Ruptured Patellar Tendon Surgery

[lamoncarter713]

@bryce73,

thank you so much for those words and the websites I am about to check them out now, since I have nothing but time on my hands. Its been rough but I am coming to grips with my injury and surgery and rehab. I guess right now I don't see an end in sight or its just to far away. I get reminded of that every time I have to use the bathroom and it takes me 20 minutes to get there. ( but I am in week 2 of post op.) Please keep us informed on how your rehab is going.

I have another question, when I am resting in the bed finally and my leg is propped up I can feel everything in my knee, is this normal or not. I am not feeling pain because of the Norco but it is quite uncomfortable and I have to shift to get a better position.

[John42]

Hi Lamoncarter713

A good tip is to sleep with a pillow or cushion between your knees - I am still doing this after ten years.

Best - JohnK/ Manchester UK

[Dan]

I have another question, when I am resting in the bed finally and my leg is propped up I can feel everything in my knee, is this normal or not. I am not feeling pain because of the Norco but it is quite uncomfortable and I have to shift to get a better position.

Around the two week mark I was having uncomfortable sensations like the kneecap was shifting, depending on how the leg was positioned. And like you, my surgeon had to repair the lateral and medial retinaculum.

At the next follow up he took an xray to reassure me that everthing was in place, and eventually the feeling went away.

[bryce73]

Thanks for the recall John42, I'll keep this in mind 

Cordell, what you said about difficulties to fall asleep reminds me exactly what happened to me the first week after the surgery. I'm only at 6.5 weeks post op, but my feeling is that the first two weeks were the most difficult for me to this point (apart from being injured  ) , not being able to do anything apart from letting the knee rest as the injury is too fresh and the wound not healed yet. So you don't really see any progress during this time (but in my case that was necessary for the tendon to begin to heal properly as my surgery was minimal). At this time the end doesn't seem anywhere soon and you wonder how its going to be with your knee. When you will start to do some rehab and PT you'll see the healing of your knee progress so you'll be in positive and ascending state of mind. But as John42 repeats on the forum don't rush it and listen to your sensations, go to your own pace. Each case is different so there should be reasons why we all have different instructions from our OS. This is an injury that obviously needs to be patient but be confident that in the end you will recover. 

I have another question, when I am resting in the bed finally and my leg is propped up I can feel everything in my knee, is this normal or not. I am not feeling pain because of the Norco but it is quite uncomfortable and I have to shift to get a better position.

I don't really understand what you mean here, could you explain a little more? I myself didn't experience what you describes but I didn't feel the need to prop my leg up while in bed.

[lamoncarter713]

Bryce, what I meant was I can feel my knee shifting when I move my leg around in the bed trying to get comfortable.

[madvillain]

Hang in there recent post ops, it does get better.   Sleeping is the worst for the first month...especially for those of us that managed to rupture both.

Try and quit the narcs as soon as you can and put a little weight on the knees if your surgeon has cleared you, the sooner you can start moving the easier your recovery will be in the long run.  If nothing else, try and do heal slides and ISO sets in bed.

______

Time flies, I'm at 6.5 months now and had a breakthrough the last two days moving laterally on the tennis court and in my agility drills.  Really starting to move side to side now and I've done more agility work in the last month then the last 10 years.  It's really taking me back to HS football and college baseball days.  I'm doing a lot of plyometrics now (very low boxes ), slide drills, backpedal drill, shuffle drill, cone drill, high knees, butt kicks, etc, etc.

That combined with the eccentric squats, leg machine day, jump rope, cycling and light jogging is really helping me get quick and fast again.

I still can't really sprint more than 75% (ROM isn't there yet) but I can shuffle and "karaoke" and backpedal fairly fast again and that means I can get to quite a few balls again on the tennis court.

It's all about putting the work in.  Getting back to daily routine in many ways was the easy part.  Getting back to athletic performance is about pushing past mental and physical weaknesses (while not being stupid).

