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Author Topic: Ruptured Patellar Tendon Surgery  (Read 1250558 times)

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Offline John42

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Re: Ruptured Patellar Tendon Surgery
« Reply #5865 on: November 12, 2015, 09:02:35 PM »
Hi JHS0804

Good news, but once again reminding you not to push it.

Investigate to get hold of a floor cycle from Amazon - sit at home in your chair and work on your ROM

Keep posting

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

Complete Ruptured Tendon

Offline mcgheea

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Re: Ruptured Patellar Tendon Surgery
« Reply #5866 on: November 17, 2015, 09:24:10 PM »
Hi all,

I hope this post finds you all 'well' under the circumstances.

I ruptured (complete) the patella tendon in my right leg which approx 24 weeks ago.  It's hard to believe the range of emotions that you will experience due to the highs and lows of relying on OS/PTs and the conflicting advice they provide.

Putting that to one side, I would say that nothing removes the fact that we are responsible for our recovery and need to educate ourselves as much as possible.  That's why this forum is vitally important.

If it doesn't sound or feel right then don't do it.  Challenge and ask as many questions as you need to.  Always remember that the time needed for a tendon repair is months and is appropriate for you and your own rehabilitation.  Remember: compare leads to despair! :-\

Once you have your cast removed and the would is healed, I would definitely seek hydrotherapy as this helps lighten the load.  You'll certainly benefit from the support the water provides.

I do hope that all us RPTs make a full and healthy recovery.

Regards,

Alec




Offline JoshD

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Re: Ruptured Patellar Tendon Surgery
« Reply #5867 on: November 17, 2015, 10:39:06 PM »
mcghea,

hows the recovery at 24 weeks?  I just had my 12 week post op appt. with my OS.  Things are moving along, albeit slowly.  I remain patient, and yes, this injury recovery has sure provided the rollercoaster of emotions.   

I have been granted (by my PT) use of the stationary bike for periods up to 35 minutes, with varying degrees of light resistance.  The simple act of beginning to do something like a cardio work-out sure does help the outlook!   

Josh

Offline champerington

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Re: Ruptured Patellar Tendon Surgery
« Reply #5868 on: November 18, 2015, 03:17:10 PM »
Hi all,

Sorry i haven't posted in a while. I'm now 27 weeks post op from a RPT on left knee.

I regained full ROM fairly quickly after coming out of brace (9/10 wks approx) and straight leg raises have been no problem from even earlier.

However, at this point i'm concerned that repair has come apart (this happened me on other knee 8 years ago) and i will require reconstruction.

My reasons for thinking this is that my knee is giving way on me quite a bit (more so after strengthening work which is natural i'd imagine) and i just have no spring off the injured leg, despite having recovered most of quad muscle mass and being able to squat nearly as much as pre injury.

Has anyone suffered this before or anyone have any views?

Offline mcgheea

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Re: Ruptured Patellar Tendon Surgery
« Reply #5869 on: November 18, 2015, 08:12:39 PM »
Hi JoshD,

Thanks for the note.

Recovery at 24 weeks is that I'm still listening to the advice given: take things slowly, be patient, don't compare too much (different countries, surgeons, people, injuries) and listen to your knee!

I'm not fully cleared to run; however, I am cleared to cycle, walk, stretch and slowly build my quadriceps.  Get as much time as you are allowed to do in the pool.  Walking up and down helps reduce the load going through your knee. This might not seem strenuous; however, this repair is by molecules and not by bricks!

I was back driving at week 10; however, this was because of the progress I was making personally.  Weekly milestones can be helpful and a hindrance as you can build yourself up to expect something and push too much - and actually push back your progress.

I've really learned to listen to my body and quieten down the voice in my head - this might sound peculiar; however, we all have a critical dialogue going on if we are truthful - saying that I should be further along.

I hope this helps - just learn to take it easy and re-position the priorities.

