may hinder recovery and muscle growth if you take them too much after working out.  Who knows?


Offline Thomas99

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Re: Ruptured Patellar Tendon Surgery
« Reply #5539 on: February 18, 2015, 01:24:50 PM »
4 Weeks post 2nd surgery update:

After spending 5 days in hospital on IV antibiotics for knee infection finally allowed to go home on the 16th.

Unfortunately the last two days I have been suffering some bleeding from the surgery incision, which has been complicated by the infection and being on blood thinners. Contacted orthopedic surgeon today and she has advised to present to the hospital in the morning for review by herself and be prepared to be admitted for further surgery. Hopefully further surgery will not be required as already spent 23 days in hospitals since my accident 8.5 months ago.

Keeping a positive outlook.

Newbies please note my poor experiences and complications is not normal as most RPT's have minimal issues.

Offline Thomas99

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Re: Ruptured Patellar Tendon Surgery
« Reply #5540 on: February 19, 2015, 12:21:22 AM »
Saw surgeon this morning and she has confirmed I will be having further surgery this afternoon to clean out wound and re-stitching up again where it has come open and bleeding from.



Offline Kaddydee

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Re: Ruptured Patellar Tendon Surgery
« Reply #5541 on: February 19, 2015, 02:10:34 AM »
So sorry to hear that Thomas99.  Your knee problems sound all too familiar to mine a couple of years back.
Let's hope this is the end of it for you! 

With my knee saga, I had to set little goals and rewards for my family because it's everyone who suffers from the ongoing complications. When I stop my antibiotics, lets go out for icecream.  When I drop to one crutch, lets go and have a picnic in the park.  When I can walk up stairs we'll have a celebratory dinner etc

When everything is going wrong, you need to have some little rewards to look forward to.


Offline alexws

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Re: Ruptured Patellar Tendon Surgery
« Reply #5542 on: February 21, 2015, 04:19:14 PM »
Just had my 5 week apt.  Doc told me I can work on rom as tolerated up to 82 in pt yesterday.  Strength is going to be slow to get back but working on it.  Doing wall slides and hamstring streches to try to increase rom and getting it to straighten all the way out -2 vs -5.  Hoping by next week ill be able to spin slowly on a bike. Not rushing it but boy does it feel good to walk without the brace locked out anymore.

Offline John42

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Re: Ruptured Patellar Tendon Surgery
« Reply #5543 on: February 21, 2015, 04:40:43 PM »
Hi Alexws

At six weeks, having come out of the brace somewhat early, you should be 30/40 ROM - Don`t push it as the Tendon has not yet healed.

Would suggest that you look on Amazon and purchase a floor cycle which costs about 30 or $45 and you can sit in your chair and pedal away.

Best

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

Complete Ruptured Tendon

Offline alexws

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Re: Ruptured Patellar Tendon Surgery
« Reply #5544 on: February 21, 2015, 06:24:25 PM »
Still in the brace, have it set at 90 just in case.  seems like my doc is pushing my harder that most do. feeling good but not going to push it as i do not want to get back into this again

Offline John42

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Re: Ruptured Patellar Tendon Surgery
« Reply #5545 on: February 21, 2015, 06:29:43 PM »
Hi alexws

You have taken a positive approach - on your next visit to the PT, ask him/her - have you seen this type of injury before? and at the same time, get your good leg measured, which should be in the region of 130/140ROM.

Best

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

Complete Ruptured Tendon

Offline alexws

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Re: Ruptured Patellar Tendon Surgery
« Reply #5546 on: February 21, 2015, 08:06:40 PM »
I have met with 2 different pts in the same practice.  The first, fully disclosed that he had never worked on one before.  On the second visit I met a different pt who had seen 4 so not ideal but options are quite limited for the experience side.  I am at mid 130's on my good leg.  I feel (unfortunately enough) having torn both ACL's prior to this has given me a good understanding of my body, when to push, when to take it easy and what is injury vs normal soreness/ pain.  Rocking back and forth on the stationary today, not expecting to get a full revolution yet and i'm no where close but it feels good regardless.

Offline aggie_ks

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Re: Ruptured Patellar Tendon Surgery
« Reply #5547 on: February 23, 2015, 07:12:25 PM »
Hello all,

My name is Kerri and I am very glad to have found this board.

I ruptured my patellar tendon on 02/08 slipping off a wet curb while at work. When I fell, there was that horrible "crack" noise and when I looked down I had to put my knee cap where it belonged. Then came the ambulance ride and visit to the ER. The one plus of having it happen at work is that I work with the medics and the ER doc on a regular basis.

My surgery is scheduled for tomorrow (02/24). It has been helpful to read everyone's experiences/advice here. I must say that I am a little worried about getting back to "normal" and returning to work. I work in law enforcement and have a very active job. My biggest fear is not being able to return to a job I love.

I look forward to reading the advise/tips posted here and learning from everyone else, otherwise I'd be lost.

Offline John42

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Re: Ruptured Patellar Tendon Surgery
« Reply #5548 on: February 24, 2015, 11:36:40 AM »
Hi Kerri

Welcome to the RPT thread on KneeGuru

Yes, you have sustained a very rare and serious injury, which is going to involve some six months of rehab.

Following the operation, your knee will be placed into a brace for a minimum of six weeks and then the PT will commence.

Read some of the previous posts on this thread and ASK questions - One thing is certain, is that you won`t be going back to work for some time, no driving until your have the authority of your PT.

Where do you live?

JohnK/ Manchester UK

Take care and keep posting
Ruptured Patella Tendon January 9 2003
Slipped on black ice.  Manchester UK

Complete Ruptured Tendon

Offline Dan

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Re: Ruptured Patellar Tendon Surgery
« Reply #5549 on: February 24, 2015, 01:44:17 PM »
Hi Kerri

Welcome and good luck in surgery today.

As for me, just passed the 6 week mark, and the protective cable is scheduled to be removed March 6.
Still having difficulty getting ROM past 20 degrees. Can't do heel slides, even pulling my heel with a towel.
The knee is so stiff I can't overcome the resistance.

The only way I have is to let gravity do the work. I have the leg extended and supported. Then I lift it with a strap around my ankle, put something firm under the knee, slowly lower until my heel is on the support.
Jan 8, 2015 slipped on wet floor, tore right patellar tendon
Jan 12, 2015 surgical repair of tendon
Mar 6, 2015 cable removal
Mar 16, 2015 begin physical therapy
May 20, 2015 stopped PT due to lack of progress
Jun 11, 2015 arthroscopic scar tissue removal
Jun 12, 2015 resume PT















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