Also, for everyone, FOAM ROLLING!  Get a foam roller and to it religiously (along with ice) after your PT sessions.  Your quads are damaged but you won't know it until you get that roller on them and you feel the pain.  It's a good pain though and you will feel great after 5 minutes on that roller.  Have a trainer or PT person show you how to do it.  It's a huge recovery tool that I was missing forever.

[madvillain]

Hello guys,

I´m glad i have found this group. It´s really hard to get quality information about this PTR injury. Mostly protocols and they seem to have some variations to one another. But it´s a totally different perspective when someone is actually going through which this group provided for me. So...
I´m from Brazil, 27 years old, and had my PTR on the May 2nd while i was playing basketball. Running down the court in a fast break, when going for the lay up, my knee just snapped. It was my third day of my vacation, i was visitng some friends in the US. Had surgery 2 weeks later. My tendon splitted in half and doctor gave me a really hard time explaining how hard that is to happen. I was a very active person and had been doing mostly crossfit, oly and some biking. despite my love for crossfit, i strongly belive that it was the cause for the degenration of the tissue. Not saying that everybody that pratices it will suffer this nasty injury. The OS din´t allow PT just yet, i´m 5 weeks post op and have 90º of ROM which is the furthest he allowed me. Can do leg raises and can support my leg wihout braces which i only use when going out. I have a question, will i ever be able to do full snatch and cleans and even if i can do, would it be ok for the tendon?

Anyways thank. I´ve read almost every post and it really helped me while i was lying on the bad with that lame question. will i ever comeback? dont know how this"comeback" will be, but it doesnt matter. i´m happy with the progress i´ve reading.

Mario Goulart

You'll be able to do snatch and cleans but honestly you might want to reconsider your training methods.   The olympic lifts are great but even with proper form they can put a lot of pressure on the knee, back and hips.  Great for younger athletes but for those of us post op and aging there are safer (and perhaps even more efficient) ways to build power.

Lookup "eccentric training" or "eccentric training for pt" on google and get yourself a couple of slant boards (Amazon has some foam ones that are fine for like $20).

I used to love do play basketball, squat 400lbs, run down trails like a NFL running back, but for the most part those days are over for me.  I have set goals for myself to be bigger, faster stronger then before this injury (including getting down to below 18% body fat to take pressure off my knees) but there are certain activities (basketball is a big one) that are just hard on the tendons.

There are many players in the NBA with chronic tendon problems (Carmelo Anthony and Kyrie Irving for example) and the pounding on the hardwood or concrete is the main cause.

If you enjoy soccer or other sports that are played on grass, might be time to give up basketball and switch to those.  If you really want to play ball again you will, but just know it will take at least a year until you feel "normal" again.

In general, this was my surgeon's (he's fairly progressive) timeline:

1st day: try and get out of bed
1st week: try and shuffle around with the walker
1st month: try and get to 90 rom
2nd month: start cycling, other low intensity ROM training (slide board is good)
3-5 month: continue to amp up strength training and ROM but tendon not fully healed
6th month : should be fully healed, now it's up to you to work to get back to normal, no restrictions other than common sense on pain levels when training
1-2 year: start to feel "Normal" during sports, full ROM returns.

[madvillain]

@bryce73,

thank you so much for those words and the websites I am about to check them out now, since I have nothing but time on my hands. Its been rough but I am coming to grips with my injury and surgery and rehab. I guess right now I don't see an end in sight or its just to far away. I get reminded of that every time I have to use the bathroom and it takes me 20 minutes to get there. ( but I am in week 2 of post op.) Please keep us informed on how your rehab is going.

I have another question, when I am resting in the bed finally and my leg is propped up I can feel everything in my knee, is this normal or not. I am not feeling pain because of the Norco but it is quite uncomfortable and I have to shift to get a better position.

