Ruptured Patellar Tendon Surgery

[mcgheea]

Many thanks bryce73 and tonestone for your inspirational messages.

Alec

[bryce73]

I haven't checked if this video has already been posted but it's very well made :

tendon healing : https://www.youtube.com/watch?v=Wc_2I3NeThM

[mcgheea]

Hi all!

I hope this message finds you all well - under the circumstances.

I have a few questions to ask and would welcome your opinions / experiences:

1) Are the PT protocols in the UK more conservative than other countries for this type of injury?
2) Is it worthwhile supplementing the NHS PT (1 session per week for 30 minutes) with private PT sessions?
3) Depending on your type of job you do, when do people generally return to work? (I've been signed off by my OS for 8 weeks.)

Thanks in advance.

Regards,

Alec

[John42]

Hi Alec

By 8 weeks, you should be off crutches, but may still be using a stick,  but remember, your tendon has not yet healed.

Can only advise to listen to your knee, and be very careful in wet weather or grass areas.  I don`t think that you need to suppliment PT - and on the question of going to work is a difficult one - no if you have to stand at all, and you may require a foot stool to lift and raise your leg.

Keep asking - take care

JohnK/ Manchester UK

[mcgheea]

Many thanks John K!  I really do appreciate your counsel.

Best regards,

A 

[carkeltom]

Good afternoon, evening, or morning to everyone on this thread.  It has been awhile since my last post, but I am posting for a milestone and felt the need to look up and get back on the board for a few.  This next Friday, it will have been two years since my double rupture.  I will not bore everyone with the details of my accident, but it was just that, a freakish accident.  I found this forum, late late at night during my hospital stay after surgery.  I was looking for answers, since no one had seen someone like myself, nor knew how to deal with double.  I would imagine most still do not.

I have been active, but not as much as I was before the accident.  I am a softball dad and enjoy my time on the field.  But, now I watch my step, don't get to eager to run out on to the field to argue with an umpire and leave some of the demonstration/teaching/coaching to the girls.  I sit on buckets to catch pitchers now, instead of getting into a catcher's position. 

I can take off on a jog, but I was never a runner to begin with.  I still have some pain on occasion, but it is mostly superficial pain.  My brain still has to tell my knees to bend/extend at times, especially on slopes and stairs.  But I take my time.  I am lucky to be up and going and I am OK with what I can do.

Best of luck to everyone.

Tom

[John42]

Hi Tom

Good to have an update of your progress - inspire other double RPT`s of which there are few.

Keep at it, the end is in sight and don`t give up.

Take care

JohnK/ Manchester UK

[bryce73]

Hi all!

I hope this

 message finds you all well - under the circumstances.

I have a few questions to ask and would welcome your opinions / experiences:

1) Are the PT protocols in the UK more conservative than other countries for this type of injury?
2) Is it worthwhile supplementing the NHS PT (1 session per week for 30 minutes) with private PT sessions?
3) Depending on your type of job you do, when do people generally return to work? (I've been signed off by my OS for 8 weeks.)

Thanks in advance.

Regards,

Alec

Hi mcgheea,

I can't answer to your 1) - I live in France.

As for your 2), personnally I should have 3 PT sessions per week (30/45 min each) but I went for 2 as I replaced one for a swimming session. Actually I used to swim 4 to 5 times a week, around 1h/1h30 each, starting week 7 post-op. During the early stages of PT (between weeks 7 and 10), I feel it really helped my knee to regain flexion and also begin to get my quad working again on muscular level. Now, starting week 11,  I feel I need to work on a more intense level, that would be much more cycling to work on my quad and swimming only on resting days to relax and work on the flexion. So to answer you, my feeling is that you could go other PT sessions if you'd like (maybe up to 3 a week) but you can do a lot by yourself without a Ptist. In anycase you should preferably ask your Ptist about it first.

For the 3) speaking of my own case, I started working again at 7 weeks post-op. I have a mixed job in which I'm working in an office but also have to go out on worksites. Actually I may have been partly operational (the office stuff only) as soon as week 3, but I needed to drive to get to my job, so I started at week 7 (still I had to pull my leg in and out of the car with my hand at the beginning!). Now it would also depends, on your job, your injury...

