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On March 26th I had a ladder go out from me, resulting in a fall of about eight feet. I struck the wayward ladder with my left foot, thus taking all the impact on that leg. The result was a torn quadriceps tendon.
In the course of getting this injury treated, I found that most medical professionals (though generally very pleasant) seem to take the view that informing the patient is a very, very low priority. Since I am rather concerned about my well being, I did a fair amount of research on the quadriceps tendon, the tear, and its treatment.
Before getting to the discussion, you should keep in mind that I am a philosophy professor and not a medical professional. I’m presenting this information with the purpose of sharing my own experiences and not with the intent of providing medical advice or a diagnosis. If you are injured, then you should see a medical professional. Now that the disclaimer is out of the way, on to the information.
The quadriceps is a group of four muscles that link to a single tendon (the aptly named “quadriceps tendon”). These muscles are located in the upper part of the leg and are connected to the knee cap via that tendon. These muscles play critical roles in allowing people to walk, run, jump and squat. The tendon, as I found out, also serves to absorb the shock of landing.
The quadriceps tendon is normally very strong and rather difficult to tear. However, there are a variety of circumstances in which it can be torn. In some cases, age or a pre-existing condition can weaken the tendon-sometimes so much so that it will tear (or rupture) while walking or due to a minor fall. Among healthy folks, a quadriceps tear is usually due to a fall or an impact injury such as suffered by football players or skiers.
To deal with a quadriceps tendon tear, you first need to know that you have one. In general, you only need to worry about this if you have suffered serious trauma to your knee/leg, such as in a fall, skiing accident, or other such accident. However, there are cases in which the tendon tears without this sort of serious calamity.
In some cases you will hear a “pop” when the tendon tears, although you might not. And, of course, there are other injuries that make popping sounds. The following are common signs of a quadriceps tendon tear. First, you might find that your knee cannot bear any weight at all.
Second, you might be able to stand and walk, but find that your knee will “give” way during movement. In my case, I was able to walk after the injury, but fell down twice before I could figure out how to compensate.
Third, you will experience pain (obviously) and swelling of the knee area. Bruising is also likely. Of course, this is compatible with a wide range of injuries.
Fourth, you might notice that your knee cap is now lower than it should be-you might even see a noticeable gap between the quadriceps muscles and the knee cap. If the knee cap is out of position, this might well cause problems with moving the lower leg (mine would lock up at a certain angle).
However, the defining test of a serious tear is that you will not be able to straighten out your knee against resistance and you will not be able to perform a straight leg lift/raise. A straight leg raise is done in the following way: lie on your back on a flat surface and attempt to lift your leg straight up. If you can do this, then you do not have a complete tendon tear (though you may have a partial tear). If you cannot do this, then the odds are good that you have completely torn your quadriceps tendon.
Naturally, you should not leave it at a self diagnosis. If you have had a serious accident, then you should seek professional help. The professionals will, if they know what they are doing, x-ray your knee and also perform a physical examination. While X-rays do not show soft tissue damage, they will show if the knee cap is out of place. You might get an MRI, but you might not-my diagnosis was based on the x-ray and a physical examination.
If you are diagnosed with a quadriceps tendon tear, then you will most likely be going in for surgery. Partial tears can apparently be treated non-surgically, but that is something you would need to discuss with the doctor.
A complete tear, which is what I suffered, requires surgery-the tendon will almost certainly not re-attach to the knee cap on its own. Here is a page that briefly but effectively describes the nature of the injury as well as the surgery for treating it. Roughly put, they will cut open your knee, drill two (or more) holes in your knee and then run suture thread through the holes to the tendon to anchor it in place.
If you are told that you will need surgery, then here are some things that you should do to prepare.
First, you will need to stop eating and drinking at least 12 hours before the surgery, so plan accordingly.
Second, after the surgery you will be even more disabled (you’ll be in pain and in a knee immobilizer, brace or cast) so be sure that you have a ride home and that your home is ready for your return. You will need to keep your leg elevated, so have some pillows set up on your bed for that. In order for the elevation to work, you need to be truly elevated (above the heart). Sitting in a recliner with the leg rest up won’t cut it. You won’t be able to shower normally, so I would suggest getting one of those shower heads that have a hose attachment. That way you can wash your hair by standing beside the shower stall. You should also get some liquid body soap. I’ve had to replace my shower by washing myself from the sink using the liquid body soap in water first and then rinsing with plain water and a wash cloth. Get some baby wipes for areas that you’d rather not use the same washcloth that you use on your face.
You will most likely arrive at the hospital/clinic a few hours before the surgery. After you check in, you will probably be brought to a waiting room. While you wait, you’ll put on a gown, have blood drawn, be hooked up to an IV, and given a pill to keep you from getting an upset stomach (take it). Then you will be wheeled down to the prep area and given an antibiotic (attached to your IV). You’ll meet the surgical team and then its lights out-the operation is performed under general anesthesia.
If all goes well, you’ll wake up in the recovery area, hooked up to a machine that lets the nurses know that you are still alive. You’ll be in some pain at this point. After that, you will be wheeled to a waiting room, given some pain medicine as well as water. Drink plenty of fluids-you will most likely be rather dehydrated from not drinking. I know I was.
The surgery is usually done outpatient, so you will most likely go home that day. If you are having problems, then they will keep you overnight. I went home that day. Be sure to get the instructions from the physician’s assistant who will speak with you. You will most likely get prescriptions for pain killers, muscle relaxents, a blood thinner, and a stool softener. Get them all. The pain killer and muscle relaxant functions are obvious: you will be in lots of pain and will want to kill that. I’m rather tough (I’ve run ultra-marathons and have a black belt) and I used them the first few days. The blood thinner is to keep you from getting blood clots. You’ll also be told to do “foot pumps” to keep the blood flowing. Do those religiously-you don’t want a clot.
While you might be tempted to pass on the stool softener, do not. I repeat, do not. Be sure to drink plenty of water and eat normally as soon as you can. Also, go to the bathroom as soon as you can. Otherwise, you will have some unpleasant problems (just imagine trying to pass packed clay…that should be sufficient motivation to use the softener).
For the next two weeks, your main job will be to rest and recover. Depending on what your doctor says, you can probably move around somewhat, but be careful. Aftter those two weeks or three weeks, you will have the staples removed from the incisions and you will probably have the immobilizer replaced with an adjustable brace. If you are in a cast, then you will probably be in it for six weeks. Lucky you.
The PA will most likely tell you to not remove the immobilizer for any reason for a week and then only to change the dressing a week after the surgery. Heed his/her advice. The immobilizer is there to prevent you from moving your knee because doing so could ruin the surgery. Resist the temptation to take it off-a fall or a moment of forgetfulness can be all it takes to ruin the surgery!
As I write this on April 20, I’m 17 days out from the surgery. My leg is in a locked adjustable brace and is also wrapped in an ace bandage. I can move around well on crutches and, when this blog is posted on April 21, I will be back to teaching.
I’ll write additional posts as I go through the recovery process.
Update (4/11/2011): I’ve written a short book about my experiences with quadriceps tendon repair. It is available at Amazon for the Kindle and at Barnes & Nobles for the Nook. Both versions are 99 cents (and might even be worth every penny).
My brother got a knee cap injury and had to wear an immobilizer, too. Lucky him he got a plastic bag type thing that went up to his hip for showering =)
What was the bag thing called? & where did he get it? I have a knee immobilizer and this could be useful???
Thanks for the info.
Get it on amazon type in cast protector it should pull it up its clear with a blue ring that sits halfway up the thigh. I’ve used it for 10 surgeries and it’s still working great!
I’ve been trying to rig one of those using a garbage bag and duct tape. I’m still working on the problem that hairy leg + duct tape = ouch! 🙂
Is your book still available?
I tried checking Barnes and Noble – no luck.
1 week out of surgery. 2 PT appointments.
Can’t raise my leg yet. My hip muscles (lower back) get tight and hurt A LOT.
Stretching helps, but takes a while to take effect.
pj
It is available for the Nook & Kindle-I don’t have a printed version…yet.
I use plastic wrap above the knee and fasten it with duct tape about an inch below the top of the plastic wrap it works well
Duct tape solves so many problems. 🙂
well I.m new at computers so bear with me on4-21-09 I had my platella &quad tendon severe scar tissue removed & a accelease tendon sewn in with wire am in straight leg brace 3-4 months done in seattle at virginia mason by dr sorenson verypleased no more pain period post surgy ? rehab suposeedly only 4 other of thease preformed oh I had a patellectomy 16 years ago have found no info of like procedur with countless hours of reserch
Sorry to hear about your surgery, but hopefully you’ll be much better off after you recover.
Digging for useful medical information can be challenging, especially when the condition is fairly rare. Of course, if medical professionals provided more information, then there would be less need for such searches.
The majority of what I know about my own injury, surgery and upcoming rehab is based on my own research. My experience with medical professionals is that they tend to take a very minimalist approach when it comes to information. Part of it is that they are busy, part of it is that they are generally not trained to be educators, and perhaps part of it is that some think that most patients lack the ability to understand medical matters. After all, being a medical professional requires years of specialized education and training.
Hey there,
My name is Jonny and i am 19 years old (20 in July) and i am currently recovering from my second Quadriceps Tendon tear. I tore it the day before new years 2009. I had to go back to college 2 weeks after surgery and was in a wheel chair and using cruches for about 2.5 months and then around the 4 month post op period my knee gave out on me walking down stairs and i re tore the surgery. I am currently a little over 3 weeks post op and i am in the transition period (6 weeks) until beginning physical therapy. It is rare for someone my age to suffer this injury, especially twice. I have no medical conditions and am in good physical condition. I am a thrower for the University of Southern Maine track team and my quadriceps muscles are quite large. Prior to the injury i was squatting over 500 pounds. It was a freak accident and has been haunting me for about 5-6 months. Just curious how your recovery is going?
Johny,
Sorry to hear about your injury and even more sorry to hear about your re-injury. It sounds like you had a rather bad initial injury-I was up on crutches the day of the surgery and walking without them in week 6 (with approval).
My recovery is going fairly well. I’ve got 50 degrees range of motion easily and about 60 with some effort when I am warmed up. I’d prefer to be at 90, but I’m taking it cautiously-I’m worried about tearing it again. I’ve been doing PT at home for two weeks and return to the PT clinic on Tuesday for a new set of exercises. I can walk semi-normal now-but have to think about how to move my leg.
I hope your recovery goes well and that you don’t tear the tendon again-I’ve been through it once and can only imagine what it would be like going through it a second time. Good luck with getting back into throwing.
Hello Jonny,
My name is Charles. I am schedule to have my quad tendon surgery monday Oct.10
Question(s)
1.) Did you have a partial tear or a complete tear the first time?
2.) Did you ever get an explanation from Doctor as to why your knee gave out?
3) Did PT iinvolve stair walking or testing
4.) Did PT ensure you were 100 % in 4 months?
I’m just curious what your leg looked like after the injury. I was hit by a truck about 2 years ago. The bumper hit about four or five inches above my left knee. Now I have a dent there and a lot of drooping skin and muscle below that. I was taken to the emergency room and xrayed for breaks but had none. They told me though that it would have been better if I had broken my leg (I’m not really sure what that means). They gave me percocet and crutches and sent me on my way. I had no insurance so I never had any MRI’s done. I just found a doctor to prescribe me pain meds. I took vicodin for about 6 months before the pain pretty much went away. The bruising is gone (except the dent is darker colored than the rest of my leg) but that is the only thing that has changed in two years. The drooping is not very pretty. I finally got insurance after I recently married and decided it was time to get it checked out. The doctor says he thinks I tore my quadricep muscle and is sending me to an ortho surgeon this coming Tuesday. I’m slightly terrified about what they are going to say. Anyways, just wanted to know if your injury looked anything like mine. Thanks!
I was also told several times by different medical folks that a broken leg would have been better. Easier repair and much faster recovery.
I did have a “dent” over my knee-this was due to the knee cap sliding down towards my foot. Normally, the quadriceps tendon holds the knee cap up, against the pull of the lower tendon. The knee swelled up a great deal and I did have bruising-the most severe being on the inner side and above the knee. I didn’t have any drooping, but I was in surgery about a week after my injury and my knee was still swollen.
If you can do a straight leg lift while lying down (lie down on your back on flat surface and lift the leg straight up without bending the knee), then you would most likely still have at least a partial quadriceps tendon. Also, if you can walk normally, that is also a good sign. While I am not a medical professional, I did learn that the hallmark sign of a complete tear is an inability to do that leg lift. This is because the quadriceps tendon and attached muscle is what you use to extend the lower leg.
If you do have a tear, the surgery is quick and has a very high success rate. I did read about repairs being done a year after the injury, but most of what I read said that the earlier, the better.
If you do get the surgery, you’ll be in a knee immobilizer for at least two weeks. Really be careful during that time-the repair will be vulnerable during that time. Also, you’ll be in recovery a long time. I’m in the 9th week after surgery and I still cannot walk completely normally.
Keep your spirits up-you will get through it!
Well I tried the test out. It seems I can lift my leg without bending my knee but it buckles a bit like it doesn’t want to work haha. I actually have to try. It’s definitely a lot easier to do with my good leg.
Must not be too horrible if I can still kinda do it.
You tore your quad tendon completely, correct?
I was recently diagnosed with a partial tear, which I have apparently had for several years. I was wondering if you found anything on this. I have looked and looked, but all the information I have found is on complete tears.
I found only some limited references to the partial tear, mostly a sentence or two in the discussion of the full tear. I actually suspect I had one as well-I’ve injured my left knee repeatedly over the years (once in a nasty tumble involving a concealed hole during a 5K trail race) and maybe that is what enabled a complete tear when I fell.
From what I have read, the partial tear can sometimes heal on its own (at least with some degree of success). Surgery is apparently the only effective treatment for a full tear. in some cases of partial tears surgery is used as well.
I have also run into some vagueness about what counts as full tear. The tendon has multiple layers and it is possible to tear them individually. So, a complete tear might mean all layers are torn through or it might mean that one layer was fully torn. Likewise a partial tear might mean that only some layers are totally torn or it might mean that one or more layers have been torn but not all the way.
How serious is your tear?
I have only begun the first steps in finding out what is actually wrong with my knee. I just had an MRI done two days ago, and anything I do know is just what my primary care doctor has told me. I have an appointment to see a knee specialist towards the end of the month. So I shall have more information then.
I’ve had the same experience when looking for information on partial tears. The only things I have found were one liners in articles about complete tears. I guess I will have to wait and see what the doctor says.
Good luck with the knee specialist. Are you having any problems with the knee, such as walking difficulties or weakness?
Just guessing here, but they will probably either have you undergo a surgery like mine or put you on a PT program to recondition the knee. I hope that it is just PT-the surgery and recovery are not much fun.
Hi, I read your description with interest as I too have recently ruptured my Quadriceps tendon and had the surgery on June 4. My precipitating incident was a wipeout on my bicycle on slick pavement, I would guess I was going about 18 – 20 miles per hour or so. What I did not know is that tendonitis in that tendon can weaken it and make it more susceptible to catastrophic injury. I had pain in that knee, sometimes significant and simply ignored it, continued to bike a lot and do a ton of other activities. As I am over 45, I think this was a big mistake. The surgeon told me the ligament was discolored and had clearly been a problem for a long time. While he didn’t think it will affect my long-term prognosis, I think it might not have ruptured if it had been healthy. More importantly, what I thought was classic knee pain was not that at all, it was tendonitis in the quadriceps tendon as indicated by pain on the top of the outside of the knee and in the front. Also important is the fact that older athletes play through pain at their own peril.
Ted, sorry to hear about your injury. How is your recovery going so far?
It does make sense that previous problems with the tendon would tend to weaken it and make an injury worse than it would be otherwise. On the positive side, the fact that you have been so active should help your recovery.
Like you, I took the train through the pain approach. That worked okay when I was a kid, but doesn’t seem as wise these days. Fortunately, I have been wise about my recovery-I’m doing everything I am supposed to do and I have been keeping myself in check. I figure that an extra week or three of waiting to run again will help me avoid a stupid injury that could send me back to square one.
Good luck with getting through the recovery. I hope you have a good doctor and a good physical therapist. And patience. Lots of patience.
Michael, recovery is going well enough, very tough the first couple of days but am off pain meds and expect to be back at work in a week. I agree with your philosophy. For the first time in my life, I intend to be the model patient and do what I am told. Too much at stake and when you take the long view, what is a few weeks in a lifetime? Having said that, sitting around with a knee brace on and limited movement is tedious to say the least. I did have one question, when you say you are not walking normally after 9 weeks, does that mean you are getting around without a crutch or cane or do you still need support? Thanks much.
Ted, I’m glad the recovery is going well.
That was my experience as well-pain, then tediousness. Then more tediousness. Then some more. 🙂
I have been off the crutches for a few weeks. The main thing is that I still have a “hitch” with my left (injured) leg when I walk. Some of this is due to the swelling that remains (and gets increased by my PT exercises) and some of it is due to bad habits picked up earlier. If I think about walking, then I walk almost normally. If I stop concentrating, I start “side lifting” my leg more. It feels like I have rubber tubing wrapped around my leg just over the knee, plus some more attached to the knee and the upper leg. It is a weird feeling. Also, I had a few minor problems with balance when I first got of the crutches. I started doing balance exercises last week in PT and seem to be almost back to normal-aside from the lower strength.
I’ve been in PT for a few weeks-mostly fairly basic exercises aimed at restoring the ROM and strength. I’ve been using a stationary bike one-legged since before the surgery-it has helped me stay sane (and thin). If you haven’t got one, I would recommend getting one. I did replace the seat right away-the factory originally numbed my butt way too quickly. Fortunately, you can get a good one for a fairly low price. I was lucky-a friend of mine had a nice Schwinn bike that he wasn’t using. I also bought a Bowflex PR 3000-I found a great deal on Amazon (free shipping, plus they had a discount and a special deal). Being able to stay fit has helped me a great deal-both physically and mentally.