Regards,

Alec

Offline jhs0804

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Re: Ruptured Patellar Tendon Surgery
« Reply #5870 on: November 19, 2015, 12:26:57 AM »
Hi Everyone -

Hope things are going well.

I have hit a plateau with my ROM.  I'm stuck in the 95 - 104 degree range at 10 weeks post op.  I've been here for a couple weeks.  Good news is that I get there pretty quickly and the movement is basically pretty free.

I think scar tissue could be the culprit to going further and so I'm looking for some guidance on how to break it down versus the PT plan for push to pain with the probable result of a painful release of scar tissue.  Doesn't sound like a good idea based on what I've read here. 

To add a little more detail, there is some tightness around the scar itself (I'll call that the top) but I seem to have more tightness on either side of the knee. 

I know there is some phenomenum called Proprioception which can mentally block us from letting the knee get past a certain point and I suspect that's going on with me. 

So having said all that, can anyone recommend a specific technique and "how to" to get in there and break this up gradually but safely?  I have a gua sha tool which may be helping some but not fully or I need more education on how to do it.   But, again, any techniques would be much appreciated.

Thanks all.

John
« Last Edit: November 19, 2015, 12:29:44 AM by jhs0804, Reason: Added detail »

Offline TH72

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Re: Ruptured Patellar Tendon Surgery
« Reply #5871 on: November 23, 2015, 02:39:09 PM »
Hi John,

I also seemed to have plateaued over the last 10 days, but seem to be getting a bit more ROM now.  Two things that seem to have helped me are.

1)  Floor cycle.  Over the last 3 days I have managed to start pedalling it, and do so 15-20 minutes in the middle of my at home PT.
2)  Sitting heel slides.  I sit on the edge of my couch, foot on the floor, planted with friction (sock on carpet).  I slide my foot towards me to get maximum knee flexion, and then "lean forwards", in other words, slide my thigh forwards to get a little more flex or stretch and hold for 10-20 seconds.  For me, these seem to be more effective than "sitting on the floor" heel slides.

Questions for all:

1)  Each time I remove my brace to do PT, my knee is very stiff.  Does anyone just sit with the brace off and knee bent while not doing exercises, just so the knee is in different positions?  Does this help with stiffness?
2)  At what point can one sleep with the brace off?  My wife thinks I should try, but I am worried about moving in my sleep and tweaking my knee.

As of this Thursday, I will be passed on to a new OS.  Curious development for sure, and I will ask the new OS the reason for this.

Safe healing to all.  Where I live, we now have snow, so moving around will be a little more treacherous.

Terho
Patellar Tendon Rupture, left knee - 9/15/2015
Surgery - 9/17/2015

Offline John42

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Re: Ruptured Patellar Tendon Surgery
« Reply #5872 on: November 23, 2015, 02:59:37 PM »
Hi Terho

Delighted that you have started to use the floor cycle - damn good - just sit in the chair and pedal away.

With the brace off, just sleep with a pillow/cushion between your knees.

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

Complete Ruptured Tendon

Offline jhs0804

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Re: Ruptured Patellar Tendon Surgery
« Reply #5873 on: November 27, 2015, 10:38:52 PM »
Terho -

Great work on the floor cycle!  Glad you're cranking.  You also motivated me to sleep without the brace last night.  Slept like a rock....

On taking the brace off, I've been doing that for probably 2 - 3 weeks and it's good just to get the leg out and let it breathe.

All
Update here is 11 weeks post op.  We got to 109 degrees of ROM today.  I might have been able to go further but there's still a little fear there. 

The weird thing about this plateau I've been in (90 - 109) is how I seem to be stuck in this range where once I met the previous hurdles to (60 then 90 degrees), I could and can return there pretty quickly.

I sure could use some feedback, encouragement, etc. to understand why I'm so stuck here.

I've added the Graston technique to the mix which I think is helping.  My chiropractor recommended another guy that does this and we seem to be making progress. 