--

For the new stuff about me, I started hiking yesterday - that's 11 weeks post op- but it was a little too much. I did 550 m height, up and down, on a very steep and rough terrain, but not on a great distance. Not very impressive but still challenging after 2 months of inactivity!    Still, the upmost difficult part was the descent. My injuried leg being still quite weak, I compensated with the other though I tried not to, so that toward the end, both my legs were pretty tired, and I had to make stops each 50 or 100 meters. That was also a bit risky as both my legs were a bit shaky and I could well have slipped...Which I did actually, but that was because of the dust, not the fatigue. Hopefully, nothing wrong comes from it but that was a bit scary!  Today my injuried leg feel ok but the other one is aching! This to say that I feel cycling or specific work on the injuried leg may be better at first to work on the quad because with hiking one may rely too much on the uninjuried leg... Just my personnal experience here but I feel I may need to strengten more my quad before going hiking on steep and rough terrain again.

[madvillain]

I think that for the most part the UK surgeon's are more conservative than their US peers, at least that's the impression I have gotten reading this forum.  John could answer that one a little better.

I did box jumps (3 foot box!) yesterday for the first time since the dual rpt -- I'm 7 months and 2 weeks now -- and that was a lot of fun.

My knees are feeling really great not close to 100% explosion but maybe at 75% of pre injury level and that's pretty damn good I think.  Hoping to get back to pre injury levels by Dec 7th (one year anniversary) and to push past that after that.

I saw 185lbs on the scale yesterday.  When I did the ruptures I was at 215.  The 30 lbs difference makes a huge difference.  I'm not here to preach about weight loss as being overweight contributed to my problems but if you can, try and lose the extra weight.

This thread is a helluva lot more positive than when I started 8 months ago and I think a lot of it is the community support.  JohnUK does a great job.

That's pretty impressive Bryce.  1500ft down is nothing to laugh at only 11 weeks post op.   Keep it at it practice makes perfect as they say.

[SellaVee]

Hi all!

I hope this message finds you all well - under the circumstances.

I have a few questions to ask and would welcome your opinions / experiences:

1) Are the PT protocols in the UK more conservative than other countries for this type of injury?
2) Is it worthwhile supplementing the NHS PT (1 session per week for 30 minutes) with private PT sessions?
3) Depending on your type of job you do, when do people generally return to work? (I've been signed off by my OS for 8 weeks.)

Thanks in advance.

Regards,

Alec

Hi Alec

I'm in the UK and I would say that rehab protocols in the UK are way behind those in other countries, particularly North America.

In my opinion it is definitely worth supplementing the NHS sessions with private physiotherapist visits.  I went twice a week to an excellent private physiotherapist and it was money very well spent.  My NHS sessions were fortnightly and meant to last 30 minutes.  Some days I was in and out in 10 (and I was on crutches).  I was usually given just 1 or maybe 2 exercises to do by a very young and inexperienced physiotherapist who had never seen an RPT before.  By contrast my 30 minute private sessions often lasted an hour for after treatment the physiotherapist would strap me up to a Kneehab and leave me with a cup of coffee while she went off and treated someone else before coming back to disconnect me and check on my progress.  I was given many different things to try exercise wise by someone who had treated the injury before and who took a real interest in me.

I was lucky to find this forum.  Carkeltom and I rehabbed at the same time as we both had our surgeries two years ago this month.  It was reading his posts and some others that alerted me to the importance of physiotherapy.  My orthopaedic consultant was not that interested in my rehab so finding a good physiotherapist was key.

I also used a protocol from Massachusetts that was posted on here.  It listed exercises that could be done at various stages.

Exercise is key, and you have to keep on doing them.  Read as much as you can of the experiences on here.

I think returning to work will depend on what you do and the environment you're in.

Hope this helps,

Sella

[Stuart Rulka]

Alec, as noted before I was a RQT and we seem to have an easier recovery. My injury was two years ago come August 1st and I was back at work four days later! There were two keys there, one being that I am self employed (in Canada ) so being away from work, with a high overhead, was simply not an option! The second was that I was fortunate not to need any painkillers because as a healthcare professional that would have precluded my working.
 I also had an experienced, and aggressive PT, three times a week and was back to my regular hiking in six weeks. Once again the key is that my regular hike (Vancouver's GrouseGrind ) is uphill only, downhill travel being prohibited. Tram travel downhill is faster and safer for us, particularly in winter which arrived at about my fourteen week mark! Must confess I would not have had the cojones to try going downhill at that point, and would still be reluctant even now.
 Have said before and will repeat, ad nauseum, that the sooner you become active again, the less atrophy and the easier the recovery. I did wear my brace, only while hiking, throughout the winter, locked at 120 max flexion so that even if I fell, and I did, there was no undue stress on the tendon.