Thanks, Michael, it is heartening to know that I will be out of this brace before hell freezes over! As far as working out, I was a bit worried about screwing things up in the first few weeks. After that, I was thinking of putting my bike on a mag trainer and doing light weights, high reps but I can see the advantage of a machine. Any sort of abdominal exercises with a brace on? Thanks, Ted
Ted,
I was given ever increasing ROM on my brace after week two, and out of it in week 9. I kept it, mainly to do exercises that involve a risk of falling-that way the brace will keep my tendon from being pulled to the breaking point. I got the okay to get in the pool and spent about an hour there today, walking, swimming, and doing balance exercises.
Ask your doctor if you injured leg can bear weight (it probably can, but it is wise to check). If so, you should be fine exercising on your bike. I set a chair beside it with a cushion for my foot and used the bike handles to aid in lifting myself. I took getting on and off the bike very carefully. Of course, the stationary bike is easy to get on-there is no upper bar in the frame to contend with. Swinging a leg over the frame on a real bike would be much more of a challenge.
Depending on what your doc okays, you could do sit ups with the good knee bent-although I’m not sure how well that would work. I use my Bowflex-I sit down in the chair, put my arms through the handle straps, and “crunch” against the resistance. It works well-even better, I think, than a normal crunch. My girlfriend, who is getting her PhD in exercise physiology, says that it is much better for my back than doing a normal crunch.
One thing I like about the machine is that it is safer than free weights when you have a bad knee. I didn’t have to lift anything to move it around-I just hook up the rods, sit down and work out.
Very interesting overview of this injury. I had surgery on 6-19-09 for a complete quad tendon repair. I was placed in splint cast and told i would be non weight bearing for two weeks, me and the walker have become good friends sine the 19th of June.
MY OS indicated i would see him again in two weeks and determine if the staples come off as well as cutting off the splint cast and replacing it with another type of immobilizer device.
My question is how long is one restricted to non weight bearing? That makes the simplest of tasks difficult.
I would appreciate any comments or feedback.
Regards
Chuck
Its interesting how each Dr. approaches these things differently. My surgery was on June 4 and could put no weight on it for a week and then crutches for a week and now no crutches. BUT always with a straight leg brace which I need to keep on and sleep with for the first six weeks. There does seem to be universal agreement that you don’t do too much for the first six weeks. I did start limited PT after two weeks and achieved my first straight leg raise this Monday – very exciting. Good luck with this, seems to require much patience.
I’ve found that some of the things that were so simple to do before are now the cause of a small celebration. Like you, I was rather stoked when I actually did a straight lift. Actually seeing that the surgery had worked really boosted my morale. When I could finally pedal the exercise bike, I felt like I had won a race.
Hi Ted
Well it appears you are doing quite well after two weeks removed from your surgery. I can live with the limited aspects for 6 weeks, being a rather active individual this sitting around and focusing on non weight bearing tries my patience. I feel once i can do my first straight leg raise my attitude toward recovering will sky rocket. Please keep me posted on your progress.
Regards
Chuck
Chuck,
In my case, the doc put me in a soft immobilizer. I was allowed to put limited weight on that leg right away-in fact, the doctor wanted me to start putting weight on it to help with the recovery process.
As far as when you’ll be able to put weight on your leg, that depends on the doctor’s approach. In some cases it can be weeks.
Hi Michael
That is interesting that you were allowed to apply weight on the injured leg almost immediately. Was your injury a complete tear that required surgery via the knife? I am only 6 days from the surgery and my pain dissipated withing 48 hours of the procedure. I am an avid golfer and i am anxious to find out when they think i can begin swinging the clubs lightly.
Regards
Chuck
Chuck,
I did have a complete tear-I couldn’t do a straight leg lift at all. That was rather disturbing (a bit like the nightmare in which you try to run, but go nowhere). I did have surgery-sliced open and the tendon was anchored to the knee cap with surgical thread.
I started exercising again about 4 days after the surgery, but this was just riding the stationary bike one legged. I started punching my punching bag a while after that. Of course, they were weak punches-I couldn’t use my legs and I had a crutch under the other arm.
While I’m not a medical professional, I suspect you’ll be able to get back to swinging fairly quickly. The quadriceps tendon handles lower leg extension, so it is probably a less problematic injury for a golfer compared to something like an ACL tear. I did find that my knee did have some stability problems, but this is a tendency to have the knee “slip”-it felt like I was going to fall. Since I’m a runner, I’ll be recovering a long time before I can back to my sport.
Good luck with your recovery.
Michael
It does sound like we had the same type of surgery after reading your most recent reply. Thanks for your opinion regarding the quad tendon repair versus an ACL repair relevant to golfers. I will know much more on 7-1-09 when a see the OS for my 2 week follow up, I would like to introduce some activity as quickly as possible.
While I am not a runner like yourself I do keep myself busy being self employed in sales. Since the majority of my activity is going to appointments,walking up and down the 15 or so stairs to my home office at least 10-15 times a day, working outside in my yard, ( walk behind mower not a rider but it does keep me walking for about an 75 minutes to mow the yard) playing golf (sadly i just don;t walk anymore) and chasing my two grandsons, do you think a stationary bike would be a good form of home rehab. Obviously I would also solicit an answer from my OS.
Lastly the slip effect of your knee, was this after the surgery and if so how long post-op did it feel that way.
Continued success in your rehab as well, thanks again for your feedback.
Regards
Chuck
Chuck,
I do recommend the stationary bike. As part of your PT, you’ll probably start by just pushing the pedal with the good leg to stretch the knee a bit. Once you can get enough flexion to pedal (the higher the seat, the less flexion you’ll need) you’ll be able to actually “ride” the bike. You’ll be told to start out with low resistance and gradually work up. The biking seems to be a good idea because it helps stretch the tendon, helps build strength and is also good for cardiovascular health. Also, you don’t have to worry about falling (well, other than off the seat) if your knee “slips.” You’ll want a TV or something to keep your attention-it is wicked boring!
The knee slip happened after the surgery, when I was in the brace. It wasn’t a fall, but I could feel the knee sort of give out a bit. This happened twice before I got the hang of walking again. I do still feel some very slight “slippage” once in a while, but it is very minor. You’ll want to be really careful navigating stairs and going down slopes. Because of the role the quadriceps play in leg motion, you’ll most likely find that challenging for a while. I actually just got back from a walk in the park-uphill and flat was easy, but going downhill was challenging because my quadriceps is still not very strong.
You’ve no doubt heard this often, but the main thing is to be patient. It is a slow recovery, but you’ll hit various milestones along the way that help. For example, I was thrilled when I could finally set aside the crutches and walk around. When I was able to pedal with my injured leg, I felt like I had won a prize. I was able to walk in the park today, which was awesome.
Hi Michael
Once again thanks for the very useful comments and real life experience with this injury. As I patiently sit and do much of nothing I will look into some type of stationary bike, I like the comment about this process being wicked boring.
Since you are a runner I wonder if you could offer some comment on an odd problem I am encountering on my right thigh which is the non operated leg.
The last few days I have been getting a slight burning/tingling feeling in the right thigh toward the outside. The muscle in that area and back toward the right hip actually feels a little sore at times. I am wondering if this is a result of keeping all of the weight on the right side since the surgery last Friday 6-19-09.
My initial thought is maybe the sciatic nerve is irritated or the thigh muscle is just being overworked on that side.
As conscious as you are about your well being I was wondering what your thoughts or suggestions might be for this matter. Oddly this is more bothersome to me the the left leg which was the one that was operated on.
Thanks again for your assistance.
Regards
Chuck
Michael
One correction to my reply, last paragraph, last sentence.
My last sentence should have read; this is more bothersome on the right leg which is the one that was not operated on.
Chuck,
I’m not a medical doctor, but your hypothesis sounds likely. My right (good) leg would get sore in odd ways (and still does) because of the change in how I handle the weight.
But, you should be sure to mention this to your doctor, just to be on the safe side. When I had my surgery, I got “blood thinner” shots for 14 days and was told to watch out for any odd pains or such. Your symptoms could involve a circulation problem-always something worth checking into!
Mike
Interesting, I was prescribed one asprin a day as a blood thinner. As far as workouts, I found a machine at the gym that you spin your arms instead of legs, worked up a real sweat for the first time in weeks. I have been lifting light weights with high reps all along but that doesn’t do the cardio. Also, figured out how to get both legs high up on the arms of a chair in our living room to keep my back flat and do crunches, for what that is worth. Anyway, I think you’ll find that after the first two weeks you feel progressively better but trying to bend the knee is unpleasant to say the least.
Mike
I do have a follow appointment on Wednesday and I will be mentioning this matter to him. As Ted mentioned in his reply i was told to take one aspirin for the next 30 days. There was a lot of soreness in the right hip area and I massaged it quite a bit for the last two days and that helped alleviate the pins and needles/ burning issue quite a bit. It is most bothersome at night when lying down and attempting to sleep, an obvious period when blood circulation slows due to inactivity.
Given the concern with blood clots I have stopped the massage efforts.
It sure sounds like I will encounter a lot of little odd and annoying issues over the upcoming months.
Many thanks for starting this forum it has been helpful reading other cases and gather information, opinions and ideas.
Continued success with your recovery.
Chuck
Chuck,
I had to get a shot everyday for 14 days to prevent blood clots. Nothing quite like starting the day with a bit of steel sticking into you! Fortunately, my girlfriend was happy to do it for me. I had a countdown on that and was very happy to have that last shot.
I’m a bit surprised that they just had you take aspirin-that will thin the blood, but it can’t compare with the shots.
I hope it is just soreness from the extra weight bearing rather than a clot. One of my friend’s is married to an orthopedic nurse and she made sure that I had a healthy fear of blood clots-so I did all the stuff I was supposed to do, including wearing the special socks (thus having to endure the obvious jokes about wearing hose).
The main things I have run into have been the knee slippage, the extra soreness in the good leg, a fear of ladders, plenty of weird dreams, and some muscle twitches in the injured leg.
When you start PT, you’ll be doing all sorts of odd things to get back strength and balance. You’ll also have to relearn how to walk-that was rather odd for me, having been a runner for so long.
Mike
What is the deal with the weird dreams? I experienced that for several nights in a row but that has since gone away.
The soreness that I mentioned in the hip joint and thigh muscle has all but gone away, however I still encounter some tingling at night when I head to bed and have lying down for about 2 minutes. It actually comes and goes for the first few hours of sleep and then seems to just go away. Rest assured my OS will be made aware of this on Wednesday.
At this point I guess my journey to recovery has only just begun, I hope I get an encouraging report tomorrow.
Thanks again;
Chuck
Chuck,
I do wonder if most people have weird dreams after major surgery. I had all these knee related nightmares for a while, which then turned to weird running dreams (like being able to run-hop on one leg). Strange stuff…if only Freud were still around. 🙂
Good luck at the OS. You’ll probably get an adjustable brace-a major improvement over being immobilized. I didn’t get any ROM for a while, but just being out of that immobilizer was a real boost.
You might start on PT quite soon, although doctors do vary. I’ve heard of some folks who start PT on day one (or claim they do), while others don’t start for quite a while. I had my surgery on April 3rd and had my first PT visit on May 11. The PT “released” me on June 26-I was doing well enough to do everything on my own (plus, the insurance just covers getting back to “normal”, not for getting back to being an athlete-that is all on me).
This dream thing is rather humorous,being an avid golfer my dreams were related to attempting to swing my clubs with a full length immobilizer on, you just have to be a serious player to understand how that is not going to fly to play the game at a high level. Really the only difference between me and Tiger Woods is his net worth is $100,000,000.00 more than mine – LOL.
Today’s follow up went well, the OS was quite pleased with the healing of the incision and there was no swelling around the knee. They did remove the staples, told me I could start to apply some weight to the left leg but that I need to keep the immobilizer on for another two weeks and not to bend it at all. He felt that on my next two week appointment that he would have me start on some minor home ROM exercises. I hope at that point they get me into one of the adjustable braces.
I will say your comment about learning to walk again was quite accurate. Even though I can;t apply full pressure it was an odd feeling allowing my operated leg to touch the ground flush with some weight.
It sounds like you moved through PT at a very good rate, I know I am not the athlete that you are but I will be committed to getting this knee back to a healthy level, remember that statement when I respond and complain about the trials and tribulations of PT.
Thanks again, have a safe and enjoyable Fourth of July.
Chuck
Chuck,
After you recover, you could use the immobilizer as a cover for your favorite cubs. That would protect them quite well. 🙂
I’m glad to hear that you had no swelling and that the staples were removed. I had plenty of swelling and still have some “puff” over the knee. But, it much better than it was. After my fall, my knee was doing its best basketball impression.
I was in my brace on week two, but it was locked for a while after that. But, I did much prefer the brace to the immobilizer-especially here in Florida. Of course, the brace still kept my leg quite warm, especially when I biked. Fortunately liberal doses of Febreze between washes kept it from becoming too stinky.
The keys to PT are getting a good therapist, following what s/he says and sticking with the exercises. Of course, you have to be careful to not overdo it. At first it will seem really weird-your leg won’t do almost anything that you remember being able to do easily. Also, the PT will probably have you do things that seem to have little to do with the knee. But that is because the whole leg will be weaker and in need of conditioning and retraining.
You’ll also probably run into some swelling once you get moving around. I got one of those ice bags that comes with a velcro wrap as well as an Ace cold compress. I got mine at Publix, although they should be at any drugstore. My girlfriend told me to put 1/3 rubbing alcohol and 2/3 water in the ice bag rather than ice. It freezes to a slushy gel which fits around the knee better than ice cubes.
Have a great 4th.
Michael
I like your comment about using the immobilizer to cover my clubs – spoken like one of my tried and true golf buddies!!! I probably will keep that thing close by the first time I can swing a club. I certainly hope that will take place before the weather turns cold here in Missouri around December.
Thanks for the tip on the ice bags, that is one thing that I have quite a few of plus they gave me a nice one the day of my surgery that has Velcro straps to wrap around the knee and stay secure. it has that nice gel type stuff inside of it.
I have read most of your sight as well as all of your replies but I was wondering if you could shed some light or thoughts as to your mental outlook during your first month post-op.
At this point still being attached to the immobilizer and the walker I am not feeling like I have attained much of a milestone yet. Normally I can find the positive/brighter side to most situations but I have to admit the things I enjoy the most feel like they have been taken away. Imagine yourself in a run and you can see the finish line in the distance but the more you run the further away the finish line appears.
How does that saying go “Tough times don’t last but tough people do” I may find out a lot more about myself in the weeks and months to come.
Regards
Chuck
Chuck,
Hospitals/clinics seem to vary a great deal in what they do and provide. A woman who works with my dad had knee surgery and they fitted her with a massive leg immobilizer complete with a cooling system. She must have really good insurance. 🙂
My mental states during the first month were quite mixed. I was glad to be done with the surgery and felt positive about getting on the road to recovery. Also, I had been pushing myself hard for years with work, training and such-so the two weeks that I was in an immobilizer was almost like a vacation. I could rest without feeling even a twinge of guilt, I didn’t have to worry about any demands from work, and so on. I did set up my classes to run online, but that was actually fun. On the negative side, I did have some down moments-mostly when something reminded me of what I had temporarily lost. I dealt with that by setting up my recovery plan, noting my progress and doing all that I could do that would make me feel normal (such as doing the exercises I could do). The support of my friends and girlfriend also made a big difference in staying mostly positive. Mainly I found that staying busy and maintaining as many of my normal routines as possible helped a great deal. Fortunately, I have many hobbies and activities I can do without using my bad leg-such as writing.
Oddly enough, now that I am making excellent progress, I am starting to feel mentally down again. I know why-I feel like I should be running, but cannot. It actually hurts a bit to see other people running. I’ve always recovered rapidly from running injuries (never missed a day in 23 years) so I feel that I should be recovered by now. To counter this, I’m focusing on the fact that I can start doing pool running in a couple weeks.
You are quite right-this sort of injury will reveal a lot about you to you. I’ve learned a lot about myself as I’ve gone through this. I’m pleased that it has been mostly good stuff.
I think its impossible not to be discouraged once and a while, but I agree with Michael that you have to stay as busy as possible and recognize that you will get better. My 79 year old father, ironically, fell down the stairs 7 months ago and ruptured his quadriceps tendon, had the same surgery all of us did and is walking fine. I will also say that the first two weeks are the hardest and after that, based on my experience of four whole weeks post surgery, you start seeing improvement. Yesterday in PT, I got to 55 painful degrees of flex. Not running marathons but something and much more than two weeks ago. My swelling is also down a good bit but my knee is still pretty big. I think the big mistake is expecting to recover quickly, it just isn’t going to happen, but you will recover and that is good news.
Ted
Thanks for your take and information on this frustrating injury. Obviously patience and being mentally strong are important during the recovery process. I do feel that my confidence has been shaken and has made me realize that one minute you are fine and then a few seconds later you are laying on the ground realizing things are going to be different for awhile.
I am glad to hear that 4 weeks your feeling good about your progress, and kudos to your dad, WOW 79 and recovered without much of an issue.
Much like Michael has stated it is nice to know you have the support of family and friends.
Take care and best of luck in your recovery.
Chuck
Ted,
Congratulations on getting to 55 degrees. More flexion should come easier, at least if my own experience is a guide. I had a heck of a time working up to 30, but once I got to 60 it went much quicker.
I was a bit worried I was becoming obsessed with flexion-everyday I’d do my exercises and use the brace markings to see how I had improved.