Another thing I experimented with yesterday was putting a heating pad on the knee area which has seemed to loosen things up though not permanently.  Would appreciate feedback on that as well to make sure I'm not doing something that shouldn't be done.

Somebody told me that ice pushes the bad stuff out and then the heat brings the blood back in to heal the area.  So, again, not sure if the science is right but the results seem to be working.

I have now walked 3 days at PT without the brace.  Longest walk was probably about 50 yards.  Had the therapist walk with me for safety.  The place I go is connected to a big box athlete training facility including an astro turf  area about 70 or 80 yards long.  After PT I went back out and walked back and forth along the dumbbell rack - probably about 20 or 30 feet long.  It felt so good to walk without the brace and by myself.  I think losing the brace is going to be soon.  My 12 week with the OS is Wednesday.

So hope everyone is doing well.  Please chime in on the ROM as this is the next big thing to get through toward independence!

Thanks.

John


Offline mcgheea

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Re: Ruptured Patellar Tendon Surgery
« Reply #5874 on: November 28, 2015, 09:07:56 AM »
Hi John, Terho, et al,

For ROM, try using a food tray on your carpet or a piece of fabric/sock if on wooden flooring - I found these helped with my heel slides. I didn't push beyond what I could do either in or out of my brace.  Totally understand the fear and my advice is make small incremental pushes once or twice a day.  I did my physio twice a day at home - in the UK I only saw my PT once per week and she would assess my progress and then set my exercises for the week.

I wore my brace 24/7 for 5 weeks - in bed, too - and it was limited to 50%.  It was on for 3 weeks longer that it was meant to be due to a mis-communication between OS and PT. However, it didn't do any harm. It actually gave me more confidence to walk without aids and strengthen the leg.

Another great piece of advice I was given was to elevate your leg in bed - this really helps reduce the swelling by draining the fluid back into your torso - gravity causes it to pool in your limb.  Simply put a folded towel on top of some pillows.  This may help when you get up to do your physio first thing in the morning.

A PT approved technique to help with ROM was to sit on a dining room chair and slide your foot back - it's a variation on a heel slide.  Once you've brought your foot back, you can then adjust your weight and see if you can get another few degrees in. Ask your PT first before trying.

I didn't use any heat on my knee - stuck firmly with ice wraps after my physio sessions.  However, I did warm up my knee with a full-leg massage.  I spent 5-10 mins working the area around the knee (loosening the knee cap), the quads, hamstrings, etc.  Then I did stretches which lasted another 10 mins - I now have a better stretch on my injured leg than I do on my good leg! I did all this before moving onto heel slides and strengthening work.

The science of hot and cold is right and it does work; however, if we heat the knee and more blood flows into it (slight swelling) then it could impact your ROM work. It's important to warm up the knee/tendon before starting any exercises. Speak to your PT/OS and take their advice re the heat pads on your knee.

I also used a supplement called Cissus Quadlangularis - it apparently helps with tendon repair and inflammation.  Could also be the placebo affect; however, I was willing to try most things to help with my healing.

Independence will be round the corner. If you are cleared to walk with crutches/sticks then ask your PT if you can add in small (5-10 min) walks to your daily routine. Gets you up and out of the house - provided it is safe under foot to do so and you don't have a huge flight of stairs to overcome.

Hope this helps.

Regards,

Alec

Offline John42

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Re: Ruptured Patellar Tendon Surgery
« Reply #5875 on: November 28, 2015, 09:47:51 AM »
Hi JHS0804

Hi John

11 weeks post op ROM 109, however, take a little care that your tendon is not fully healed and you could be pushing the ROM to far  -   listen to your knee -

Keep posting

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

Complete Ruptured Tendon

Offline jhs0804

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Re: Ruptured Patellar Tendon Surgery
« Reply #5876 on: November 29, 2015, 05:59:25 PM »
Thanks Alec and John -

Very helpful stuff as we navigate these ups and downs.  I thought I would share something that might be important to the ROM.