I'm trying to remember the exact sort of pain I felt in my knees but it was often sort of a dull throbbing or sometimes a sharper sort of "twinge" almost.  Especially the left knee (and that one is still a little weaker than the right one, doh) so what your experiening is certainly normal but with time and proper rehab it will go away before probably coming back around week 12-15.

In fact, I will always remember at the 6 week followup reporting low pain and my surgeon telling me "that's because all your nerves are dead".

Sure enough, around weeks 12-15 I started to have a little more pain when I was working out and afterwords.  Even at week 30 I still have a persistant nerve/muscle pain on the right side of my left knee, right above the kneecap and going up into the quad, when I first start to warmup or after a really hard workout.

It's normal though, the muscle is getting adjusted to the new reality of kevlar in the knee and tendon.   

Keep the faith and let the injury bring you closer to yourself and your family.  You'll have lots of free time and trust me I get the frustration with bills and work and all that.  I basically had 30k in student loan debt paid down to 5k, and now I just got 40k more in medical bills on top of that.   I didn't have insurance at the time (thanks mostly to all the login errors at the WA exchange I gave up) and mentally you have to put that aside and focus on recovery.

For the first 2 months, your recovery is 100% the most important thing in your life.  Make it that way and your knee(s) will respond well.

[madvillain]

SellaVee here, celebrating my 2 year anniversary this week.  Boy did time move slowly when I first ruptured my tendon, but now it's flying by.

I would agree with everyone who says that your physiotherapist is key.  Living in the UK I had an NHS physiotherapist but I also went twice a week to an excellent private physio.  I used an old skateboard to practice heel slides and bought a floor pedaller.  In addition I followed one of the rehab protocols that someone posted on here - I think it came from Massachusetts.  Patients in the US seem to rehab faster and I found the NHS frustratingly slow. 

So assiduous was I in my exercising that I broke the wire that was holding my knee together.  I had to push to have it removed but that happened at the end of January this year and involved more open knee surgery.  It was a piece of cake compared to the original operation.

Despite the second surgery I flew to Asia for a month in March and coped with the long flights.

One point I'd like to make is don't get hung up on measuring your ROM.  Work on strengthening your legs and the ROM will come back.  I only ever had my ROM measured once and that was simply because I asked!  The result disappointed me so I didn't ask again.  I can now touch my heel to my derrière - what more could a girl want.

You have to keep up the good work.  The second surgery set me back a little bit because I took some time off from exercising due to the wound.

To see me walking on level ground you'd never know I'd had a problem.  I'm not as quick as my son but he's in his twenties and I'm about to retire.  Going upstairs is a breeze, downstairs requires concentration.  I've hugely improved on downward slopes.  I can jog on the spot but when I lengthen my stride I look ungainly.  This doesn't bother my little grandson when I chase him round the sofa.

I can dance when no one's watching!  I'm in a good place and I owe a lot to my friends on this board.

It's funny how I still notice any downward slope that before I never would have thought about.   It's def one of the last things to come.  The last couple weeks I've finally "loosened" up enough to "jog" down some staircases. 

I thought I'd never be able to go down stairs again without thinking about each step or going slowly but I can tell that in the next few months I will probably pass that phase. 

I"m always coming in here and telling everyone to work hard but I just can't say it enough the more you work the more you will get out of your knees.  On the days I work the hardest my knees feel the best the rest of the day and even the next day.  I took like 5 days off in a row a month ago from any PT and just sat around and played computer games.  What a huge mistake my knees got so damn stiff I went to the gym on that Saturday / Sun and just worked my butt off to get them loosened up again.  Since then I haven't gone more than 2 days without some sort of activity to loosen up the knees and get the blood into them.  Gotta get the blood into the tendon.

Just general walking and getting in and out of your office chair isn't enough IMO.  You gotta get out and about and do some sort of hiking, hill climbing, biking, or something to get the blood moving.

Remember to RICE and massage/foam roll after all your workouts and your knees will feel better everyday.