I’m glad your father is doing well.
Michael
Thanks for sharing your mental perspective during your injury recovery. The last couple of days I have found my moods swinging from I am going to conquer this to I wonder if I will be able to do all of the things that I previously took on before the injury.
Being self employed is almost like a hobby, you are constantly monitoring the business side of things as well as staying on top of the sales side of things. That is a disappointment to not be able to get out and interact. My wife has been more than accommodating taking care of the simple things that used to be mundane. She is already telling me we need to plan a trip in October or November to celebrate the rebirth of the rehabilitated knee.
I probably will steal a page from your book and make notations of any and all progress. When I was in management one thing I always mentioned to my staff was “Know where you are, Know where you are headed and always know where you have been” A rather broad statement but it was meant for people to stop and reflect about what is, has and will be going on in their personal life as well as their work life. I will be mentally reciting that statement throughout this recovery process.
Thanks for the reply.
Chuck
Chuck,
I felt (and still feel the same way). When I get a clear sign of progress, I feel good. When the day for a race that I always have run arrives, then I feel bad. Fortunately, recovery from this injury is generally very good. The doc told me I’d lose some ROM, but I can deal with that. Now, if I was a gymnast or some sort of dancer, then I’d be worried. But, as a runner I just need a modest ROM. I do worry a bit about getting back the full strength, but that should not be much of a problem.
It is great that your wife has been such a help. My girlfriend has been wonderful-I don’t know how I’d have gotten through this without her.
Keeping track of your progress is an excellent idea. I even have kind of a checklist of progress that lists when I can do various things. It is a boost to be able to see all those checks of accomplishments.
Michael
I was reading most of your replies again in this forum and was wondering if you could talk a little about swelling and muscle twitches. I am starting to experience a little more swelling around the operated knee and muscle twitches in that leg throughout the day. Every once in awhile I encounter a dull aching pain in the knee cap area but it only lasts for a few seconds.
I might be micro managing these matters but I noticed you had mentioned some of these things in previous replies.
While the knee area has more swelling than the last few days it does not feel warm to the touch. I do apply ice treatments throughout the day. if the immobilizer gets to tight could that create some of the swelling in your opinion?
Thanks
Chuck
Chuck, I am very surprised that you haven’t had a lot of swelling, my knee is still warm to the touch and is still pretty big but going down. I think pain in the knee cap is par for the course as well.
Ted
Thanks for your input, it sounds like the swelling is part of the healing process. I was moving around a lot more yesterday and became concerned that maybe I torn something. I will be glad to eventually get out of this PITA immobilizer but with surgery just a little over two weeks ago I am still stuck with it for awhile.
Thanks
Chuck
Chuck,
Moving did make my knee puff up. I did worry a great deal that I would tear the repair and was very happy when I got my x-ray at week 9 showing that everything was good (the knee cap being in the right place).
I worry too now that we are pushing it in PT, I keep thinking the tendon is going to rupture again but have to assume the PTs and the Doc knows what they are doing!
Ted,
My PT pushed things a bit as well and I was a bit worried about some of the exercises I was assigned. But, as you said, they probably know what they are doing. Of course, it is also a good idea to gauge what you think you can do. If something starts causing pain or if an exercise worries you, then you should ask the PT or doc about it.
Chuck,
I did notice that my knee seemed to swell more after I was up and about. I also experienced swelling in the leg below the knee and in my foot. In the case of the knee, being active causes swelling for the same reason that stressing any injured tissue causes swelling. I dealt with that with ice. The swelling that occurred prior to being up an about was probably in response to the surgery as well as the lack of activity. Fluid will build up when the limb/knee is not moving as it should-those normal motions keep blood and other fluids moving properly. To counter that, they wrapped my leg with ace bandages and had me do foot pumps. As my movements get more normal, I have far less swelling. I do notice that if I get “sloppy” in moving properly, the puffing returns.
My guess about the twitching is that it might be a response to healing, or perhaps due to the lack of use or maybe the muscle is just sort of firing off at random because it is being triggered by in an odd way. I did notice that the twitches stopped fairly early on. In some cases I knew why they were happening-I was trying to use my quadriceps and it was out of condition-hence it fired poorly and did a twitch rather than a proper contraction. As it got stronger, that stopped.
A too tight immobilizer could definitely cause swelling. I found that it was tough to keep it tight enough to provide the needed support without making it so tight that it impeded circulation.
When you get your brace you will probably have swelling problems as well. It will most likely have various bands on it that velcro attach across your leg. These will impede the flow of blood and fluid (especially since your leg won’t be moving properly) so you’ll get bands of swelling. To deal with this I’d take the brace off when I was lying down, massage the leg, and also elevate it to get the fluid flowing. That will reduce as you are able to move more normally.
Michael
Thanks for your take on the swelling and twitching aspects during recovery.
I definitely increased my ice episodes yesterday and will continue to do so for quite sometime.
The only area I see swelling is around the knee cap, the ankle and foot have very minimal swelling. It sounds like the brace will create some discomfort/swelling issues as well but at this point I am ready to move away from the immobilizer, sadly I can’t make that call until my next appointment with the doc on 7-15-09.
Currently the operated leg feels like it is now connected and getting stronger, again the pain is not present other than a minor twinge of pain that lasts only a few seconds from time to time.
You may have stated this in previous responses but at how many weeks post-op where you able to do away with crutches? Once they were banished from your routine did you use a cane and if so how long did you use that device? Also at what post-op perod did they allow you to begin applying 50% or more weight to your operated leg.
I will echo what I have read from both you and Ted, there is certainly a fear of tearing this thing again during the recovery and PT process.
Thanks as I am off to take a quick walk around the house with my friend the walker.
Chuck
Chuck,
It sounds like you are making excellent progress. The swelling caused by the brace was a small price to pay to get out of that immobilizer.
I was officially off the crutches in week 6, although I was walking a bit without them before that inside my house. I didn’t have a cane after that, although I have heard of people using them at that point. At first, it felt a bit weird being off the crutches and I had to overcome some fear of falling-especially on stairs without any handrails.
The PA actually had me applying weight right away, although I was not applying the full weight until after I was off the crutches. Apparently the approach varies-some docs stick with the “no weight” approach while my PA said that the weight bearing would help. I have even read that there is some talk of having the knee moving right from the get go to help the muscles and tendon heal in the proper “direction.”
Hi Michael
Just got back from my 4 week post-op follow up with the doc. He indicated I could go full weight bearing on the operated leg as long as I am wearing the immobilizer. While in the office they had bend the knee slightly and had me hold the leg out over gravity for just a few seconds. I felt no pain doing either test but they where quite minute in comparison to what really needs to be accomplished. They do have scheduled to start PT this Friday and I believe I will be going twice a week for awhile. i wonder if the PT will suggest a locking brace as I progress or if that needs to come from the doc. I am not scheduled to see him again for 30 days.
It was quite odd taking those first few steps with equal weight on both feet. I am still using the walker but what a relief to be able to actually take walking steps to go forward.
A question for you or anyone who reads this post has to do with applying weight to the operated leg, did you bend the knee slightly as you shifted your weight from one leg to another? I noticed as I was going up just a few stairs to get in my house I was more prone to really keep that leg stiff even though it is in the immobilizer.
Thanks
Chuck
Chuck,
It is good to hear that you can go with the full weight. Hopefully you’ll be outfitted with a brace when you see the doc again, although I have read that some docs keep their patients immobilized for six weeks. The clinic I went with is sports oriented, so they seem more inclined to get people mobile faster.
Like you, I found that I tended to keep my knee stiff when walking, even when I was able to bend it. Part of it is probably the habit created by the immobilizer. Part of it might also be some worry about the knee’s ability to do its job. It took me a while to break myself of “stiff leg.” My girlfriend corrected me whenever she saw me doing this-that helped because I would not even realize I was walking like Frankenstein.
Hi Michael
Since I am going to start my PT this Friday would you be able to overview some of your experiences, fears during the first few PT visits. I think all of us have stated we don not want to do anything that might create another tear.
Once they allowed you to go full weight bearing did you try to walk around your house without your crutches.
I have said this before but I will state it again you should really feel good about starting this site, it has been mentally refreshing and informative.
Thanks
Chuck
Chuck,
Good luck with the PT.
The first visit was an evaluation. If your PT is similar, the PT will look at your knee, have you bend it (perhaps measuring the ROM), ask you questions, and probably put a cool pack on it for a while. You might also get hitched up to a machine that will stimulate the muscles. You will most likely be given a set of basic exercises to do (pushing down your knee with your quads, hamstring stretches, and assisted knee bends). The exercises will eventually include balance (standing on the surgical leg and balancing) and strength training (lifts and such).
I only went once every two weeks for a new set of exercises and was “cut lose” after about 7 weeks. This was because I am an experienced athlete, so I was already well prepared to do such workouts on my own. It also helped that my girlfriend worked at a PT clinic and is getting her PhD in exercise physiology. Plus, I already had the equipment I needed at home.
Overall, the experience was fine. The PT was enthusiastic, serious about his job and quite good at evaluating me and what I needed to do. Be sure that you have a good PT who is serious about what s/he is doing and, most importantly, knows his/her stuff. If possible, get someone who specializes in knees/legs.
My main fear in PT was that I’d end up hurting myself. The PT would have me take off the brace as soon as I arrived and then set me to work on the exercises. I must admit, the first time I was balancing on the surgical leg without the brace, I had a few nightmare flashes of falling and having my tendon go “pop” again. Fortunately, that never happened.
One challenge you might face is brace dependency. Psychologically, I felt that the brace protected my leg and hence felt safer with it on. But, getting out of the brace is an important part of the recovery. After all, to walk normally and do normal things, I had to believe that my leg would work as it should and not be trapped into reliance on the brace. The fact that it made my leg rather warm and soaked up sweat helped make it easier to ditch it. I did use it for a while when doing my more risky exercises, but now it mostly just sits in my closet.
I did try walking around without my crutches a bit before the PA said I could shed them, but I was careful about it. In the past I just toughed my way through injuries and did not listen much. But, this time I decided to just do the smart thing and follow instructions. So far, it has paid off. I might be getting back to activities a bit later than I could, but I’m willing to be a couple weeks late rather than risk having to start this all over again!
Michael
I completed my first PT appt on Friday. You were quite accurate that they spent the first 30 minutes gathering more information about me and how the injury occurred. The PT I was assigned to has worked with several other quad tendon injuries and I felt quite comfortable with all of her explanations of what we are going to try and achieve over the next month.
While at my appt they had me do some quad muscle exercises that are designed to ever so slightly begin sending signals to alert the tendon that it is time to walk up and start working again, that once was simple and not painful at all.
The second exercise was the heel slide, that was painful and quite a shock. I could not believe how tight the knee joint was. I was able to achieve 50 degrees range of motion on the tenth slide.
I was instructed to perform 3 reps of 10 heel slides at 3 different intervals throughout the day for a total of 90 per day. The same process was to be performed for the quad muscle exercise.
I will be going to PT twice a week for the next month, out of curiosity could you share what type of home exercises you were given and how your reps compare to mine.
Thanks
Chuck
Chuck,
Good to hear that you are in PT. Your on the faster track to recovery now. I found that it really helped to have things to do-it made me feel like I was making progress.
Here is what I was given to do in week 6: The first is called “patellar mobilization.” While this sounds like an alien army gearing up for war, it is simply manually moving your knee cap (patella). To do this, you sit on a firm, flat surface and gently move your knee cap side to side and then up and down with your hands.
The second is the quad set (sometimes called “quadriceps setting”). To do this, you lay down and bend the healthy knee. You then tighten up the muscles on top of your thigh and hold for about 5 seconds. Then you relax. Then you do it again. A variant of this involves pushing your knee down so that the underside of the knee is pressed against the surface.
The third is a hamstring set, also known as a heel slide. To do this, you lay down and bend your knee to a height of roughly six inches. Then, push the heel down and pull it back towards your body, holding for 5 seconds. Repeat.
The fourth is an assisted knee bend. It can be done lying down or in a chair. You just slide the leg so the knee bends, using your arms to assist (not force!) the motion. Repeat.
The fifth is another knee bend. For this one, you sit in a chair (pick a stable one with room to move), bend your knee and then gently slide your butt forward, thus causing the knee to bend more. Repeat.
The sixth is a hamstring stretch. It is just a hurdler’s stretch without bending the other leg. Lie down and gently stretch out over the injured leg, reaching for the foot. Hold about 15 seconds and then repeat.
I was supposed to do, as I recall, 10-15 reps of each in cycles of 3, three times a day. So, about the same as what you are doing.
Hi Michael
I thought I would drop a comment or two about my current status. Today is my 6 week post op anniversary, my rehab is going well as I am easily achieving 90 degree ROM on my heel slides, chair slides and basically every other kind of bend that they have me perform. For the last week I have been able to go up and down the stairs in my house to work in my home office. Obviously this is done still via the immobilizer but they are allowing me to take it off and sit with the leg bent while working at my desk.
My PT indicated yesterday that are the exercises she watched me perform I was actually going to far, I was hitting the 100 degree ROM quite a bit. She indicated it would be best to stay in the 90-95 degree range and instructed me to perform the reps twice a day instead of three times a day. I am not scheduled to go back to PT until 8-10-09 since they feel I am performing the exercises quite nicely and diligently at home.
I do have an 8 week post – op follow up with the doctor on 8-12-09 and this leads me to your previous comments about crutch dependency. Given my rehab progress I am quite sure that the immobilizer will be a thing of the past. However I will be curious to see what the next step for support will be for the repaired knee. I do know that the doctor will write a script for PT strengthening and I am sure part of that will be walking without anything on the repaired knee.
basically that is my current status, I will keep you updated.
Thanks
Chuck
Chuck,
It is great to hear that you are making such excellent progress. In fact, your ROM is ahead of what I was able to do at that time. Of course, flexibility was never my strong point (one of my Tae Kwon Do teachers joked that they’d put three stripes on my belt if I could do a full split). 🙂
It sounds like your doc is taking a very conservative approach-I was in the brace at week 2 and out of it a few weeks later. But, injuries differ so it can be difficult to compare two sets of treatment.
I started doing pool running about two weeks ago, which has really boosted my spirits. It is not quite real running, but it really helps me feel more normal. It has also been great for my knee. I hope to be able to run on land (or at least jog) in a couple weeks. My ROM is almost back to normal, which is nice. I am still very careful when I go up and down stairs or walk on wet concrete. My university was built on hills, so I’m always going up and down stairs outside, often in the rain (summer is the rainy season in Tallahassee).
Michael, thanks for saying that on ROM. I am now 8 weeks after surgery, at 95 degrees and sounds like well behind Chuck’s progress. I was never the most flexible guy either so perhaps that has something to do with it. Anyway, recovery seems to be going well, I started swimming again two weeks ago and walking back and forth in the pool. I think walking (or running) in the water is a good strengthening exercise and gets you used to walking normally again. Good luck with the running.
Ted,
The pool seems to be a great recovery environment. The resistance without impact has really helped me recovery. It is nice having a working muscle again. 🙂
Hi Michael
Well as of 8-12-09 I no longer need to use the immobilizer!!!!!!!!!! Eight weeks of that thing was enough. My doc indicated that things looked real good from a healing aspect and that I could start walking with the walker and then go to a cane. I followed his instructions exactly and by the time I walked out of his office and got to my car with the walker I knew it was time for the cane. By the time I used the cane that evening I was rather convinced that I would only need that for stairs.
The strange thing is even though I was able to hit 110 – 115 degrees ROM in the doctors office he wrote another script for more ROM. My right leg which is the non injured leg goes to about 125-130 degrees ROM but he indicated we need to do more ROM before starting strengthening,he indicated that there is plenty of time for strengthening but ROM has a time limit in his opinion. My PT is confused as she really believes I am ready for the strength aspect.
What I have noticed since I am immobilizer less is that my knee does seem to swell a bit more and the majority of the tightness is directly above the top of knee cap closest to the quad muscle. I have experienced as you mentioned a couple of episodes where I thought the knee was going to buckle,that was when I was going down some steps.Going up inclines does not bother me but going down inclines is a little scary as you can feel the quad muscle tighten and engage around the knee as you head downward.
I do have to say at this point the mental aspect and the confidence factor are going to be my next big challenges, as I write this comment I am 9 weeks from my fall and 8 weeks from surgery so I am sure there are many more weeks and months to endure before I reach the almost back to normal stage.
What type of strengthening exercises were you required to perform and how long did you have to do yours. Lastly did you encounter some of the mental/anxiety issues, I really think mine is more anxiety related.
Thanks again and I hope you are progressing and getting close to your previous pre-injury status.
Chuck
Chuck,
It is great that you are out of the immobilizer! I was thrilled to be rid of mine-and I was only in it two weeks.
I suspect that there is a time factor for ROM. After all, it makes sense that as the injury heals it will tend to heal within the limits of the motion. So, getting ROM back ASAP would seem to be a good idea. My PT had me strengthening fairly early on, but I did find that the doc, the PA and the PT all had different ideas of what I should and can do. My guess is that the PT probably has a better idea about the PT aspects, but perhaps your doctor has experience in PT beyond what doctors usually have.
Going down inclines and steps still worries me, but I can do them almost normally now. I do hold the rail on stairs, though. I am sure I can handle a fall on an incline, but tumbling down a flight or three of stairs would be bad…
If your experience is like mine, you should hit various milestones that will boost your confidence. For example, I got a boost with each new exercise added and each bit of progress in balance and ROM. But, it will be long and trying-but quite doable.
When I first started, the PT had me do basic muscle tightening exercises. After that, I would stand on a platform or stair and use my surgical leg to lift myself up and down (almost like the ballet dancers do). I also would do an exercise that involved leaning against the wall and bending my knees. I’d slide up and down the wall. Eventually I moved on to actual weight/resistance work with my bowflex.