I have noticed that I have swelling below the kneecap and around the back of the knee.  I mentioned it in a previous post.  Today I heated up the knee with the heating pad and then grabbed my gua sha tool and started to push on the swelling to break it down to see if that could help things.  Specifically, the areas were on the right and left front of the knee and then around the back.  Again, below the kneecap.

I am almost certain that I got an instant increase in ROM with no pain and not a lot of pushing it too hard. 

After I got done with my ROM work, I immediately elevated and iced the leg to see if I could get that fluid or whatever it was to drain into the lymphatic system per Alec's advice. 

Again, too early to tell but that fluid may have been the culprit in getting more ROM and counter intuitive in that it was in the back of the leg.

I'll keep everyone posted but this could be a mini break through.

Another small victory is I've been walking around the house today brace free just trying to gain a little confidence on that front.

Question for the veterans.  As we transition out of the brace, did anyone use a compression sleeve or anything similar?  I bought an Enerskin leg/knee sleeve that is enroute.  If there are better options, I am all ears....  I'm hoping that the OS clears me out of the brace this week so want to be prepared.  Can't have any stumbles with the cold and snow in Michigan.

Hope everyone is having a great Sunday.

John

Offline John42

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Re: Ruptured Patellar Tendon Surgery
« Reply #5877 on: November 29, 2015, 06:53:09 PM »
Hi John

In response to your question, even after twelve years, I wear a full high length open toe with waist attachment lymphoedema garment right siize

It`s like a compression sock, but fastens with a belt around the waist -   does the trick - help the circulation and gives added strenght to the knee/leg.  It`s made in Germany  (Mediven Plus.)

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

Complete Ruptured Tendon

Offline TH72

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Re: Ruptured Patellar Tendon Surgery
« Reply #5878 on: November 30, 2015, 07:40:50 PM »
John, Alec and others; thanks for the responses.

Small update.  Last week Thursday I saw my PT and my new OS.   At PT, ROM hit 75 (10 weeks), which is a 20 improvement over 2 weeks.  Happy with that if it continues.

New OS asked me to perform a straight leg lift with brace off, which I could do with some pain.  She cleared me with instructions for PT to wean me from the Zimmer splint, and no restrictions as to PT protocol.  I guess anything goes going forward.

Question about straight leg lifts:  I can do them, but I have a sharp pain just under the skin where patellar tendon joins patella (site of my repair).  I have also noticed that the skin is "flat" in that area, and seems to be stuck to the tissue underneath.  It does not move freely along with the rest of the skin over the knee.  Is this cause for concern?  Is the repair causing pain, or is it more superficial?  Anybody else experience this, specifically pain during a straight leg lift in full extension, without a brace?

John, happy to hear that things are progressing well with you!  Walking without the brace on must have been phenomenal. 

Safe healing to all.

Terho
Patellar Tendon Rupture, left knee - 9/15/2015
Surgery - 9/17/2015

Offline JoshD

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Re: Ruptured Patellar Tendon Surgery
« Reply #5879 on: November 30, 2015, 09:01:58 PM »
Glad this thread is active these days....  Strength in numbers! 

I am almost 14 weeks post-op today.  I have good range of motion - approaching 120 active, and 135ish passive.   I can ride the stationary bike with a bit of resistance for 30 minutes w/out pain.  I do PT prescribed leg presses, lots of (attempting) balance on my injured leg, and I am only using my cane occasionally (when im on snow, when my leg is tired). 

To that point - I can lose the cane (ok per my PT) although i still have a fairly wicked limp.  I'm ready for my gait to return to normal, and would love to hear others ideas of when/how that happens.  All of the side-to-side limping makes my lower back super sore.   

When i take my brace off for at-home shuffling, my leg feels super weak and I'm not confident at all.  Hoping that the next breakthrough is soon.   Thanks. 

Josh