[bryce73]

Bryce, what I meant was I can feel my knee shifting when I move my leg around in the bed trying to get comfortable.

ok, nothing really like this for me, but after my accident/surgery, my patella was moving with a jolt when my knee was shifting from a bent to an extended position. It's not very comfortable but it tends to disappear with the rehab. I had already this occasionnaly before, but it was quite casual and I knew how to make it disappear.

[agold55]

Hello all my Patellar friends......
UPDATE on REHAB.
Just over 9 weeks and things are starting to get better on a faster pace.  PT still going well....at appointment today, left knee was at 90 degrees before warming up & right knee was at 78.

The list of things I have done in PT and read on this site is really long, so I try to incorporate a much as I can on a daily basis.  Always special attention to Quad sets (hundres a day), heal slides (hundreds a day - from a variety of positions), sitting leg lifts - which are really easy now, laying on my stomach or standing upright - doing sets of hamstring curls/sometimes with light ankle weights - damn those felt very restricted at first, but getting better.  Some other things are calf raises, minimal squats (just body weight) with braces locked at 20 degrees, lateral sides raises and rear glute raises with either a resistance band or 2.5 lb ankle weights....ALONG with some upper body work with dumbells and ab crunches.  Also continuing to simply massage the legs and scars. 

SUPPLEMENTS:  Started taking Collegen pills in the morning with OJ - 20 min before breakfast.  Got these at Whole Foods....
Also read about Cissus on this site.....researched this a lot and bought some on line.  Started it this week in my shakes after workouts.

Again it's been really solid to be on this site and hear so many stories....it really let's you know that others are fighting the fight & that things will improve.  These pesky knee injuries can't and won't keep us down forever!!



4/19/15 - Bilateral RPT
4/20/15 - Surgery
 

[Stuart Rulka]

 Posted this earlier on the RQT thread but think it may be equally relevant here.
Had appointment today with Sports Medicine Specialist to discuss results of MRI taken last month. Apart from"large intra-articular ossification fragment" my tendon repair looks good.
Less appealing are the presence of a complex medial meniscal tear, focal cartilage irregularity of the adjacent posterior medial condylar surface with subchondral oedema, as well as probable old MCL strain. To round things out there is mild free edge degenerative tearing of the lateral meniscus, and background tricompartmental osteoarthritis!
Makes one want to curl up into a ball and pull the covers over one's head.
Bottom line however is, I am in no discomfort and have no impediments to my reasonably active lifestyle.Most of the above I suspect is to be found in any active 67 year old; my best course of action is going to be to sustain my current level of activity as long as I am able.
I bring all this up to emphasize the point that too much information can be counterproductive; the important thing is how your body feels. Exercise will only have a positive effect on most of the above conditions as it stimulates blood flow.
Or, don't be put off by medical mumbo-jumbo!

[lamoncarter713]

update

Well went to the doctor for my 3 week checkup and I got my staples taken out. I start rehab next wednesday, with the goal of 30 degree reflexion to be achieved. Let me ask a question how is this that first day of rehab, will my knee be incredibly sore afterwards? I can see the end, I can see me walking without this hideous, uncomfortable brace, and no crutches.

[bryce73]

update

Well went to the doctor for my 3 week checkup and I got my staples taken out. I start rehab next wednesday, with the goal of 30 degree reflexion to be achieved. Let me ask a question how is this that first day of rehab, will my knee be incredibly sore afterwards? I can see the end, I can see me walking without this hideous, uncomfortable brace, and no crutches.

hello,
At 3 weeks the operation is still very fresh and you might start the rehab very gently (this is how it went for me : passive flexions, quad sets, patella mobilization...everything I was already doing!), but maybe you will have a more agressive rehab protocol... whatever it may be, IMHO you souldn't feel you knee very sore or painful afterwards, if so it may means you have pushed the rehab too hard.

[Egatsby]

Been a minute since I checked in. I'm at the 14 month mark but I'm still having problems walking down stairs. Any suggestions on exercises to help?