I went back home to Maine last week and walked my favorite running trail-at least 10 miles of it. Walking that long had a huge impact on my knee, plus I also started working stairs seriously.
Hi Michael
I thought I would drop you a line and let you know that I started the strengthening portion of my PT on 8-28-09. I did not realize how weak the operated leg had become but I am pleased with the progress. As of the last few days I am actually going up my stairs to my office (14 of them) and doing it in the normal fashion one would walk up stairs, no hopping, that has really boosted my confidence. I have been swinging a golf club and hitting some very short 30-40 yard shots and not experiencing any pain or other issues.I am walking as much and anywhere that I can and while I do get some tightness at times it subsides rather quickly with rest and some ice. I did have several experiences over a two week period where I encountered a sharp pain in the knee that lasted just a few seconds and then went away. The PT surmised this was scar tissue tearing away.
I do agree about the confidence factor on slopes as I have encountered some of those on hard surfaces as well as grass surfaces, the fear and confidence factors are going to take time to conquer in my opinion.
I head back to the doc on Wednesday for a 12 week post-op appointment, I am sure he will write a script for more strengthening but the PT indicates I am about 4-5 weeks ahead of normal pace. I will say this, the strengthening portion of PT is much more challenging than the ROM,I go twice a week as well as performing many of the exercises at home twice a day, it has become a process for me.
How are you progressing theses days with your recovery? I hope you are getting closer to your goals.
Regards
Chuck
Chuck,
Good to hear from you. I’m glad that you are in the strengthening portion-you’ll probably feel like you are making real progress here.
It is rather surprising how quickly the muscle goes when it isn’t in use. My surgical leg is still noticeably smaller, although it looks much better now.
Facing stairs is quite a challenge-it is great that you are able to go up and down them normally. I get to face about 8 flights of stairs on my way to my office, so I’ve gotten plenty of stair practice (I have to go up two hills, then down a couple hills, then up into the office). Naturally, the students grab the parking spaces near my office. But, I suppose I can use the exercise more than they. 🙂
Any problems with swelling now?
I started jogging/running again on Friday (9/4/09) and did 2.38 miles of continuous jogging. I did 3 miles Saturday, 2.38 Sunday and 2.38 this morning (I have a GPS watch, hence the exact numbers…). I have one last appointment in December to make sure that the tiny bones that grew in the soft tissue have stopped growing (heterotopic ossification). Hopefully, that will be it for me.
Good luck with the ongoing progress.
Hi Michael
Sorry it has taken me so long to reply but since my last post on 9-7-09 I have made incredible progress with the strengthening portion of my rehab.The exercises that they had me doing where beyond belief but I am here to tell you that if you are diligent you do get stronger and when that happens you build confidence. On 9-8-09 doing a two legged press I could only doing 3 reps of 10 at the 25 pound level, some six weeks later I am doing 4 reps of 10 at the 185 pound level. As of last week my PT has suggested I only go once a week for four more weeks and then I will be done with their portion of rehab. The trick however is to formulate the exercises at home. I will say that during strength rehab I was doing exercises at home twice a day on the non scheduled days at my rehab facility. I have been back mowing my yard again for over a month and again that is a nice little one hour walk. Additionally I am hitting golf balls again on the range and I must say my swing speed is about 85% of my normally swing. I should be able to play a full round of golf by mid November if the weather holds up here in Missouri. Also it is so nice to be able to go up and down stairs normally, I do admit that going down is still a bit of a challenge but I have come such a long ways since I began commenting here on your site in June.
You had mentioned swelling issues that I might be encountering, actually the more I use the operated leg/knee the better it feels and while there is some swelling it is not very much after completing an activity or workout session.
Michael I noticed that since my last post there have been several new posters and while I wish them the best in their recovery I have to again tell you how much your site helped me as I recovered from this injury, the mental support that I took from your comments and others is priceless. Let me know if you ever want to publish a quad tendon recovery book and with my printing expertise and your superb writing and research skills it could be highly beneficial for many.
Tell me about your progress since early September, it sounds like you are getting back to running some miles.
Thanks and best of luck in all your endeavors.
Chuck
Chuck,
it is great to hear that you are making excellent progress. I bought a Bowflex and found that very useful for doing the exercises, although I originally bought it so I could just keep doing some exercise.
Glad to hear that you are back to playing golf. You should get back your full swing soon-hopefully before the snow arrives. I still am a bit wary about stairs-but I can handle them fine. My knee does bother me a bit after a long day of teaching-I stand when I teach and I walk quite a bit getting between classes and to/from my truck.
I still have some swelling in my knee, but I think some of it is here to stay-perhaps some scar tissue or something else.
Interestingly enough, I did think about putting together something on quadriceps tendon repair recovery. I think it would be very useful to people to have easy to understand guides to various medical issues. While there is some good info available, it is scattered about and takes some effort to find it. So, the book sounds like an excellent idea. I wonder if Oprah would pitch it on her show? 🙂
I started running again on September 4 and had my first “race” on September 12. I did that 5K in about 30 minutes. I’ve done several 5Ks since then and ran a 22 minute one last Saturday. I’ve even managed to win my age group in three races. I still have some stiffness and minor swelling, but I feel that I’m at about 80%.
Mike
Hi Chuck,
I has my surgery on the 18th June and had my follow up on the 22nd June. (It was a complete Quadriceps Tendon tear and also quadriceps muscle tear.) On the 22nd the Doc said go to PT, I asked when “His reply was the sooner the better.” I have been going to PT now twice a week to work on Range of Motion which is now at about 69 degrees (also have exercises to do at home). I keep the immobilizer on when walking but have been bending it a bit especially if the immobilizer slides down my leg a bit. I do keep the immobilizer on when I am walking. My next appointment with the doc (5 weeks) is 27 July. The PT doubts that the doc will suggest a locking brace … but she did say every doc was different. Good luck with your recovery.
Ken
Every doctor is different, I never had an immobilizer but a locking brace which has been fully locked since my operation on June 4. I hope to get some greater ROM when I see my Dr. tomorrow. The six-week anniversary is a big one, apparently. Ken, you must be superman because 67 degrees is quite impressive so soon after surgery. I just got to 60 degrees this Monday and hope to start working it aggressively after I get cleared tomorrow.
am now 6 weeks post surgery..was immobilzed4 weeks startted pt and did 46 degrees week4 with ease am now at 7o degrees at week 6 post op…..still use brace but continue to flex when i sit..quad isometrics are done all day..have no pain but need muscle mass..have done leg raises without doctors permission am happy with my 6 week progres..walking a bit without crutches and am ready to kick it in….assited rang of motion exercices are great with a strap.. cant wat-it to do short arc quads with weights..need some cardio though..all i do is situps and 25lb dumbell workevery othr day ..have put on 8 lbs..even thogh i have tried to eat the same good way i have for 6 years..but the holidays and grey goose on days i normally wouldnt drink..(only drink on sat./sun.) have been a factor….when can i get into the pool and tread for and hour and get some cardio ?
Ray,
As far as when you can get into the pool, that would be up to your doctor or PT. In some cases, they get people into the pool rather quickly. In my case, I got into the pool after I was out of the brace.
I started water running around 16 weeks after my surgery (which was done on April 3, 2009). I was running on land on September 4.
Here is a link to a PDF that has an excellent timeline for recovery: http://www.rcmclinic.com/protocols/lind/knee/quadriceps_tendon_repair.pdf It is primarily for athletes, but does provide a useful guide. But, as always, be sure to go with what your actual doctor says.
Hi, I’m re-posting this comment, because I’m not sure if anyone will see my first one as it was added in the middle of this comment page between comments dated 2009..
So, I’ve been reading many posts of folks who have gone through what I’m about to regarding surgery for quad tendon tear. I have an added twist to my story and was wondering if anyone out there has come across some useful information.
My situation:
I’m an above knee amputee who wears a prosthesis. My hydraulic knee has had the tendency to buckle without warning due to a failure in the unit. This failure is common once the seal of the hydraulic unit becomes worn and leaks fluid.
I was tossing a football recently when the prosthetic knee buckled and in an instant i fell. Unfortunately the “good” leg wrapped around the prosthesis and as I hit the ground my real knee was stretched too far, considerably tearing the quad tendon.
I’m wondering if anyone has any experience similar to mine in which after having surgery one does not have a remaining healthy leg to stand on.
I’ve been getting around on crutches and the one injured leg in a brace..I’m pretty good on crutches as I walked on them for eight years after my amputation and prior to wearing a prosthesis. But, I’m guessing walking on crutches is going to be very different after my surgery next week.
I have also put the prosthesis on once or twice and locked it in a straight phase position. In that phase and with my knee brace on the injured leg I can “Frankenstein” walk around a bit, but I don’t trust the hydraulic unit as it has a habit of clicking back into a normal bendable knee phase and more potential buckling!
I know a wheel chair may be in my future and for how long, I do not know.
Any feed back is greatly appreciated.
Thank you,
Patrick
Patrick,
Sorry to hear about your injury.
There are cases in which people have torn both tendons at once, which would be a situation somewhat like yours. In most such cases the person is generally limited to laying down/sitting until his legs are up to the task of getting about.
If you cannot rely on your prosthetic, then you will probably be in a similar plight, which won’t be very enjoyable. Is there any chance of getting a better prosthetic?
After surgery your surgical leg will probably be in a soft immobilizer or locked brace. You’ll gradually get ROM and so should be able to get about on crutches with due care. But, be sure to be very careful-I had some problems getting about even with one leg at 100%.
Mike
Thanks Mike,
I’m trying to get a refurbished hydraulic knee replacement, but everything is out of pocket at the moment, so I’m doing some prioritizing. I’m very lucky that the surgery is being done at a major discount (my good friend is a nurse). I’m told these surgeries can be upwards of $30,000!
If I can keep the prosthesis in a straight locked position for walking that may be my best bet, as that is the primary way of getting around now, with the injured leg in a brace.
Thanks again for your reply.
Patrick
Patrick,
Good luck with the knee replacement. You might have a look at open source prosthetics. Apparently because of the fact that prosthetics are not high profit, they tend to be ignored by the big players. But, the open source project is working hard to make better prosthetics available to people who need them.
My surgery and hospital stay was billed at about $11,000. I have BC/BS so my out of pocket was about $1500 overall. If possible, don’t stay overnight (that costs more plus increases the chance of getting an infection).
Thanks again!
I will look more closely at the site you linked. I noticed they are looking for users/testers for prosthetics, I’ve always wanted to do that.
P
Hi Ken
My surgery was on 6-19-09 and what a difference between doctor philosophies. You were headed to PT 4 days after surgery and i was told no weight bearing for two weeks. I am interested to see how much they want to bend my knee when I head for my first appointment Friday. i can’t believe how much smaller my thigh and calf muscle have gotten from the immobilization the last four weeks.
When do you do away with your crutches or walker?
Thanks
Chuck
Hi Chuck,
I got rid of my crutches about 2 weeks after surgery … the zimmer splint kept my leg straight and the crutches did not really help much anyways …
Ken
Ken,
Good luck with the recovery. My progress in ROM was slower than yours, but my doc did not have me go to PT until May 11 and my surgery was on April 3. I did have some very, very limited “exercises” to do before then, though.
It seems that every doc takes a somewhat different approach. Or perhaps it is that each patient gets a different approach? Or both?
Chuck how long was it until you were able to play. I love to golf and am 6 weeks out of surgery from complete quad tear and am feeling good and want to play. I have tried practice swings with the Gary Player walk through and I think I can do it. I will go crazy if I can’t play for 6 months as OS said or 5 months as PT said.
Doug,
I was operated on June 22 2012 and ran a half marathon in the middle of November. I then ran another half in Jan of 2013 and have ran 370 miles so far in 2013. It could be done. Just do it!
Here is a time line on my quadriceps tendon repair:
8 June – Injury Occurred (complete tendon tear) while taking a free kick in soccer. Never had an injury before.
18 June – Surgery (tendon tear also included muscle tearing, doc said the reconstruction was quite extensive)
22 June – Follow up with Surgeon and physio stars
Currently – Physio twice a week. Weight bearing on leg with zimmer splint. Up to 54 degrees ROM …
Ken,
Good luck with the PT. It sounds like your injury was rather severe, but with luck you’ll be back to kicking again in less than a year. That is quite good ROM so soon-hopefully that is a sign of a fast recovery.
10 weeks post surgery … now at 103 degrees. Physio twice a week. Still very careful walking especially on uneven surfaces or down stairs.
It is a slow recovery … but with Physio it is progressing a few degrees in ROM each week.
Ken,
Good to hear that you are making progress. I still have problems with stairs and downward slopes, but much of it is now psychological. Doing stairs carefully is apparently supposed to help restore strength and balance. I found that to be true. Because of renovations my office was moved across campus and I now have to go up and down several flights of outside steps. While I dread the stairs a bit, they are actually helping me.
I found that my progress was slow as well, but it seems to be going along steadily. People keep telling me to be patient and I suppose that is a good advice.
The twitching is nerve activation from underuse. I had the same thing happen after knee surgery when my quad had shrunk to half its size.
Michael
Great write up, wish I had read it before my surgery on July 21st! Especially the notes on stool softner….I learned the hard way….why don’t doctors (or the pharmacist) tell yu these things.
I am just shy of four weeks non weight bearing/crutches with two more weeks before I can start rehab. My question is this: I will be traveling to Europe for two weeks 11 days after the immobilzer comes off and I start the rehab….what kind of shape am i going to be in as I try to walk around europe? It will be about 8 weeks post surgery, will I still need crutches, a cane? How uncomfortable will I be? I am 59 and I am a runner (30 years) and biker (5 years), pre accident I work out hard every morning for 50-60 minutes so I was in pretty decent shape before the surgery. My wife says not going to Europe is not an option….any tips on making this a pleasant trip?
Thanks,
Bill
Bill,
Yeah, they really need to warn people rather pointedly about that. I almost needed therapy after that. 🙂
Based on my experience, at week 8 you should be off crutches. You’ll most likely still have the brace on then. I was able to walk slowly at that point and could navigate stairs, albeit very slowly.
If you are flying, having your knee bent for the flight might be painful. I’d suggest getting some long lasting and effective pain medicine. I recently flew from Orlando to Portland, ME and used one of the pain killers I had left from the surgery. That helped a great deal. Also, try to book with an airline that has the most leg room.
If you will be walking around a great deal and facing stairs/inclines then a cane might help a bit. I could walk reasonably well at 8 weeks, but stairs and inclines challenged me for quite a long time. You’ll also get pain and swelling when you are moving about, so you’ll want something for the pain as well as an icepack. I got one of those Ace packs that can be refrozen over and over again. They also make some designed to wrap around the knee/leg so you can walk around with one in place-that should help quite a bit.
Comfortable shoes with good traction are also a good idea. Your foot will probably swell a bit, so you’ll want a shoe that will allow for that. I used my running shoes, since I wasn’t running anymore.
so that is weird, i never knew the human body had such intricate workings with the bicept etc
Michael, curious to know how the running is coming along? I am now 12 and 1/2 weeks post-surgery and overall I think it is going well but progress is getting harder to come by. My ROM is 120 degrees and working hard to rebuild what used to be a pretty strong quad muscle. I can walk and knee slips less and less every day as strength returns but the ROM is hard to come by, every degree is a struggle. My goal is 140 – not impressive in the yoga studio but is about the range of my other leg.
I have rejoined a masters swim group and can swim fine and can do the staionary bike as well but running seems like a whole different story. Good luck. Ted.
Ruptured (r) quad tendon 4 months during a martial arts class, got kicked in the tendon area, quad muscles ceased instantly and collapsed under me. Had surgery 6 days ago to re-attached the tendon, surgeon had not seen such an injury where the tendon snapped mid-way leaving a stump of 20mm at the distal end of the patella and the gap was 15mm wide. Usually the tendon will just pull off from the patella and the outcome of this sort of surgery is much better. Surgery was similar to any achilles tendon full rupture except the quad tendon is much bigger in size. He was unable to give any statistics or the percentage of the fact that it will not re-rupture! Have to wear Richard splint for 6 weeks without any extention or flexion ie just in a 180 degree locked splint. Can have full weight bearing on leg but walk with crutches as aids. Just wondering whether there is anyone out there with similar rupture. Thanks
Ruptured (r) quad tendon 4 months during a martial arts class, got kicked in the tendon area, quad muscles ceased instantly and collapsed under me. Had surgery 6 days ago to re-attached the tendon, surgeon had not seen such an injury where the tendon snapped mid-way leaving a stump of 20mm at the distal end of the patella and the gap was 15mm wide. Usually the tendon will just pull off from the patella and the outcome of this sort of surgery is much better. Surgery was similar to any achilles tendon full rupture except the quad tendon is much bigger in size. He was unable to give any statistics or the percentage of the fact that it will not re-rupture! Have to wear Richard splint for 6 weeks without any extention or flexion ie just in a 180 degree splint. Can have full weight bearing on leg but walk with crutches as aids. Just wondering whether there is anyone out there with similar rupture. Thanks
Sang,
Sorry to hear about your injury. Mine was the usual sort, with the tear close to the patella so it could be fixed the usual way. Just guessing here, but I suspect you’ll take longer than I did to recover. On the plus side, tendons seem to be able to heal fairly well, albeit slowly.
I was able to get back to punching and blocking fairly quickly, although having one leg immobilized rather limited what I could do. You should be able to get in some training as well, subject to what your doctor thinks.
QUAD TENDON RUPTURE 3.15.09, SURGERY 3.28.09—WHAT A RIDE! HOPING 2 GET BACK TO JIU-JITSU SOON!
