Ruptured Patellar Tendon Surgery

[BendTheKnee]

Nic:

Thanks for pushing me towards getting a second opinion - I really do appreciate it.

I added you on Instagram and sent you a couple of messages on there.

I'll keep following your progress on here, and on Instagram and i'll definitely keep in touch.  It sounds like you have made great strides from when it originally happened and I hope everything continues to go great.  It sounds like you are almost through the toughest part.

Hopefully I won't have any negative news to report.  I am going to do PT, but I am semi-cautious because these injuries are so rare.  I don't want my PT doing anything to mess my knee up.  I guess I have to learn to trust.

[GDJ]

Hi Justin,

Just joined this forum today and thought I would comment on your original post...
I have recovered from a partial patellar tear... unfortunately ended returning to sport too quickly and ended up rupturing it 

My tear was originally diagnosed with MRI as about 60%... Then had ultra sound scan done and it turned out to be more like 30-40%. Ultra sound is the only way to definitively check a tear due to it not being a static scan. The measure blood flow through the tear when you leg is bent and then while moving it... very interesting and fascinating to see...

Important things to remember and my advice;
- Rest your tendon as much as possible, in other words do as little as possible to load the tendon
- Take your time, I went back to sport 6 months later and still ruptured it...
- Go to physio at least twice a week if possible and do your rehab exercises
- If you get a steroid injection, remember this is a false economy, it dulls pain and reduces swelling but that does not mean it is healed... (my biggest mistake)
- Once you are able to load your tendon, typically 6-8 weeks after resting it properly, make sure to do exercise that stretch your rectus femoris muscle... again making sure not to overload anything...
- Once you are sure your tendon is healed make sure to exercise and strengthen your vastus medialis

Hope that helps and that all goes well with your healing...

[BendTheKnee]

Hi GDJ,

My doctor isn't 100% sure if I have tendinosis and/or a tear.  I don't have any brusing and I am able to walk just fine, so he was leaning towards tendinosis.  I do have a small amount of swelling and pain where my patellar tendon attaches to my patella.  I've been trying to ice that.  I am not 100% sure why they didn't have me do an ultra sound, as that sounds like it would have given me a much better answer.

How do you know when a good time to return back to sports is?  6 months seems like a long time, but I don't want to rupture it all the way so I am willing to wait as long as I need to.  I am currently able to walk and slowly go up and down stairs without much pain.  I asked my PT if I should be doing stairs, he just said if it hurts then stop.

I've been doing PT twice a week, but I am not 100% sure my PT knows exactly what they are doing.  They give me the standard knee stretching and exercises I see everyone else doing.  I haven't done any eccentric squats, which I read was good for patellar tendonitis.

Did you have any specific exercises you used on your vastus medialis?

Thanks for replying.  I will definitely listen to your advice.

When did you rupture your tendon?  Hopefully it was a while ago and you are doing much better now.

[GDJ]

Hey Justin,

I knew my patellar tendon had torn because I felt it... if you have not had any tearing sensation and or extreme sharp pain, then I would hazard a guess that you doc is correct... recovery and rehab logic are the same either way.. R.I.C.E... Rest / Ice / Compress / Elevate all the time or as often as you can through the day...

Listen to your knee... if it is hurting when going up or down stairs it is unhappy so "off load" by using hand rails etc... you have a fat pad or bursa below your patellar under the tendon which could be inflamed as well as your tendon being sensitive, swollen etc...search the web for strapping techniques for "runners / jumpers knee" this helped me a lot and is something you can do yourself...

My PT sessions consisted of basic exercises to strengthen my quads and hamstrings and massage...

If you can get your hands on a Compex machine I would highly recommend this...invaluable... I have the Compex SP 2.0... again search the web and do some research on these little machines, they are fantastic!

Every person is different and recovers at different rates so don't worry about me mentioning 6 months... I am 45 so heal more slowly now days 

I tore my tendon completely 10 weeks ago... but am healing well considering I had a 2 and half hour operation and over 100 stitches inside my knee... I have 95 degree ROM, am walking, can go up and down stairs albeit slowly and am almost able to do a full rotation on a static bike which is my main goal by the end of this week...

Hope that all helps...

[BendTheKnee]

Hi GDJ,

I had extreme sharp pain when I first injured my knee anytime I'd try to bend my knee.  I never really felt any tearing sensation though...just really sharp pain.  It has been about 10 weeks now and I have full range of motion in my knee with no pain when bending (maybe my tendon healed?).

My knee feels about the same as it did before the injury going up and down stairs (it hurts, but I can do it - I have bad tendonitis, so I am sure that is still there).  I'll look up some strapping techniques for jumpers knee.  I was wearing a tendon strap over my knee, but my knee feels well enough that I have ditched that and am currently not using anything.

My PT is basically doing the same thing.  My quad is extremely weak compared to my "good" quad.  I imagine i'll be working on this one for a while.

I tried slowly jogging 100 feet the other day, and I felt ok while doing it and immediately afterwards, but then my knee was sore the next two days.  So I've stopped that again for now.  Maybe I'll try again at 3 months - I just dont want to have any set backs, or make the tear worse if it is indeed partially torn. 

I'm sorry to hear about your torn tendon   I am glad that you are healing well.  100 stitches is crazy!  Why so many if you don't mind me asking?  That is a long time to be in surgery for.  Is it the typical surgery where they run sutures through your tendon and drill holes into the kneecap to attach them to?  It sounds like you are making great progress though.  I hope that you were able to do a full rotation on the static bike this week!

