Ruptured Patellar Tendon Surgery

[diane72]

Hello All,

So I am now about 14 weeks post-op. and it has felt like a very long journey. I am now walking 'independantly' indoors (but still feels like I'm carrying a bowling ball on my knee! Does that feeling ever go away?), one crutch outside to build up distance from short distances on even terrain but two crutches for long distances / uneven terrain like the woods (we were at CenterParcs this weekend and it was challenging even with two crutches due to the gradients). I do still need a crutch on the stairs though, particularly going downstairs. I had the physio today and my ROM is now about 110 but it has been VERY slow compared to the 0 to 90 progress.

Thanks for all the tips on the ROM exercises quickrecovery, looking for all ideas now to get beyond 110 and nearer the 120 mark at least. Glad to hear it is all progressing more quicklynow.

Brett, so g;ad everything is getting back to normal for you, did they give you any advice on driving? Now I can walk it is the one thing I have been wondering about.

Sending get well vibes to everyone else!!

Diane

[John42]

Hi Diane   

Don`t drive until you get the OK from your OS - Have your good leg measured - however, any thing over 130ROM is a bonus.

Best

JohnK/ Manchester UK

[Bmcnamara417]

Driving? I never stopped driving!  Doctor never gave me a solid no.  That being said he is a pretty layed back doc....

[John42]

Hi Bmcnamara   

You are invalidating your car Insurance policy until such time you are in full control of the vehicle i e with enough strength to depress the brake pedal.,  This is a legal requirement.


JohnK/ Manchester UK 

[Bmcnamara417]

I did have full control of the vehicle.... lets not worry about me john...i assure you I had full control.  Lets also remember US and the UK are different.  Lets also remember  that most vehicles in the US have automatic transmissions (as does my truck).  That being said..I am 10 weeks post op.  Full range ROM, walking with no brace since week 6.  Juat a little gimpy from time to time...knee gets a little stilff with the weather changes and me over working it.  Continuing to bulld strength.  Fully expect to be released back to full duty as a firefighter in mid May.  Thata 3 montha folks!  Work hard and have the right Doctor/PT team and it can be done!

[quickrecovery]

Hi everyone,
I have a question for you guys.  I'm currently starting my 11th week and I'm at approximately 85 degrees flexion.  I still can't do a full revolution on the stationary bicycle.  What exercises did you do in order to get your range of motion back?  What are you doing at physio?  I'm having a lot of trouble getting past 90.  I believe I have a lot of scar tissue in the bottom part of my knee (near the tibual tubercle). 

Has anyone had any experiences with infection?  I was advised to go back to the hospital in case my knee was infected and was given a 7 day course of Keflex.  I take this 4x a day.

Also, how often do you ice your knee?

 

[John42]

Hi quickrecovery

You are bang on target   - week 11 or week 12 the ROM is about 85/90 - your next mile stone is 110 at week 14/16, so PATIENCE is required.

JohnK/ Manchester UK

[rideandshoot]

First a long overdue update.  Bi-lateral patellar tendon rupture and subsequent surgery on Sept 14, 2014.  In many ways I am fully recovered.  Cycling is back up to pre-injury power, I can hike all day, run a little.  What I can't do is squat all the way down like I might have pre injury .  I'm not talking about squatting in the exercise/bodybuilding sense but in the 'I need to squat to pick something up or look under something' sense.  I have full range of motion stretching and I can get down into a full squat but getting out is not working.  When I contract my quads to rise out of a squat there is pain and tightness in enough quantity that I have to will myself to get up.  Has anyone else experienced this and fixed it?  Do I need to stretch differently? My PT was against full squats but I'm wondering if I need to do them with no weight.

Thanks

[diane72]

Hi All,

Quick recovery as John said don't worry it doesn't seem to be a linear progression. I got really frustrated at your stage as I couldn't get past 90 and it seemed to stick there f for about 3 weeks and then suddenly I seemed to get to 110. I'm coming up to 16 weeks post op and I only did my first full rotation on the exercise bike yesterday.

Ride and shoot, interesting to hear how it is going for you. I'm still realtively earlyon so have no suggestions but wanted to offer sympathy you just want to be 'back to normal'.

Hope everyone is well

Diane x

[madvillain]

First a long overdue update.  Bi-lateral patellar tendon rupture and subsequent surgery on Sept 14, 2014.  In many ways I am fully recovered.  Cycling is back up to pre-injury power, I can hike all day, run a little.  What I can't do is squat all the way down like I might have pre injury .  I'm not talking about squatting in the exercise/bodybuilding sense but in the 'I need to squat to pick something up or look under something' sense.  I have full range of motion stretching and I can get down into a full squat but getting out is not working.  When I contract my quads to rise out of a squat there is pain and tightness in enough quantity that I have to will myself to get up.  Has anyone else experienced this and fixed it?  Do I need to stretch differently? My PT was against full squats but I'm wondering if I need to do them with no weight.

Thanks

First, congrats on your progress so far.  I'm at 17 months now from duals and I am just now starting to get to the point where I can "squat down" on a "natural" level approaching pre injury levels.  IMO it's all about regaining that VMO power that is the absolutely last to come back no matter how hard you target and work it.   I would suggest unweighted deep squats on the balance training "half ball" at the gym / PT office / home and then weighted back and front squats on the Olympic rack either to parallel or use a bench to ensure proper form.