Rick,
Good luck with the recovery. Don’t rush it though-getting thrown around sounds like it would be rough on the repair.
Thank you Michael, your site is the best so far. Weight training is coming along slowly however progress is happening every day :)…FYI, the doc nailed me right between the eyes be4 surgery & said I had a damaged quad from prior steroid use…My meat head years caught up 2 me…anyway cant wait to get back on the mat however it looks like I still have a ways til competion.
Rick,
Good luck with your recovery. Making progress is great for morale-I know that I felt much better as soon as I made even small improvements. Like Arnold, you’ll be back. 🙂
Oddly enough, I think I’ll be in even better shape after this than what I was before. I had to branch out my training and plan to keep up the variety even after I’m back to 100% as a runner.
Michael,
This is an outstanding collection of stories and information, and it is serving as an educational source and inspiration for me. I stepped into a previously unknown sinkhole in my yard on 9/12 and landed full force on my bent right knee. I have a “high grade partial tear” (that’s 70% or more) of the quadriceps tendon (there are a “few instact strands”), and fully expect that my ortho will tell me on Tuesday that I will require surgery. There is something else going on with the medial meniscus but it is in doctor-speak and I haven’t found a site to translate it yet.
I am almost 57 and don’t lead a very active lifestyle, and I am looking at this event as a wake-up call to make some changes in my level of exercise. If I want to make a full recovery, I’ll have to spend a lot of time going to PT and continuing it at home.
Reading the story of your recovery and of the others on this site lets me know that there is a light at the end of the tunnel that I have unwittingly stepped into!
Dave
Dave,
Sometimes partial tears can recover without surgery, but I suspect that your doc will go for the surgical option. Having at least some strands intact will help, though.
Based on what I know about running impact injuries, you might have damaged the medial meniscus. It acts like a shock absorber (it is located between the tibia and the femur) and a sharp impact (or many repeated impacts) can damage it. In some cases, not much needs to be done. Hopefully that is the case for you.
You are quite right-to get back full use of your knee you’ll be put through some extensive PT. I found mine challenging, even though I’ve been a competitive athlete since I was 15.
The road to recovery is a slow one-my main advice is to set staged goals. Reaching them can be a real morale booster. Also, be sure to take those stool softeners (and drink plenty of fluid) after the surgery, if they are prescribed. They are really, really important. Trust me! 🙂
Thanks for your reply. I went through major hip surgery 22 years ago, and your observations about the stool softeners ring true! I’m getting around on crutches now, and trying not to tear what little is left of the tendon. The patella seems to be held in place, more or less – it’s hard to tell due to the swelling.
I’ve read that 6 weeks of immobilization is how partial tears can be treated non-surgically, but the drawback is that it is unlikely to be as strong as if it were surgically repaired.
Dave,
That is apparently the downside of the non-surgical repair. I suspect that the tendon will heal, but probably not completely or properly. Of course, much depends on the extent of the damage and the sort of recovery a person goes through.
If your patella is still in place, then that is great. Mine wasn’t-it was pulled down enough so there was a very visible gap. Plus, it would wobble in all directions.
Good luck with your recovery.
Hi Michael,
I’ve just finished reading your entire blog and comments. What a great resource!
I tore the quads in BOTH legs on September 1, and had surgery on September 5. Now almost at the 2.5 week post op mark with both legs in zimmers until 6 weeks post op.
Your site has really helped to give me a clearer idea of what to expect in terms of PT and it is inspiring to hear that you are running again! I am (was?) a runner too but I think it will be a long time before I try to run again. We have long winters where I live, with lots of ice and snow, so I will likely spend the upcoming winter working out in the pool.
I am still in shock about how this happened. I essentially missed the last step going down a flight of stairs. The next thing I knew, I was on the floor with both quads contracting painfully. What worries me is… Since I don’t fully understand the kinetics, if you will, of the fall, I don’t feel confident about how to prevent it from happening again! And I wonder what other factors might have contributed to the ruptures. The fact that I injured both legs suggests to me that some general systemic factor has caused this. Too much caffeine that morning? Inflexibility? Some kind of vitamin or mineral deficiency?
Do you have a clear idea of what might have contributed to your injury, and will you consciously make any lifestyle changes as a result?
Thanks again for a wonderful blog.
Ken Larry
Ken,
I’m glad you found the blog useful. Man, both legs…that is horrible! I can imagine how awful that would be-I had a heck of a time with just one leg out of commission.
It is great to be back to running. I think you’ll be back during the same sort of time frame that I had, although not being able to use at least one leg will give you a bigger hit to your cardio. But, they do make “hand bikes”-they are basically just a pedal mechanism that you pedal with your arms. It isn’t as effective as a normal bike from a running perspective, but at least it does help maintain endurance.
True-the ice and snow would be scary. I’m glad that I’m in Florida in that respect: warm weather for outdoor pool running and no ice to worry about. I just have to deal with the rain.
That is the same sort of thing that happened to Clinton-he missed a step and pop, there goes the quad. Weird how that happens-it is an extremely strong tendon and is supposed to very rarely tear.
I did read that some pre-existing conditions can increase the likelihood of tears, such as previous partial tears. However, sometimes it is just a combination of factors that have nothing to do with what you have done.
In my case, the main cause was that I hit the metal ladder with one foot while wearing hard shoes. So, I took the full impact on that leg alone. If I had landed on both feet or if I had landed on the grass, or if I had been wearing running shoes…it might have been different. I also suspect I had accumulated some damage to that tendon over the years. I have had some on-and-off knee problems, so perhaps I had a pre-existing partial tear.
My main change is to stay off ladders during rainstorms. 🙂 I can’t think of any change in my diet or behavior that would have made a significant difference-it was just one of those accidents caused by poor decision making. 🙂
But, I have been working on flexibility and strength more-I got a Bowflex and added leg workouts to my routine. This was initially as part of my PT, but now it is a permanent thing. Plus, it never hurts to improve one’s diet.
Hi again Michael,
Thanks again for replying and for your excellent blog. I’m into week 5 post op and have an appointment with the surgeon on October 21.
I think they’ll start me on some sort of physiotherapy after that. I’m wondering what to expect… will I stay in splints or will I move to some other form of support? And what kind of exercises do you start with?
I was alarmed when you said you had no range of motion for three weeks after you started PT! With both legs in splints, I’ve been confined to the top floor of my house for six weeks, and I’m hoping to get some sort of mobility, particularly on stairs, soon (even if just with crutches)!
As I expected, it has started to snow where I live–an added stress!
My inspiration is knowing that you have started running. My question: Having started physio in late October, is it reasonable for me to expect to be walking around unaided by mid-December?
Best wishes,
Ken
Ken,
I was fitted with an adjustable brace in week two and had some ROM at week 3 (about 10 degrees). But, that was with just one leg-since I could use the other normally, I was able to start walking on crutches right away and was walking without them in a few weeks. After about two months I was out of the brace. I suspect you’ll be fitted with braces soon, but will have a slower recover schedule because both legs are healing.
My initial exercises were these: At week six, the exercises were very limited and quite basic. The first is called “patellar mobilization.” While this sounds like an alien army gearing up for war, it is simply manually moving your knee cap (patella). To do this, you sit on a firm, flat surface and gently move your knee cap side to side and then up and down with your hands.
The second is the quad set (sometimes called “quadriceps setting”). To do this, you lay down and bend the healthy knee. You then tighten up the muscles on top of your thigh and hold for about 5 seconds. Then you relax. Then you do it again. A variant of this involves pushing your knee down so that the underside of the knee is pressed against the surface.
The third is a hamstring set, also known as a heel slide. To do this, you lay down and bend your knee to a height of roughly six inches. Then, push the heel down and pull it back towards your body, holding for 5 seconds. Repeat.
The fourth is an assisted knee bend. It can be done lying down or in a chair. You just slide the leg so the knee bends, using your arms to assist (not force!) the motion. Repeat.
The fifth is another knee bend. For this one, you sit in a chair (pick a stable one with room to move), bend your knee and then gently slide your butt forward, thus causing the knee to bend more. Repeat.
The sixth is a hamstring stretch. It is just a hurdler’s stretch without bending the other leg. Lie down and gently stretch out over the injured leg, reaching for the foot. Hold about 15 seconds and then repeat.
I’m guessing you’ll be doing modified versions of these.
As far as walking, I would suspect that you should be able to walk by the end of December. It took me nine weeks before I was out of the brace and even then I was not walking normally. I suspect you might be using a cane for a while even after you get off the crutches because of the two leg aspect of the situation.
Hi Michael,
Thanks for the descriptions of the initial exercises. I finally started physio last Monday. They have started me doing ROM stretches, but still no strength training. I think that will start this week (week 9 post op). I’m really eager to start strength training as it seems building up strength will be my ticket out of these splints!
Strangely, both the OS and PT have not recommended braces at all. Instead, the plan is to wear the splints while walking until I gain enough strength to walk with crutches or a cane for support. Maybe it has to do with the fact that I have injured both legs.
I was just reading a post by a quad ripper on another forum who is running 4 miles and working out in the gym every day. It is spirit-sapping to consider my comparitive lack of progress.
How is the running going?
Ken
Ken,
I did start some very, very limited strength training early on-things like tightening up my quads or lifting my leg while laying on my side. But, it took a long time to get to any actual resistance training.
I can see why they would go with splints with both legs. After all, without a good leg to provide support, staying upright could be a problem. I didn’t start running again until September 4 and my surgery was on April 3. I’m still not at 100% and probably won’t be for a few months. Don’t get discouraged about the progress-it is a slow return and, as they say, everyone recovers at a different rate. Plus, you have two tears to deal with. So, I would say that you are doing quite well givin the challenge you are facing. Like you, I did see some people posting about making rapid and amazing recoveries. But, I decided that I needed to go at the right pace for myself-and I also heard about people tearing their repair by pushing to hard. To be corny: run the race at your own pace and you will win the competition that counts.
Running is going well. I can hold a 7:18 pace for a 5K with surges into the 6 minute range. I’m still very cautious on the hills (up and down) and have yet to try to actually sprint. My knee still feels a bit weird-but I expect that will be a lifelong thing, what with the scar tissue and all. Mainly I am pleased to be able to run again.
Mike
Hi Mike,
I’ve been in PT for almost three weeks, with the first two devoted to ROM only. I’ve been working on strength for 10 days now.
I started practicing walking without the splints (using a walker for balance) two days ago. It’s amazing how difficult walking is at this stage! It feels like I am wearing two untied hockey skates–very wobbly! Hopefully I’ll be able to move to a cane, or two, before long. The PT says I’ve got the strength but need to re-establish the neuro pathways between the muscles I stopped using while healing. I think he is right.
At least at this stage in the recovery process, one can actually do things to affect one’s recovery. The worst part was laying around for eight weeks like a vegetable just healing while immobilized.
Just thought I’d keep you and others on this board posted. I think I’m seeing the light at the end of the tunnel.
Ken
Ken,
Good luck with the walking. The PT is quite right-it seems that the muscles and nerves “forget” what to do when they are not used for a while and have to be re-trained. When I was going through that, it was weird having to actually concentrate on how to move my leg and foot. As with most things, practice is key.
I found that I had to really work to overcome the habits I picked up while in the brace. I also had some random “control issues” from time to time even after I was walking again-nothing major, just a little unexpected knee “slip.”
Mike
Michael,
Well, I chose surgery, and it turned out to be the correct route. The tendon was 80% ruptured, so the odds were high that any attempt at rehab would just be a postponement of the inevitable. They used a neural block on the leg but also some general anaesthesia; it’s been over 24 hours and the block is just wearing off, so the discomfort to date has been surprisingly minimal. I have an Iceman pump that is keeping the swelling down – I feel like a Borg (part machine, part human).
I’ve been told that it will be 4 weeks of zero ROM, then start PT slowly to increase it, but no strengthening exercises until after the first of the year. We’ll see how it goes!
Dave,
I’m glad the surgery went well. I didn’t get the Iceman, but my brace was certainly borg-like (I got a comments about that from trekkie friends).
I had about 3 weeks or so of zero ROM, then got a little bit each week or two after that. I was a bit shocked by how long it took to get the full ROM back. Fortunately, I was (for once) sensible enough to stick with the plan.
The recovery is a slow process, but focusing on your progress will make it easier to deal with it. If you have any questions, feel free to ask-I would have been largely in the dark if I hadn’t gone out on the web and researched things.
Hi Michael and all of you fellow knee suffer’ers!
What a GREAT thing it was for me to discover this blog today! Thank you Michael!
I’ll be 4 weeks post-op on Friday (10/30/09).
During a tennis tournament I ran back behind the baseline and returned a lob. My opponent then attempted to hit a shot down the line for a winner off of my return. Instead his ball hit the top of the net cord and bounced straight up, becoming an unintended drop shot.
I took off, sprinting as fast as I could to the net to get the ball just before it bounced a second time.
You might already imagine what happened next.
I attempted to stop on a dime, from a all out sprint, and bend down low to scoop the ball up. And of course, that never happened. I planted my right foot, bent low and lunged forward and then … POP!!! went my right knee … and I went down.
Game, set, and match.
That was on September 22 and surgery for a torn quad tendon and meniscus was on Oct. 2.
I’m so very happy to have read this blog … I’m a 52 year old fitness instructor and this down time is about to drive me crazy. I’m not a very patient guy! But I want to thank each of you for taking the time to write about your injury, your surgery, and the different things about your rehab and recovery. It was been so very very instructive, inspirational, and encouraging. One year ago I was in Washington, DC to run the Marine Corps Marathon … and now I’m working hard just to bend my fricken knee!
Misery does indeed love company and I’ve been so happy to have found you guys.
Tony Ludlow
Tony,
I am sorry to hear about your injury. But, at least it was sports related and not stupidity related like my fall. 🙂
Being in good shape, you should make a rapid recovery. One challenge you’ll probably face is restraining yourself-I had to work hard to be sensible and pace myself (normally I take the “I’m tougher than the injury” approach). I just kept reminding myself that a little patience now could keep me from being back on the table, under the knife once again. That, and memories of the post surgery “side effects” kept me on track. Riding a stationary bike one legged and getting a Bowflex also helped a great deal. I was surprised at how much of a workout I could get even with just one functional leg.
I had my first run on September 4 (surgery was April 3), so you can probably expect to be back in a similar amount of time-as long as you keep that patience going. 🙂
Did you have a full tear or a partial tear?
Hey Michael!
Thank you for writing with some sorely needed words of encouragement!
I had a full tear. I don’t do nuthin’ half way! hahaha I’m a retired Marine and we don’t really do “kinda sorta” … we go all in! However, this is one time I should have been smarter than eager to win!
At 3.5 weeks post op, I’m at 100 degrees of ROM. Painfully acquired. My leg is in an immobilizer from high thigh to ankle and I hobble around on two crutches.
My doc believes that I can be jog/walking on a treadmill by New Year’s Day! And I’m hoping he’s right!
In addition to the tennis, I was (AM!) an avid runner and was training a group of people to run the St. Jude Half Marathon in Dec when the injury occurred. I’m also a triathlete. And was leading a boot camp fitness program two to four times a day, Monday through Friday.
The doc thinks that I’d probably partially torn both the quad tendon and the meniscus before the tennis tournament that put me down. I’d been favoring that right knee for several years, but adhered to the “train through the pain” philosophy. (If that can be accurately called a “philosophy!”)
I’m trying really hard to be patient. Hardest thing I’ve ever had to do! I go to PT twice a week and do my homework 2 to 3 times a day on my own.
I have to say, I’ve read other blogs and message boards of those with the same injury but they were so negative and were mostly written by people who’d been sedentary prior to their injury. They seemed to have a defeated attitude and I just got depressed reading those posts. On the other hand, this blog is a breath of fresh air! Most of the posts here are from active and positive people. There’s hope in that! And as you know, it’s not that hard to fall into a funk and believe that you’ll never be an athlete again!
I’m doing some limited dumbbell work at home. All upper body stuff. Curls and presses, crunches, and flys. But I can really see how a Bowflex would be great. I’ve got a bike on a trainer and will look at taking the right crank arm off in order to ride with the left leg only. A life with no cardio really really sucks!
Without question, the hardest part is the waiting. I’m goal and results oriented and driven by goals. So having no goals can drive me quite up a tree!
What percent would you say that you are at the present time? And this is a question for you and any others who read this blog. How far beyond surgery are you and what are you able to do?
Thanks Michael and all of you fellow Knights Who Say Ni! 😉
Tony
Tony,
You know, sometimes it is okay to give less than 110%. 🙂
At 3.5 weeks I was at about 15 degrees of ROM, so you are kicking my butt. It took me months to get back to 100%. I still have some stiffness in the knee, but my ROM might even be a tiny bit better-all that stretching was more than I normally did.
You should be in a adjustable brace soon-I was in a fancy Donjoy rig that made me look a bit cybernetic. I was off the crutches in a few weeks, then out of the brace in a couple months. It was weird being out of the brace at first, but it was great to be out of that sweat machine.
You should be back to walking semi-normally fairly soon and able to do pool running in a few months. I was thrilled to be able to finally walk around, although you will probably be wary of going down steps/hills for quite a while. I found that my knee worked great going up, but the going down was a bit problematic.
I suspect your doc is right about having a partial tear. I suspect I had one as well-I had a wicked fall once during a race involving a hole-I tried to stay up and actually ended up running about twenty feet before I finally hit the ground. I think that the stress did some damage. I did wear a basic knee brace after that, but just followed the same philosophy as you.
As soon as I learned I had the tear, I thought about how I’d deal with it. I immediately decided that I would be positive and do the best with the hand I’d been dealt. Interestingly, my philosophy experience was useful here-I had coincidentally being reading Plato’s Republic and he wrote about when one falls, the thing to do is get back up and focus on mending the hurt (rather than crying). While I know that positive thinking does not make stuff happen, I also know that defeat and victory begin in the mind. I’ve been very pleased with the positive outlook of the folks who have posted here and have tried to do my small part in providing what encouragement I can.