[John42]

Hi Madvillian

Just wanted to give you a big thank your for your compliments - having gone through the hoop some 12 years ago, and still suffering, I continue to share experiences and will continue to do so.

I always welcome posts on this thread, as there is so little information available concerning a RPT injury.

Please do keep posting -

Take care

JohnK/ Manchester UK

[agold55]

Hope everyone is doing ok today.

UPDATE: Yesterday was 3 months out from my Bilateral RPT surgery!
The toughest part is being tied to rehab daily in the summertime, while your kids and friends are doing the lake thing, biking, etc....but all in all it's gone fairly quickly.

My physical therapist is awesome!  With my Drs blessing, she's started really working on strength training the legs and gaining some more ROM.  My right leg is at 90 degrees...left leg is at 108.  Seems the right leg is a bit slower to come around.  Sessions last about 1 hour 45 minutes, twice a week.  Also doing a bit of pool exercises at night, with some resistance training with a noodle (foam floating devise). 

Took John42's advise and bought a floor pedaler.....trying to do that 20-45 minutes a day.

Also trying to get into the gym a few times a week to lift some free weights and work the legs / calves a bit....sure feels good togged back in a gym and work out to some capacity!!

I've seen all kinds of posts on this site from single and double RPT's & it seems that every Dr is a bit different in how long braces are worn.  My Dr has me in them still, but unlocked and progressing 10+ degrees a week - depending on the PT's thoughts.  I'm supposed to be out of them completely by 3rd week in August which will be 4 months.  At that time the legs will be a bit stronger. 
What has been others length of time to be in the braces....especially if you were a Bilateral RPT??

Hope everyone is doing well.....keep the advise and stories coming.
Cheers!

[mcgheea]

Hi all and many thanks for the responses - opinions and experiences very much appreciated!

Today is 8 week post-op.  I had my 30 minute weekly PT session and was given more strengthening repetitions - no new exercises .  No change to brace ROM (limited to 50^o max.) as the PT is waiting on input from OS who I'm not due to see until 06 August.  All of which is proving to be very frustrating and disappointing as my progress seems to be very slow compared to what others are doing and experiencing!

I fully appreciate that everyone's injury will be unique to them; however, there just seems to be such a wide gulf in what other sufferers are and are not doing.  The main thing is that I'm following 'doctor's orders' and don't want to push the repair and set myself back - including taking the time off from work to let the tendon repair.

Anyway, perhaps a call with OS might be called for to see if she can advise what the best course of action is from her perspective and experience.

Thanks again to all who replied.

Regards,

Alec

[agold55]

Hi all and many thanks for the responses - opinions and experiences very much appreciated!

Today is 8 week post-op.  I had my 30 minute weekly PT session and was given more strengthening repetitions - no new exercises .  No change to brace ROM (limited to 50^o max.) as the PT is waiting on input from OS who I'm not due to see until 06 August.  All of which is proving to be very frustrating and disappointing as my progress seems to be very slow compared to what others are doing and experiencing!

I fully appreciate that everyone's injury will be unique to them; however, there just seems to be such a wide gulf in what other sufferers are and are not doing.  The main thing is that I'm following 'doctor's orders' and don't want to push the repair and set myself back - including taking the time off from work to let the tendon repair.

Anyway, perhaps a call with OS might be called for to see if she can advise what the best course of action is from her perspective and experience.

Thanks again to all who replied.

Regards,

Alec

Alec.....I had my Dr and PT get on a call to discuss in detail what I could get more aggressive on.  It was at the 12th week once they spoke in detail.  Keep in mind I'm bilateral RPT, had wires removed on July 1st, stitches removed July 8th.  So a bit more cautious since I don't have a good leg to stand on ;-).

The Dr gave the PT the okay to start opening up the braces to 50 degrees for me to walk & 60 degrees in therapy.  Increasing the degrees weekly based on what she saw.  Now at 70 degrees while training/PT and walking.  Started really working on strengthening exercises with the PT last week and this week & ending my day in the pool at my house for 45 minutes.  Also working on various exercises at home, floor pedaler and rowing machine at the gym - that was great to get a bit of a sweat going.  Lifting weights every other day and ab work is helping too.

You have to listen to your body & push to a point of not injuring your knee. 
I hope this helps!