I have only now really started to do heavy squats again (did 235 x 5 reps the other day as my last set!) and I really feel this is letting me take the next step in my recovery by getting the quad strength back.  I've found that the natural, day to day "squatting" you talk about is getting easier as I get the power back.

You also might look into "eccentric squats" and VMO specific exercises.   One I do is where I squeeze a ball between my knees during a wall sit for 100 reps x three.  Another one I do by tying a resistance band around my knee and anchor and then slowly just contracting and straightening at the knee.  Lots of videos / guides on VMO specific stuff on the Internet.

[madvillain]

Hi everyone,
I have a question for you guys.  I'm currently starting my 11th week and I'm at approximately 85 degrees flexion.  I still can't do a full revolution on the stationary bicycle.  What exercises did you do in order to get your range of motion back?  What are you doing at physio?  I'm having a lot of trouble getting past 90.  I believe I have a lot of scar tissue in the bottom part of my knee (near the tibual tubercle). 

Has anyone had any experiences with infection?  I was advised to go back to the hospital in case my knee was infected and was given a 7 day course of Keflex.  I take this 4x a day.

Also, how often do you ice your knee?

 

11 weeks is a trying time as you're anxious to get back on with life but the pain is perhaps increasing as you get the feeling back in the nerves and also as you push the knee and break up scar tissue in PT / workouts.

My "magic" ROM exercise at this point was the rowing machine.  I found I could safely push my ROM on the rowing machine as little are as much as I could on any given day and after about 10-20 minutes my knees always felt looser. 

You also should be doing iso sets (contracting the quad in a sitting position), and also heel slides multiple times a day as much as you can.

This guide from UW medicine is pretty contemporary and is a good starting point for any self teaching on the rehab from this injury:

http://www.uwhealth.org/files/uwhealth/docs/pdf6/sm_pat_tendon_quad.pdf

As for icing, I'd ice as much as you can as well especially after PT.  I would also be doing gentle "gua shu" scraping and kneecap manipulations to break up scar tissue.  Ask your therapist any good one will be trained in gentle patella manipulations.  Also plenty of videos online.

In general I think weeks 10-18 are trying as the progress isn't always linear and the injury is getting a little "old hat" at this point.  Just keep working, you'll get better.

[madvillain]

As for me, hiked twice this week and played tennis today and was absolutely ripping the ball.  Best I've played by far since the injuries.  All the hard work is paying off.  Still have some stiffness and mild pain in the left knee from time to time but the right knee feels perhaps even better than it did pre rupture.  Dropping the 50lbs has done wonders as well for me.

[Saskman]

Hi All,

Here's my update.

I'm 7 weeks post-op. My brace is set at 75 degrees. I can get more with the brace off but don't want to over do it. My brace so far has got extended 15 degrees a week starting at 45 degrees a few weeks ago. I don't use crutches at all any more and actually haven't for about 3 weeks now. I go to physio once a week but have quite a few exercises on my own everyday. I started driving as soon as the surgeon unlocked my brace which was awesome. You don't realize some of the freedoms you have until they're gone. I have also started walking around the house without the brace and started sleeping without it too.

Kelly.

[rideandshoot]

[/quote]

First, congrats on your progress so far.  I'm at 17 months now from duals and I am just now starting to get to the point where I can "squat down" on a "natural" level approaching pre injury levels.  IMO it's all about regaining that VMO power that is the absolutely last to come back no matter how hard you target and work it.   I would suggest unweighted deep squats on the balance training "half ball" at the gym / PT office / home and then weighted back and front squats on the Olympic rack either to parallel or use a bench to ensure proper form.

I have only now really started to do heavy squats again (did 235 x 5 reps the other day as my last set!) and I really feel this is letting me take the next step in my recovery by getting the quad strength back.  I've found that the natural, day to day "squatting" you talk about is getting easier as I get the power back.

You also might look into "eccentric squats" and VMO specific exercises.   One I do is where I squeeze a ball between my knees during a wall sit for 100 reps x three.  Another one I do by tying a resistance band around my knee and anchor and then slowly just contracting and straightening at the knee.  Lots of videos / guides on VMO specific stuff on the Internet.
[/quote]

Thanks for the help... I will up the VMO specific work.  I think I'm going to make a visit to the PT for a evaluation too.  BTW great work on getting back to heavy squats again. 

[diane72]

Hello All,

Madvillain, thanks for all the useful tips, especially on the ROM. I never thought of a rowing machine but it makes sense. I seem to have reached another plateau at 110 degrees so looking for all tips just now!

Saskman, sounds like you are making great progress. Was it your left or right leg you ruptured?

As for me I'm off to see if I  trade my car in today as I think it will help with getting back behind the wheel. I have a Vauxhall Astra and it is just way too low on the ground to be comfortable and requires you to hang off the handle just inside the door to get yourself in. Sat in quite a few cars yesterday and the Kia Soul seemed to be a much better height and the knee didn't hurt at all when sitting in it- a high up car I think will make a big difference. I did think about automatic but as it is my right leg I can't see it would make any difference so may just stick with manual, which is what I have always driven.

Diane