I’m confident that you’ll be back. With a tear, there is almost never any reason why someone can’t get back to their fitness routine. After all, some folks lose a leg (or two) and keep on running.
The bike should really help-I know it helped me stay sane. I need that cardio fix. 🙂
I found it useful to set recovery goals. That helped my OCD personality cope. 🙂
I had my surgery on April 3, and I’d say I am at about 80% in terms of running strength and speed. I can do 7:18 miles in a 5K, with surges down into the 6 minute range. I can even get below 6, but I am very cautious about that. In the martial arts, I think my leg is at about 60-70% in terms of jumps and kicking-but I’m being very careful about that.
My left leg is still visibly smaller than my right, so I can plainly see that it is not at 100%. But, when I first had the immobilizer off, I had almost no quad definition at all (that totally sucked). Now I’ve got good definition and most of the mass back. So, I’m a live parrot. 🙂
Mike
What percent would you say that you are at the present time? And this is a question for you and any others who read this blog. How far beyond surgery are you and what are you able to do?
Thanks Michael and all of you fellow Knights Who Say Ni! 😉
Tony
i slipped off the last stair of my deck today. first, after a short 10 minute rest i was able to walk. 2 hours later the pain worsened and it was becoming difficult to stand on my right leg. i iced the knee and raised it. swelling began and pain increased. after 6 or 7 hours i cannot stand on injured leg. the swelling increased. i think it is a quad tendon tear as the pain and swelling is under and above the knee as opposed to the pain i had mid way above knee when i pulled my quad muscle on left leg. i plan on docter/hospital visit tomorrow. great site for info, thanks!!
Jason,
Sorry to hear about your fall. I hope that you didn’t tear anything. Being able to walk is a good sign, although I could walk after my fall. Are you experiencing any “knee slip” (that is, your knee goes out when you try to walk)?
Michael et al., I don’t want to mention the term “setback” but alas I have no choice. My surgery was June 4, three weeks after an unspectacular bike crash that ripped my quad tendon off my kneecap. After 5 months of PT we were able to build up substantial leg strength, I returned to biking, golf and swimming but no running. I still had some swelling, limited ROM and most recently a noticeable and not pleasant pop every time I walked down the stairs. After an MRI, my doctor recommended that I have arthroscopic surgery to remove excess scar tissue and that we do an “MUA” manipulation under anesthesia. In other words bend your leg all the way while you are, thank god, asleep, to break the rest of the scar tissue. Did this all this past Tuesday and, unlike, first operation PT started the next day. Goal is to be 100% with good ROM (over 135), stretching my knee already feels different, feels like a more normal stretch rather than a very tight knee so am cautiously optimistic. Best of luck to all. Ted.
11 days post op. on complete quad tendon tear…….pain less than I thought,more of a stinging ,burning where the cut,stitches and staples are….have no control of leg and changing dressing is awful..need 2 people one to hold heel up,one to wrap and myself to brace back of knee….aldente spaghetti has more stability than my leg….been doing isometrics (tightening thigh muscles) but cant wait to start the real PT.I coach college baseball and expect to be throwing batting practice in march,with or without a brace….how hard should i push or go the slow route? Ray T
Ray,
Sorry to hear about your tear-it sounds like a bad one. I had no ability to lift my lower leg, but had some stability-so I just needed one other person to help with the dressings.
My advice would be to not push things. Prior to my own injury, I was a “push it” sort of guy, but the severity of the injury and the prospect of having to go through the surgery and recovery again change my mind. Also, pushing hard in this case would not really speed things up that much-mainly it is a matter of waiting for the body to repair itself, at least at first. Once the tissue is healed a bit, you’ll be able to do some basic exercises-mostly just stretching at first. Be sure to get a good PT who understands your specific injury. Once you get a program, then you can push it-within the limits of your recovery.
What can really help is doing what exercises you can with the functioning parts. For example, I got a Bowflex and a stationary bike (rode that 1 legged). That not only speeds up the recovery process, it also keeps you sane.
91/2 weeks post op. things seem a bit better…am functioning with brace weight bearing with and without crutches (doc told me with only)..have not started any pt with weights..just range of motion..doc. told me wait 2 more weeks..he wants cement to grab? what the heck does that mean? first I’ve heared of cement?….is cement or an adhesive used in these operations?..I thought it was sewing the tendon and attatching it to the knee cap…Cement? does anyone know of this terminology?..other than that I feel the swelling decreasing,since I’ve been moving it more..cant wait to hit the weights and get my thigh back
I guess this site has ceased.. no one has responded to my last post..but.. anyway I am 10 week PO and still have brace on and havent done any weight bearing PT stuff…my range of motion is at 110..and I can weight bear without crutches with ease..Am i behind sched.? or is my Doc. just taking a conservative approach? thanks Ray T
Hi Ray, I had surgery last June and as I recall 110 sounds about right. But, I wouldn’t worry about where you are with your ROM so much as whether you are still improving or not. I eventually got stuck at about 125 degrees after 5 months and a lot of work. My doctor recommended at that time a second surgery called a manipulation under anesthesia, I described it in a post on this blog. It worked quite well and I have pretty much the same ROM as my good knee which is about 140. I have been even able to start running again so there is hope, it just takes a very long time to get back to normal. Other issue for me was that I had tight knees to start so tight knees is what you end up with. Good luck. Ted
Ray,
Everyone proceeds at their own rate, and there is no fast and firm guideline for recovery. As Ted said, as long as you are making progress, you are on the road to recovery. I hit a plateau at about 10 weeks, but have made substantial progress since then.
At 12 weeks, I was at 105 degrees; my doctor was a little annoyed, but the physical therapist said I shouldn’t worry. At 16 weeks, I’m now up to 130 degrees, and can walk up stairs normally (but not down – yet). We are continuing to strengthen the muscles, but I am not yet back to the pre-injury strength, and don’t expect to be for a while.
My silver lining is that I was excused from shoveling the 34″ of snow we got yesterday (Maryland)!
I guess this site has ceased? no follow -up to my 1/13 posting…
I have a partial tear and after talking to the doctor and physical therapist I have decided for surgery.How long before one can drive? Anyone try therapy without surgery and had good success?
Thanks
I drove without docs permission after 8 weks of my operation..but it was a challenge.the more you increase youre rom (bending0 the better you will be..my doc said legal concerns .getting into an accident with a brace or immobilizer on is not good.i am now 10 weeks PO and driving ok am at 123degrees but last week i was at 105..so be positive and drive when you can drive or get in and out of car alone..relying on rides sucks..Onceyou start weight bearing with or without crutches strenghtens your leg..go slow and do what you can do..i thought my doc was conservative,but it is all working out.
Has this site ceased? any follow up comments?
Ray,
The post is still going, I just missed the comments under all the comments on the newer posts.
Last week on wednesday I slipped on ice while walking and hurt my knee since then I am not able to bend my knee and can’t do straight leg raise test.
I went to ER and they took x-ray and checked my knee with ultrason and said they couldn’t see anything. I have an MRI appointment for Thursday. I hope then everything will be more clear.
But I think I torn my quadriceps tendom. I can’t do any contraction. As I learned If an operation will be done for this injury it has to be done as quicly as possible. Since then already 6 days passed and still they couldn’t diagnose me.
Bests for everyone.
Adam,
The straight leg rise is generally considered a fairly definitive test, although other injuries can also impede movement.
As far as the x-ray goes, they won’t show tissue damage but can show if the kneecap is out of place. If the knee cap is too low, that is a fairly definitive sign of a tear. In my case, the doc did a diagnosis without an MRI, since the x-ray clearly showed my knee cap way out of place.
My operation was 8 days after my injury and my recovery went well. Of course, the earlier the surgery, the quicker you’ll be back to normal. In my research I did find that people have been operate on quite a while (weeks even months) after the tear and still came through fine.
Good luck-I hope that you didn’t tear the tendon!
I injured knee on 11/22 and had operation 12/3..usually they say 2 weeks is operating soon…youre ok
So, I’ve been reading many posts of folks who have gone through what I’m about to regarding surgery for quad tendon tear. I have an added twist to my story and was wondering if anyone out there has come across some useful information.
My situation:
I’m an above knee amputee who wears a prosthesis. My hydraulic knee has had the tendency to buckle without warning due to a failure in the unit. This failure is common once the seal of the hydraulic unit becomes worn and leaks fluid.
I was tossing a football recently when the prosthetic knee buckled and in an instant i fell. Unfortunately the “good” leg wrapped around the prosthesis and as I hit the ground my real knee was stretched too far, considerably tearing the quad tendon.
I’m wondering if anyone has any experience similar to mine in which after having surgery one does not have a remaining healthy leg to stand on.
I’ve been getting around on crutches and the one injured leg in a brace..I’m pretty good on crutches as I walked on them for eight years after my amputation and prior to wearing a prosthesis. But, I’m guessing walking on crutches is going to be very different after my surgery next week.
I have also put the prosthesis on once or twice and locked it in a straight phase position. In that phase and with my knee brace on the injured leg I can “Frankenstein” walk around a bit, but I don’t trust the hydraulic unit as it has a habit of clicking back into a normal bendable knee phase and more potential buckling!
I know a wheel chair may be in my future and for how long, I do not know.
Any feed back is greatly appreciated.
Thank you,
Patrick
I just found your blog. I am having quadricep tendon surgery tomorrow morning. I had the option of spending 24 hrs. in the hospital and I am taking advantage of that. My injury occured when I opened that basement door to go downstairs and someone had placed a towel on the other side of the door. I was able to keep myself from falling down the steps by grabbing the door jamb, but was unable to stay on my feet. I could not get off the floor. Most painful thing I ever experienced. Left the house by ambulance. I was seen in emergency and was told I had a deep muscle contusion and was released. I did not know how I was going to get off the bed. Somehow I managed and spent the that night and the next in bed until 4:30 pm the next. I followed up with my doctor 5 days after and had an Mri that afternoon. I seen the surgeon on Thursday and he is going to surgeory on Saturday. I have the first surgeory of the day 7:30 am. I opted for the 24 hour stay in the hospital because in May 2009 I stepped off about an 18 inch wall and I actually heard my achiles tendon pop. The day after that injury was the most painful for me. Thats why I opted for the stay this time. Hopefully I will be more aware of how I actually feel when leaving the hospital. I had the out patient surgeory and did not even remember how I got home or even got in the house. I left the outpatient surgeory center doped up with crutches and I am 51 years old, 50 when that happened and never ever had to use crutches. I just found that wierd, after thinking about that situation I thought it to be quite dangerous. I abandoned the crutches after a few tries at getting the hang of using them. The way my house is setup, when you go from the first floor to the second floor, at the top their is about a 4 ft landing but the door to the bathroom is on the left at the top of the steps and closer to the steps than the wall across from the steps. I used a walker I really feared falling with the crutches down the steps. I am hoping I will be able to use the walker again. I do have a friend that has a one level house no steps with only about 1/2 step from her garage into the house. I can stay their, but I hate putting a burden on her. I have 6 steps to the front porch of my house and 13 to the bedrooms upstairs. I shake my head and simply cannot believe this happened. I have been promised that no more dirty dish towels will be placed on the otherside of the basement door. I guess I should have been more observent before I stepped.
Mike,
I hope your surgery went well. Good luck with the recovery. Like you, I learned a valuable lesson from my experience. Mine was “stay off ladders.”
I opted to go home the day of my surgery, mainly to avoid the extra cost and the exposure to infection.
had quad tendon operation 12/3,tore tendon and avulsion(came from knee cap)am progressing,started bike and eliptical 3/1,have progressed to 50 min on eliptical(used to do 60),but have also started stair master 3 weeks ago (10-20 min).I am not at my normal workout routine but getting there.Stair master has increased strength.I put on 8 lbs,due to negatve binge drinking.I was just pissed off at being hurt.It does take time ,I have started light jogging,2min walk,1 min. jog,for 15 min.still need to get muscle mass back,and am doing it with leg presses and short arc quads.Do your therapyand take it slow it will get better.
I fell on the edge of a 4inch deep pothole as I fell my foot went one way and my knee the other I heard a sickening ‘pop’ and had a searing burning pain in my knee- – I broke my back at 11 years of age, broken other bones over the years but I have never, in my 56 years experienced any pain like this. I was taken to hospital – xrays showed no break so was sent away in a cricket splint and crutches and a follow up appointment. At my follow up I was assessed and given an ultra sound only to be told I would be admitted to hospital for a quadricep tendon mechanism repair as I had completely torn the tendon away from the knee cap. I had the operation on 29th May and was in hospital 5 days – released from hospital in the cricket splint. I had the staples out 14 days later and had an adjustable splint put on. Yesterday I had my first physio and the splint has now been set at 30 degrees – that wasnt too bad but today I feel like I have gone backwards as I an scared to walk as my leg wants to give way. I have tried my excercises but am unable to lift my leg as they said I should be by now – anyone elses experiences of this type of injury and recovery will be most welcome
Sue,
Sorry to hear about your injury, but I’m glad you are making progress. When I was injured, it took me quite some time before I could raise my leg. I blogged about my progress here-you can do a search on the site using “quadriceps tendon.”
Hi,
My situation is a little bit different from all of yours. I had total knee replacements in 2007. Apparently my body does not like the knee replacements and forms a fibrous tissue (not scar tissue)in my knees. Last Aug I had to have my right knee scraped out to remove the fibrous tissue. This past March I had my left knee scraped out but before surgery I discovered two lumps above my knee and there was a divot above my knee also. The Doctor said before surgery that he would check out the lumps before he closed me up but not to be too upset if there was a full incision when I woke up. He scraped out my knee and found two nodules attached to my quadriceps tendon. He removed the two nodules. I have been in a knee mobilizer since then. I was home bound for 12 weeks with my knee at 0 degrees and had therapists coming into my house. My brace is now at 90 degrees and I have started outpatient therapy as of the beginning of June. I am weight bearing as tolerated. My PROM is now at 87 degrees. I was told to expect at least a 9 month recovery and will be wearing the brace for quite some time and when I finish with that brace I will have another one not quite as bulky to wear after that. I’m on a walker as my balance is not quite steady enough for crutches.
I worked in therapy and I know that there is light at the end of the tunnel but it takes time. The only thing that I can tell you all is you have to have patience and just make sure that you do your exercises because you have to get the strength back into the leg and that only takes time and hard work. I told my Doctors that this is much harder than having a total knee replacement. God Bless You All.
Rosemarie,
Good luck with the recovery.
Interesting reading – Quick health history; very active from age 15 – soccer through college, indoor and outdoor court sports, running (only up to 15 miles, recreational, meditative), alpine racer/coach, etc.) Severe burn (85%) at age 30; excellent recovery (notwithstanding significant scarring, some minor ROM limitation) due to health, nutrition, support systems.
History of injury: May 27,2010 – unbelievably minor slip on boat ramp; resulting in full thickness tear of quad tendon, 40% additional tears lateral quad, patella dislocation.
Surgery June 8 by Dr. David Casey at Pinehurst Surgical; sedative, spinal and femoral blocks, overnight, released the following morning with knee immobilizer; staples removed two weeks later, full straight leg cast to current date (July 4).
Some surprising struggle w/ dealing w/ the immobility, hence the search for additional support systems – am trying to keep busy by reading (six books so far), taking a class (UOP), trying to maintain schedule w/ volunteer commitments (w/o traveling).
Pat,
Sorry to hear about your injury. It is odd how a minor fall can result is such serious injuries; but chance can be very cruel indeed.
My main coping mechanisms for my immobility were computer games, reading and using my exercise bike. I found that I could ride it one legged starting about 3 days after the surgery. My leg got rather sweaty in the wrapping and immobilizer, but it was well worth it. I also got a Bowflex a while after the surgery-since all the “weights” are from the resistance rods, I could just sit down and get in a decent upper body workout without stressing the leg. Also, it came in very useful for the PT once I was able to do that.
The PT also helped by providing a clear sign of progress. Being able to set clear goals and reach them helped quite a bit. After I could get about (after two weeks) I “walked” as much as I could. Eventually I could walk for real and then started exercises in the pool (followed by pool running with an Aqua Jogger). Finally I could run again.
quick update
fall/accident 20 May 2010 / operation 29th May for quadricep tendon mechanism repair – past 2 weeks the splint has been set for 30 degree bend and physio today set it at 60 degrees. I managed 5 straight leg lifts (in locked position) this morning and felt good as this was my first goal achieved.apparently my muscles have wasted away and so I need to work harder at them. the splint will be set at 90 in 2 weeks time then they are going to remove the splint and teach me to walk without it – wish I could turn the clock back this has not been a good year so far what with one thing and another.
I have been off work since 20th May and am signed off for 4 months at least- I do a desk job but i have to drive to visit outstations – I know theres no hard and fast rule of people returning to driving and working but wondered what others timelines are?
Sue,
Sorry to hear about your injury, but I am glad to hear that you are on the road to recovery. I had my surgery at the start of April last year and was driving without any problems again in early June.
One factor will be how much you can bend the leg. In my case, I’m tall and have a small truck-so being able to fit comfortably took a while. Another factor will be whether you have to work a pedal with the injured leg. In my case, I have an automatic and busted up my left leg, so that was not a factor.
Not sure if anyone is still reading this site but it has been an interesting read for me and I appreciate Michael for creating it and all that have added to it.
September 12th, 2010 I had a weightlifting accident where I was trying to re-rack the weight on a Smith Rack and didn’t lock it out properly so as I released, the 350 lbs on my back and my 225 lb body came tumbling down with my left leg underneath me and hyperflexing to the point of the complete quad tear.