My main worry is doing exactly what you did.  If mine is partially torn, I am sure it is weaker than a normal tendon, which means it is more likely to rupture.  I just want to take any precautions I can so that mine doesn't rupture, even if that means waiting 6+ months to do anything strenuous.

[GDJ]

Hi Justin,

General rule of thumb is that it takes a minimum of 6 weeks to recover from a tear... and that you a should do rehab for 3 to 4 months after to strengthen quads, reduce swelling etc etc...

Sounds like the strapping will definitely benefit you...
Tendon strap? If it is the strap that goes around your leg at the bottom of your patellar then I would continue to use it until you are at 100%. Reason being as it acts as a shock absorber for your patellar, especially if you still have swelling in that area...

I presume your PT has encouraged you to do exercises that have little or no impact on your knees such as static cycling and cross training? they put far less pressure on your knees than jogging...

As vital as it is to strengthen your quads, don't forget to also work on your hamstrings and glutes...

Swelling and pain after exercise can be expected, I think it is a good sign that you felt ok during and straight after...trick is to remember to elevate and ice...

Did you research a compex machine? I can't stress enough how much mine has benefited me... especially with pain and swelling...

As for my 100 stitches...well I damaged all the tissue around the tendon as well. As well as the hole drilling etc they also put in a neoligament which is quite interesting. Take a look at the link below

https://www.youtube.com/watch?v=RTSrqSJEM3k

I have progressed to static cycling and this week there is no pain either but I still have to have the seat way back... the good thing is my quads are getting a good work out...

I wouldn't worry too much about rupturing your tendon at this stage, I did mine playing rugby. My surgeon has asked to see me again at the end of September and he reckons he will be Abe to sign me off to start playing touch rugby at that stage... he has obviously said I should not play contact again...
End of September would be +- 5 months post op for me so I reckon you should be doing ok in the next 6 weeks or so...

keep me posted   

[John42]

Floor Cycle

I have mentioned many times, suggesting that RPT patients should purchase a floor cycle.

This strengthens your arm and leg muscles whilst you are reading working or watching TV.
For anybody on this thread living in the U.K., I noticed that LIDL are selling them at a special price of £24.99.   WORTH EVERY PENNY.   
JohnK/ Manchester UK

[GDJ]

Floor Cycle

I have mentioned many times, suggesting that RPT patients should purchase a floor cycle.

Great idea... Cycling has been the most beneficial exercise getting me back to where I need to be... I cycle at the gym every day but a floor cycle is at home is something to consider...

[John42]

HI GDJ

Delighted you are considering purchasing a floor cycle -

Cost about £30 in the UK and $50 on Amazon, keep us posted how you
get on.

JohnK/Manchester UK

[JC55]

5 years out from RPT surgery.  Never even think about my knee anymore.  Have been very fortunate with rehab...I listened to my body but pushed myself everyday once I started physical therapy.  To all the newbies, it WILL get better and your body will heal...be patient but compliant.  It is NOT a race to see who can get better the fastest, so please don’t compare your injury and rehab to others but rather take the advice given on this thread and take charge of your own recovery. Thanks John (and all those others I went through this with, you know who you are) for all you do to keep this thread going...it really did save me from my anxiety and gave me hope through a VERY difficult time. Peace and recovery to all.

[John42]

Hi Jerry

WELL DONE - an inspiration story - enjoy life to the full, and put the past behind you.

JohnK/ Manchester UK

[RuptureLife]

Tomorrow marks 25 weeks post repair surgery and all seems to be going well. I have been able to run (on a treadmill) up to just over 1 mile with zero knee pain. I have also been able to jump rope and even do one leg jumps on a yoga step, using the repaired leg. My biggest adversary in my recovery is lack of muscle, my quad and vmo muscles are still regenerating. I feel stronger with every workout and just daily in general, I can tell I am getting stronger and in a few more months I will be back to 100%. My ROM is totally back to normal, I can easily achieve a good baseball catchers position. Overall, I a very happy with my recovery and I am looking forward to completing this recovery in the next few months. Thanks for all the advice and encouragement!

[John42]

Hi Ruptured Life

Doing well - respect your knee and keep up the pT

JohnK/ Manchester UK

[John42]

HI R P T folks

I have mentioned many times, the best aid in your recovery is to purchase a floor cycle - many positive responses from RPT`s on this thread.

For the information of UK patients, this morning`s Daily Express have a special offer at £34.99, but you can get them on Amazon for about $50. 

Worth every penny - did me a power of good.
JohnK/ Manchester UK

[Tehtoo]

Hi Gang,
I was on this thread 7 years ago (2011) with an RPT in my left leg. My recovery was smooth and 100%. That leg is very solid!
Early this September I ruptured my patellar tendon in my right leg! Same surgeon as before. This time the tendon was not blown up like a mop but perfectly cut across like a knife cut it. He predicted a fast recovery. It is almost 1 month since surgery. I have had 7 rehab sessions since. Around the 5th session I was able to complete a revolution forwards and backwards with a recumbent bike. I have been walking with a brace since day 4. First rehab appt I had 62 degrees of motion, 85 the second week, and 105 last week. Stitches came out the 2nd week but there is some scab left so I have not swam yet. One of the keys to my quick recovery was using a pull buoy between my legs and slowly add more legs in my front crawl (freestyle). Always listen to your medical professionals that know your situation best. I hope everyone knows our situation is temporary. Keep working! Have patience with your knee! Dont get frustrated!