I had my surgery September 16th and was in a compression bandage and fully extended brace for 2 weeks. The bandage came off and I was told I would be in the brace for another 4 weeks but my next appt is at the 3 week mark October 12th.
My OS is different than most because he wants me bearing no weight on the leg whatsoever until 6 weeks after the surgery. I asked if I could go to the gym and do upper body weight training and he stated he feared the action of the weight training causing the entire body to tense and flexing the repaird quad, and was told no. The only thing I can do is take the brace off, roll onto my stomach and try to curl the leg. During my 9/29 follow up that removed the staples, he stated he would like me at 90 degrees on my next visit October 20th. My first attempt couldn’t get my toes off of the carpet. I’m just shy of a month removed from my surgery and still 8 days from my next appointment and am around 50 degrees. I’ve been feeling pretty bad about not sniffing the 90 degree mark with such a short time to go but feel better that some have experienced similar limits. I’m shocked at those who could start weight bearing, flexing, and moving the leg so quickly when I have been told to do absolutely nothing. I’m not even to weight bear while standing at the sink to brush my teeth.
I was really hoping to be back to “normal” by the end of the year but to read about people still not feeling good about going down hils or stairs 6 months after the surgery has me somewhat disheartened but glad that I can adjust my expectations. I’m really looking forward to being able to walk without crutches, bearing weight, starting some strength training, driving my car with a clutch (left leg) instead of my wife’s automatic, riding the motorcycle again, and being somewhat normal. I hate that it will take so long but appreciate all on the site for the information provided.
For reference, I am a 42 year old male, 5’8″ tall 225 and 15% bodyfat (presurgery). I hate to think what I am now because all I hear from my co-workers is how emaciated I look as it compares to my “normal”.
Robert,
Sorry to hear about your injury.
I suspect that your doctor is being extra cautious because of the extent of the damage or perhaps the doc is just cautious with such injuries. My doc had me putting weight on it right away and I was told that was part of the recovery. Of course, this was with the brace on and with crutches for the start.
You might be able to find some exercises that can keep you active without risking the leg. I was able to use my exercise bike a few days after the surgery and was using a Bowflex within a few weeks. If you have the extra cash, check with your doc and see if you can use one. Since it uses resistance and many exercises are done sitting down, there would be no real strain on the leg.
It did take me a while to handle stairs properly and even now my knee still feels strange. But, you will get through this and be back to normal.
It’s the one-year anniversary of my surgery for an 80% partial tear (treated as a full tear surgically). I can do pretty much anything that I could do before the surgery, but I am “aware” of the knee and have to think about going down stairs and steps. I was kayaking this past summer with some friends, one of whom is a cardiologist and who tore his ACL several years ago. As he observed me climbing in and out of the kayak, and later climbing around on the rocky island we picked to have lunch on, he said that I had an issue with “proprioception”.
I had to look it up – it refers to the body’s “nerve sense” to know where its limbs are without looking (that’s probably a poor translation, but I’m not a medical professional!). An injury like a quad tear also damages the nerve endings, and they take a much longer time to heal than the other damaged tissues. My friend’s experience was that it took him about 3 years to fully regain the “nerve sense” in his knee so that he didn’t have to think about where it was going to land when he extended it. There are lots of references to exercises to address this on the web.
So, the good news for me is that I can get around just fine and that the fact that I have to “think” about where to put my repaired leg on a step or stair is not abnormal, and that – eventually – I’ll get all or most of that feeling back. I don’t expect to regain full sensation in the skin where the nerves were cut for the incision, but I’ve had other surgeries, and most of the feeling returns eventually.
Dave,
Interesting. I did wonder about that sort of impact. I did notice I was very cautious with my leg (actually, I still am). Even now I am extra aware of the leg, mainly because of spending so much time protecting it. My running seems to be fine, though-perhaps all those miles really burned into the nerves. 🙂
I am now 18 months post surgery and was wondering similar things, in that my knee is mostly fine but still gives out every once in a while and feels tight above the knee. I knew the giving out was nerve related and hope the tightness goes away. Having said that, it all works pretty much fine. Best of luck to all.
You can probably expect the tightness to remain, at least if my experience is an indicator.
It takes up to a minimum of 2 years for nerves to regenerate after any serious surgery. I was at 30 degrees ROM after my surgery in March. I am now at 104 degrees PROM, and 95 degrees ROM currently. It’s a long hard struggle but you will get there. I have basically just started working on doing steps the right way today and it’s going to be a lot of work but you just have to keep working on it.
Good luck!
I had a full on, ripped from the bone, quad tendon repair that I collected while playing in a tennis tournament in Sept. 09.
It’s been one year for me! I posted here on October 29, 2009 when I was three weeks post-op and looking desperately for anything that might give me a word of encouragement. And this was a great place!
In April 2010 I won my age group in a local 5K! That was 7 months after surgery.
There have been set backs and I’ve had to have fluid drained from my knee several times. In May I hit my knee on a metal bench when I was walking toward it and not paying attention. I had to use a cane again for a couple of weeks. ugh.
To those reading this who are early in the process, be patient and know that your recovery will take work and won’t happen in a linear straight line toward 100%. There will be ups and downs. Just roll with it and keep your spirits up! Celebrate ALL of your victories and any progress, large or small! And if you have a set back, just be patient.
I’m training for a half marathon in December. This past Saturday I ran 10 miles! That’s the longest I’ve run since surgery on October 2, 2009!
A year ago I was so depressed that I thought I’d never run again. Don’t let those dark voices into your head! Do what you can! Work around your injury. Do your PT. Do your homework. Suck it up and don’t give up or quit!
Good luck everyone out there who is battling your way back! No one knows what you’re going through like the readers and responders on this site!
Thanks again Michael. This was, and is, a great thing!
Tony Ludlow
Memphis, TN
Tony,
It is great to hear that you are doing so well. Good luck with the half marathon!
I am glad to have had the opportunity to read this blog and thanks to Michael for starting it and sticking with it. I am going for surgery in two days for a partial tear and I am more informed by all the comments from everyone. I now know so much more than I did before. I will keep you informed.
Slim
Slim,
Good luck with the surgery. Since you have a partial tear, you can probably look forward to a faster recovery.
Im glad to see people are still finding this site and taking comfort from people who have been through or going through the painfull knee injuries.
I have posted a couple times and here is my update.
I fell awkwardly on may 20th 2010 rupturing my quadricep tendons – right knee. I was operated on to repair the mechanism on 29 may. I have a desk job but am still signed off 5 months down the line, as although I am now able to sit – my leg continues to give way causing pain when doing so. I am still receiving physio. I have had a course of hydro-therapy (that did the bend a world of good) but I just cant do a straight leg lift (I can lift my leg but apparently not using the muscle and so its wasted away). I still have to use one crutch and cant walk too far. I have been in a meeting with the HR e from work and felt because they have never experienced any knee problems they do not understand- I feel like they dont believe the trauma I (like thousands of others) have been through. I have now been asked to attend the occupaional health dept. in order to see how I can go back to work. I want to go back so im ok with that.
Has anyone else experienced a disbelief of the extent of such injury and how do you cope with this
sue
Sue,
I didn’t run into any problems with people doubting the extent of my injury. I was out of work for two weeks (but kept my classes going via the web). Going back to work was rather challenging because of all the stairs (inside and out) and the need to get across campus between classes. As you said, sitting was rather difficult-I would unconsciously just let the leg straighten out.
You might be able to educate the folks who have doubts about the injury by telling them about the nature of the injury and how this requires a long recovery time.
Sue,
I feel for you on the work thing. My injury happened the day before a weeks vacation and my surgery was the Thursday of my vacation. I work from an office but have an ability to take my work computer (it’s a lap top) and travel with it so I was approved to work from home and was lucky to only miss two days from work. I’ve had some friends that equate it to their knee surgeries even though they were working the knee and the muscles around them the next day and I’m unable to do a damn thing for 6 weeks. It’s such and uncommon injury, I can see how people have a hard time understanding.
Guys,
You are killing me with the leg “giving way” and I’m stressing about the going down stairs and hills being something you have to “think about”. I guess I envisioned me just being back to normal in about 3 months and to think this could affect me 3 years or more is incomprehensible at this early stage. How does it affect any sprinting or weight bearing exercises like squats?
Robert,
In reading through all of these posts, it seems that there is quite a bit of variation in the speed of recovery and the amount of rehabilitation required because everyone’s injury is unique, even if the damaged structure and repair procedure are similar. It’s an uncommon injury, which is why it is not so well understood, and – at least in my case – it took me a while to grasp just how serious it was. Pro footbal players, for example, don’t bounce back from this kind of injury the way that they do from an ACL tear, and they are a lot younger and in much better shape than many of the people who post here (and they get first class rehab treatment too!). For example, there’s a guy on the Ravens who had his surgery about the same time I did, and he is still on the PUP list, while two of his teammates who tore ACLs later in the season are back playing.
This blog has been very helpful to me because it helped me to see that there truly was a light at the end of the tunnel. It’s a process – everyone moves forward at their own pace, but there are common milestones that most of us go through. Age and physical conditioning also have an impact. That said, your orthopedist and/or physical therapist are best equipped to advise you on how long the recovery and rehab process is expected to take in your particular case, and when you can resume strenuous exercise of the type you describe.
I haven’t read of anyone who was back to normal in 3 months, though, but I’ve read about some people who are aggressively athletic and who were back doing long bike rides, running, or skiing at about the 6 month mark. You do want to be careful in your rehab, because if you rush it, you run the risk of repeating the injury, and it’s tougher the second time (at least that’s what I’ve read).
Robert,
My leg was unreliable for quite some time. However, I was able to start racing again in about 6 months. My knee still feels weird, but you should be back to full capacity withing that time frame. I’ve had no problem with sprinting or weights (other than the impact of age).
Unless someone has been through this they have no idea. Even though you may have a desk job I don’t know about the rest of you but I had trouble sitting for any longer than 20 minutes at a time. I can now sit for longer but I still have problems after 6 months. You try to explain that to someone like your employer and they just look at you because they think that you should be able to sit and do your job. When I had shoulder surgery I complained to my one therapist about things that I could not do and they just could not understand what I was talking about. My therapist later had shoulder surgery and told me that now she understood what I was talking about with the difficulties in doing things.
True-I had no idea how rough it would be or how challenging it would be to get back to normal stuff.
Dave,
It is definitely a freak thing making it infrequent and uncommon. I agree everyone is different and heals at different rates and I’m continually astounded at the time this will take. I definitely won’t rush anything past what is safe because there is no way I want to go through this hell again. I wasn’t aware of any pro football players suffering this type of injury. Who is it?
I’m only 4 weeks from my surgery and just feeling frustrated. I’ve worked hard to stay fit and the 15 PBS of muscle lost during this period of inactivity has me wishing for a milestone I CAN celebrate. Hopefully, that arrives with my next OS appointment by him telling me I can weight bear, start PT, and go to the gym for upper body workouts. Once I feel I’m progressing, I’m sure my mental state will improve over the despair I’ve been feeling. The only thing I’ve really felt a progression on is my arm pits not hurting from the crutches anymore. Thanks for the input.
Rosemarie,
I definitely have to switch positions with the leg from being elevated to sitting more on the edge of my seat and it extending straight to the ground at my desk job but I have never had a problem sitting mor than 10 minutes due to me being in a non-weight bearing phase. It seems like all I do is sit sit sit.
Robert,
Like everyone else here, I watched my quad muscles (there are 4 in the group) shrink weekly while the right leg was immobilized, and for a while afterwards until PT began to restore muscle mass. In my case, the injured leg has always been the “good” leg (I have a congenital left hip condition), and it was astonishing to watch the right leg atrophy to the point where the two were almost identical in size. Months of regular PT completely restored the strength and most of the flexibility in my right knee, but I have to keep working on it regularly.
I’ve felt that the joint isn’t quite normal, particularly when going down stairs, but when my cardiologist friend identified the medical condition it made me feel a little better to know that it is not abnormal and that it will pass with time – it just is going to take a little longer for me than I thought it would.
Brendon Ayanbadejo (an all-pro special teams player and linebacker) ruptured his quad tendon against the Patriots 10/4/2009 and is still on PUP. Do some web searching for the condition – that’s how I found this blog (there’s another one at EpicSki.com for people who are aggressively athletic – not like me!).
Dave.
I really appreciate your quick feedback. Sorry to hear about the hip issue. Are you going to have to get a replacement? I’ve heard of some really good success stories around that.
I’m definitely ready to start some PT and just hope the doc gives me the ok when I see him next on the 20th.
Hello folks. I suffered a complete quadriceps tendon rupture in December 2009, and I became an avid reader of the blogs during my recovery. You guys have provided a good deal of inspiration for me. I am a former strongman competitor and weightlifter. I ruptured by quad tendon by slipping and falling down a flight of steps in my home. As of October 2010, I have fully recovered, and I hope the video below will inspire others.
Take care, and keep your head up.
Joel,
Great to hear that you have recovered and back to lifting. I’d need a crane to lift sort of weight. 🙂
Wow. That video said it all. I am a full quad ripper one month today post surgery. Your scar looks exactly like mine. I hope my recovery looks like yours. I am an athletic older female and u r inspiring my recovery efforts
Good luck with your recovery!
I had my surgery on the 16th and the Dr says all went very well. I have had little or no pain since the surgery and happy for that. I am in a full leg solid cast until next Monday and the I go into a range of motion brace. I know I will be happier when I take off the cast as it weights a ton. The Dr has allowed me to put weight on my leg once it is comfortable to me. Michael, what can I expect when I go in the brace? How soon can I expect to start using the set bending on the brace? I am also looking forward to starting PT as soon as possible. Even with the heavy cast I am able to do some straight leg raises now.
Slim,
Sorry to hear they put you in a hard cast. I was in a “soft” immobilizer, which was probably much more comfortable than a cast. One you get in the brace, you will probably be locked at 0 flexibility for a few weeks. I got a bit every few weeks, starting with 10%. It was a slow process.
What you will probably find a little odd is that it is hard to get the flexibility back. Your PT/Doc will almost certainly give you a set of exercises aimed at restoring flexibility to the knee. You will also get exercises to get the muscle back. Be prepared for having your leg muscles shrink down a great deal-I was shocked at how small my leg muscles had become.
Need some input if anyone out there is still reading this blog…on November 12, 2010 I slipped on black ice, landed with all my weight on my right leg causing a 90% tear in my quadriceps tendon. Operated on 11/19/201. After reading all of the helpful input on this blog relative to my injury, I am resigned to being laid up for at least 8 weeks due to my age (71). I have never experienced this type of an incapicating injury which requires assistance in things like going to the bathroom, using a bedpan (which is truly disgusting) or using my walker to get to the raised toilet seat. As I have never used either device, I feel as if I have two left feet, especially getting on and off the raised toilet seat without causing great pain to my injured leg. I would also like to mention that my wife and I have been married for 45+ years. After post op of three days she and I are both very frustrated and at each other’s throats already. Any help or advice out there? Nobody else who wrote on this blog seems to have mentioned the personal hygiene issues or marriage issues…another issue is lowering the injured leg off the bed to the floor (we have a king sized bed with a tall mattress)…
Dennis,
Sorry to hear about your injury. In my case, I was able to handle all the toilet and shower stuff myself (although it was challenging). My girlfriend did help me out a great deal, but we did not have any conflicts. Of course, she got to shoot me in the abdomen everyday with the anti-coagulant, so that probably helped her.
As far as getting off the bed, maybe you can move another piece of furniture close to the bed so you can transition without the abrupt drop?
Dennis,
I think that we all have experienced the things that you are talking about. Make sure that your raised toilet seat has bars along the side that you can lift yourself up off of the toilet with, don’t just have a raised seat as you need more than that. As for getting in and out of the bed you should be on the side of the bed that your injured leg will go up first on the bed and then the other leg. You need to use the good leg as much as possible. When you get out of the bed come out with the good leg first and then the bad. Get yourself a small step stool if the height is high. Your wife will have to help you for a while but as you get stronger you will be able to do it yourself. You are lucky that you have a wife who can help you. I had no one and had to learn how to do it myself. When you were in the hospital did you go to Occupational Therapy? They should have showed you how to do things like getting in and out of bed and on and off the toilet. Don’t be stubborn about using Occupational or Physical Therapy because that is what they are there for and they will teach you many ways to do things. It does get better as time goes by but you have to have a lot of patience because I’m not going to kidd you it’s a long haul. You have to be really good about doing the exercises because you need to start building up the strength of the muscles and the only way to do that is through Physical Therapy. Good Luck!!
Sorry to hear about your injury Dennis. I had my surgery six weeks ago. Being a heavy person and living alone, I had a block and tackle system installed to my ceiling over my toilet so I can pull myself off of it. It has been working great.
Dennis, it gets better as the weeks go by. I can not respond on the wife…LOL
I am in a DonJoy ROM brace and living outside the US. My OS wants to leave me at 0 degrees straight leg for a full eight weeks. From all that I have read I should have started some fixed bending by now. Any suggestions?
Dennis,
This does get better with time. I had an 80% tear over a year ago and also have a high mattress, so I needed help from my wife in getting out of bed for the first week or so. As Rosemarie suggested, sleep on the side where your good leg is on the outside of the bed so that you can use it for support as you swing your leg out and down. I am assuming that your injured leg is in a locked brace, so it shouldn’t bend as you swing it out of bed, but you will need help at first just to lower it out of bed. A low stepstool can help too.
Having a high toilet seat is a great help; I didn’t this time (I did when I had major hip surgery about 20 years ago) and it was very awkward at first. I really had to lean on my crutches to get on and off the seat. Using something like Dulcolax or another stool softener helps too, as some of the pain medication can cause constipation.
At your age, it may take a little longer to achieve some of the milestones that everyone else talks about here, but it will happen eventually.
Want to thank you all for the replies to my questions…they have been a big help. I learned I have been sleeping on the wrong side of the bed!!! Did any of you get little “stabbing” pains in the upper portion of your thigh during recuperation? Feels like little knives jabbing. My wife thinks it is the healing process from pulled muscle damage done at the time of my fall…the doctor doesn’t seem to really have any answer. He is a good surgeon, however. So far I am making some progress. I am in a brace with a 30-degree bend and anticipate increase to 45-degree when I see the doctor next week. Hope you all have a very Merry Christmas and Happy New Year.
Dennis you are getting the jabbing pains because when they operated they had to cut through nerves, arteries, veins, muscles, ligaments and such. Everything has to rejenerate and grow back and those are the pains that you are feeling. Everyone really goes through it. I worked in physical therapy and that is part of the healing process. You will be going through that for awhile. Everything has to grow back together and that takes time, my Doctor told me that it actually takes 2 years for the nerves to grow back. I had my surgery in March and I still have pains. My Doctor told me that because of how deep he had to go in, that is major truma to the leg and it is not a simple recovery. Just keep up the good work and hope you and your wife have a fantastic Merry Christmas and a Happy and Healthful New Year!
Thank you, Rosemarie for that explanation…and now it all makes sense. Think I am being way too impatient and want this thing to heal, but day by day am coming to the conclusion that it will just take time…especially with the encouragement and help I have gotten from all of you out there!!!
Merry Christmas and Happy New Year to you and yours!!
Hi to you all.
As this is my first posting on this blog, I want to start by thanking you all for sharing your quads rupture experiences in this way.
On the 31 October 2010 I fell while jogging (I’m 48 years old and fit), hitting the pavement sideways, knee first, rupturing the quads tendon and dislocating the knee cap in the process. Paramedics sorted out the dislocation before taking me to the hospital where I was X-rayed and put in a splint cast and sent home to recover. The follow-up consultation with an orthopaedic doctor a week later also failed to spot the ruptured tendon, and subsequent treatment focused on the dislocation, only.
After three weeks the splint was removed, and I started intensive physio therapy to recover strength, balance and range of motion. I spent many hours per day on this and learnt to walk and swim reasonably well within 10 days, but proper straight knee lift was still impssible, and walking up and down stairs (facing forwards) was also impossible.
On the 30 November (exactly 1 month after the injury) I had arranged an appointment with an expert consultant on knee orthopaedics. The first thing I said to him was to apoligize that I might be wasting his time, because I was recovering quickly from the injury, and that I was just seeking confirmation that there was no significant soft tissue damage. As soon as he felt the 2 cm gap above may knee cap where the quads tendon normally sits, and the wedge of displaced quads muscle tissue above the gap, the consultant doctor became quite concerned and sent me for an MRI scan. Complete quads tendon ruptire was confiirmed. Two previous doctors and two qualified physios had failed to diagnose my real problem, perhaps because I was coping better than expected with such a significant and serious injury. I was told I would never be able to run and never be able to walk properly up and down staris without surgical repair.
I was operated on the 10 December, 6 weeks after my fall. This is late and far from ideal, as the tendon and quads have stiffened up and shortened by then. Artificial tissue had to be used as a bridge between the quads tendon and the patella. Initially after operation I was in considerable pain. Quads seemed on fire – just thinking about flexing the quads gave shooting pain through the leg.
I’m back in the same splint cast again – depressing, but this time I know i am on the road towards real recovery. Today is 9 days after surgery and I have been essentially pain free since day 4 (when I went back to work full time in an office). Surgeon says I can put weight on the operated leg, so I manage without cruches while at home and in the office, using crutches outdoors and for walks longer than a ten meters or so. I’m 48 years old and fit, keen on running, swimming, fitness and gym, doing exercise more than once a day on average when injury free. Today (day 9) was the first post-op day back in the gym. Was able to do a full upper body and abs workout with the splint on, leaving the crutches behind. Had to rest with my leg up and ice afterwards. The general idea is to keep the knee straight (or slightly bent without load?) for 6 weeks post-op to allow the repair to heal. Thereafter, I expect intensive physio for many weeks to get some leg strength back.
Erik,
Sorry to hear about your long road to a proper diagnosis. At one time it would have surprised me to hear that it had not been diagnosed properly, but my own experiences have shown that seems to be pretty normal (I essentially had to diagnose myself using Google and then went to a second doctor to get the referral I needed).
I hope your recovery goes well. From what I have read, repairs have been done as much as a year after the injury with success. It sounds like you will have no problem sticking on the road to recovery.
The missed diagnosis is perplexing and should not happen so frequently as you say. My quads tendon was indeed completely ruptured, as seen on MRI by the OS. At the time of the initial (incorrect) diagnosis, an X-ray was available that shows a small piece of bone broken off from the top of the patella that has moved up the leg (a cm or two) with the broken tendon. This was not deteced or not correctly interpreted by the two first doctors that saw me, and not by the X-ray doctor either. The X-ray statement says ‘no fracture’, and this is plainly wrong. The physios saw me in generally good physical condition, being able to stand walk and swim front crawl, and did not question the doctors’ diagnosis, although they could see and feel the gap above the patella. Apparently – the two most useful indicators of quads rupture are 1) inabiility to straighten the leg (from bent) while lifted and 2) you can feel a gap above the knee cap (where there should not be one) – both of which you can do yourself at home!
Today is day 14 post-op. I’ve seen the OS, and he is very pleased with how it looks: no pain, no bruising, almost no swelling. But I must keep the knee immobilised for the duration of the healing process (to six weeks post-op), with passive ROM to 30 degrees as the only exercise. This very cautious approach is motivated by the use of artificial tendon material to bridge the gap, in my case, due to the late diagnosis. Full weight bearing is OK.
Erik,
I assume docs are like most people: we tend to just learn what we need most often for the job and don’t think much about less common matters. The doc who looked at my x-ray said nothing was broken, but gave me no more advice beyond putting ice on it. The x-ray showed a classic tear-the patella was way out of place. When I saw it, I could easily tell that something was very much not right. Google, as it often does, saved the day for me.
Good luck with your recovery-you’ll be doing PT in no time. Be prepared for a challenging recovery, though. You’ll actually have to learn to walk again.
Today is 23 days post-op and I’m very happy that more than half of the 6-week long immobilized healing period is now behind me. Since driving my car is out of the question, I have focussed on regaining some independence by increasing my range and endurance on crutches. The local shops and the gym are now within easy reach under my own steam, which is great! The unexpected plus is that my wife and I go for daily walks (me on crutches) for miles which totally exhausts me and makes my hands. arms and shoulders ache, but this is the type of challenge and stimulation that I need. The injured leg does not seem to mind, as it is protected inside the immobilizer brace.
Has anyone tried swimming with the immobilizer on? I have tried but the brace is quite heavy and drags the leg down. Would like to try again with some buoyancy aids for the leg?? I have two immobilizers so I don’t mind that one gets soggy wet.
You again? 🙂 🙁
Good to see the post-op period is going well. . .
Erik,
I didn’t try swimming with my immobilizer on-by the time I got the okay to do pool work, I was out of it. I must admit that after going without a proper shower for quite a while, I was tempted to jump in the pool. Well, carefully wade into the pool anyway.
Erik @ 12/19 5:14 I see that this is your first post. I’ve been posting here for several months now as erik–in fact, I believe I may have started as Erik in Sept. You’ve just begun posting as Erik. This may not seem to be a problem, but I’d rather not have other posters confuse your posts and mine. You could become the unfortunate recipient of some vituperative responses aimed in my direction.
I’ll forgive you this time 🙂 . May I suggest that you change your poster name ? Eureka, perhaps? Or Urik? Or Erik2. Etc?
And btw, good luck with the therapy. God bless.
Hi to all, just a short update on my recovery. Yesterday was nine weeks since surgery. My brace was taken off ten days ago and I started physio the next day. I have had three sessions so far, two sessions of laser treatment which I am told helps with healing and I have done some time in the pool. I am happy to say that today I am at 110 degree bend and I am feeling comfortable. I am also walking without any aids, stairs are still a bit of a problem and I am driving once again. So all in all I think I am on the right track to a full recovery in time.
I would like to wish everyone a very happy holiday and a great 2011.
I don’t know if you are all still out there, but have found reading the postings on this blog really helpful. I have just completed 6 weeks in a splint following a repair to my quad tendon. I have no patella from an injury many years ago, so the repair was not straightforward. I start physio next week. I can weight bear on my leg when it is supported by the splint but am surprisingly very anxious when my leg is not supported. I seem to have no ability to support it myself at the moment. Like many of you I am frustrated by sitting around and not being able to be fully independent. My husband has been very patient but I think I must have driven him mad. I had no idea that recovery was going to be so slow. I have been able to go to work but cannot do all that I need to do, and find I am exhausted by late afternoon. I have felt quite pathetic at times and thought I should be capable of more. Reading that others have taken a while to recover and being told its O.K. to take things steadily helps. Thanks everyone. I hope you are all well on the way to full mobility now.
Linda,
Good luck with your recovery. What you are feeling is natural-I felt the same way. The way I coped was focusing on what I could do and aiming at small victories each day/week/month. I had been accustomed to running and working out, so having to struggle to get from the bed to the bathroom was a bit rough.
Hang in there-it is just a matter of time.
Mike- I had a quad tear and repair surgery bery similar to what you had – had many of the same issues. Did you aor anyone else have any issues with swelling/soreness in the toes (and at the main joint “pad’ under the big and middle toe) of the injured leg ?
i wondered if it is arthritis or part of the inflammatory process of healing ??
I’m still working on my ROM (3+ months post-op) and after exercises the knee seems to get stiff again while I’m sitting down (propped up on footsttol) and seems I have to start over at same point at next session) I’d like to have more formal PT but Medicare only goes so far so I’ll be on my own after a couple weeks.
thanx for any info.
Charlie G.
(could I get a reply from you to my email since i’m not too good at net-surfing and finding this blog aagin)
Charlie,
I had some wicked general swelling of my lower leg and foot, mainly (I think) due to the brace. It needed to be snug enough to do its job, but this tended to result in swelling.
If you just have swelling in the toes, then that might be due to the brace (if your are wearing one). While I’m not a doctor, I’d say you should ask about that the next time you see your physician.
Dear Michael,
I am 54 days from surgery for the same injury you had. Mine happened on the job simply slipping on a wet floor. It seems after reading your information here we have had similiar processes and progress as time moves. I am 61 y.o. and an avid outdoors person…kayaking across the Sea of Cortez round trip, mountaineering and working for Outward Bound the past 27 years – but this one due to this injury…
I REALLY appreciate your site as I, at times, am overcome with anger and grief for the things I cannot do. Intellectually I “get it.” however the emotional issue is my main nemisis aside from the painful PT. As you stated one does learn of one’s self during times such as these and I am learning alot – some things I would rather not…be that as it may life happens and considering what is happening in the world I am fortunate to have the spouse I do, the wonderful surgeon Dr. Eric McCardy of CU Boulder and my PT Luke – who is a great coach.
So – do keep up the great site and work, it is very important, and good luck in your recovery.
Best regards,
Dg.
Dear Micheal,
I am 32 years old male. I slipped on my office stairs on 22nd March 2011, my doctor put an immobilizer on my right leg after having an X-ray. He told me that there is no fracture and asked me have bed rest for a week. After a week a visited an OPD surgeon who asked me to have an MRI which showed a complete tear of my quadriceps tendon. I got operated on 1st April. My surgery report tells that holes were drilled in my knee cap and broken tendon was sewed back. A leg long cast was applied immediately after the surgery. I was allowed to move with the help of a walker after the surgery but was advised to not to put weight on my right foot. After 10 days, my surgeon said i can put weight and can anything that does not hurt. After 6 weeks of surgery my cast has been removed yesterday. The surgeon has advised to lift my leg -while laying straight on back, but i cant lift it! My knee seems de-shaped, i mean on the left side of my knee cap i feel something real hard, like a bone which is not the case with my good left knee. He has also advised to bend my knee as much as possible, which i can do a little. Is it normal to not able to lift the leg just after the cast removal?
Fahim,
Sorry to hear about your injury.
Based on my own experience, it will probably take a while before you will be able to lift the leg. During my PT, I had to work up to doing that. At first, I had to work on being able to tighten my quad at all. I was also on a fairly gradual bending schedule-I was fitted with an adjustable brace and I would gradually get more range of motion. You’ve no doubt noticed that bending the knee is rather hard.
As far as the knee deformation, my knee was also a bit weird after the surgery. In fact, it still feels a bit odd, especially on the left side-thanks to the scar tissue in there. It is likely that is what is going on with your knee. However, you should have the doctor check it out-just to be sure.
The recovery process will be rather slow and unpleasant, but as long as you are careful and do the right sort of physical therapy, you should be back to normal in a few months.
Hi Michael,
Thank you very much for your reply. I feel much comfortable now after reading your reply because what i am feeling about my knee is not abnormal. Today, after 2 days since my brace was removed, i can walk without a walker, but i am carrying a stick for little support. I feel happy about it!
How do you feel now after almost 2 years of surgery? And how long did it take you to feel as you are all OK?
I have a few questions stuck in my mind which i would like to share with you. I was unable to bend my leg with broken quadriceps tendon, which is quite logical because there was no connection of the tendon with the knee cap, but now since the tendon is in its right place, why can’t i bend my knee normally? Why does it feel hard to bend? Is it because the muscles are not in their normal working condition or is it because of something else?
Regards,
Hi from England – 3:30 am and out of hospital yesterday – desperate for a decent night’s sleep! Excellent blog; extremely informative. Heading out in the morning for a ‘stool softner’!
Best wishes
Jonathan,
Good luck with your recovery. Drink plenty of fluids. 🙂
Thanks for all the great info Michal. I am scheduled for surgery in 2 days to repair a complete tear. I have a job where I can set at a desk with my leg propped up all day. Irrespective of Doctor’s orders, how quickly can one expect to be physically capable of returning to this type pf job? Thanks again.
Denny,
I was out for two weeks from my teaching job. But that involved walking (well, “crutching”) between classes way across campus (almost two miles of walking in total). I’d say that would be a reasonable amount of time to recover and heal a bit.
Meant to say “Michael”. Geez, the least I couold do is get your name right. Must be the pain meds. 🙂
Amazing. I found your post while doing some research for my own quad tendon tear I suffered this weekend.
Thanks for a great write up — I’m in the same angry, frustrated state regarding a lack of information flow from the doctors, techs, and other medical staff I’ve been involved with. Your posts have given me a better feel for what to expect going down this long road.
I’ll be grabbing your book for my Kindle later today!
Good luck with your recovery. It is unfortunate that the medical folks don’t do as much as they should to keep the patients informed. Like you, I had to cull the net to find out things. I even had to self-diagnose after the first doctor just let it go with “your leg isn’t broken.”
Unfortunately it’s been this way with a number of serious health issues including developing type 1 diabetes very late in life.
It’s frustrating because in my day job I work hard at fostering early communication around difficult issues, figuring well-informed folks make better decisions around tough problems.
Again, thanks for your great info here!
Sorry to hear about the diabetes. But, at least the management options are much better these days.
You are right-well informed people tend to make better decisions. I’m all about that.
Dear Mr, LaBossiere,
I was relieved to finally find a blog such as yours. It is, as you have said, so difficult to extract information, let alone simple conversation, from a physician. Today is August 31. I fell down some stairs at home (my knee, quite simply, just “went out” as they say) on August 24. I am lying in bed with my laptop in my, what else, lap and wondering when I will every get outdoors again as I peer out the window onto another lovely day here in Indiana.
When I fell down those 4 or 5 steps I landed in a heap at the bottom with something (my patella?) poking out of my jeans like a child’s fist. I instinctively snapped my knee back into place and dragged myself on my butt out into the driveway and up into the back seat of the car and called a neighbor to drive me to the emergency room. I just didn’t feel the need to tax city services and despised the spectacle of red lights and badges and how that might play with my 16-year-old daughter who looked upon the whole scene horrified.
The emergency room was, of course, a 5-hour odyssey during which I never received one cube of ice for my leg, let alone to drink! But I survived.
My question for you is, in your blog and in most other descriptions of a quadricep tear, it is mentioned that the afflicted will NOT be able to STRAIGHTEN his leg. For me this appears to be the opposite. I can straighten it but I certainly cannot bend it!
I was wondering if you might be able to help me out with that part. I was inspired reading your story and was heartened by your statement that you returned to teaching after THREE weeks. That sounds wonderful. I am a copy editor at an ad agency in Chicago (don’t hold that against me! I used to teach English overseas for many years but because of my wife’s illness I had to end the international hobo’s life) and I do not like being away from work.
Thank you again for your very helpful, inspirational and informative blog.
Sincerely,
Patrick
Patrick,
Sorry to hear about your accident. I hope you are doing better. Did they do the surgery right away?
The sure sign of a tear is that a person cannot do a straight leg lift while lying down. However, as you pointed out, the injury can make it hard to bend the knee (the knee bone slides down). After surgery, the usual thing is to put the patient in a cast or immobilizer, so as to prevent the knee from bending (and tearing the repair). A tough part of the recovery process is getting the knee to bend again.
If all goes well, you should be back at work about two weeks after surgery. In a leg brace and using crutches, though. 🙂
Mike
Surgery was two days after the accident. I am now 12 days post-surgery and the pain is still intense but I can put “some” weight on the leg while using crutches so I can now “shuffle” to the bathroom instead of hobble.
The doctor gave me one and one exercise alone to do until we take out the staples at the third week after surgery (in 9 days) — he told me to “twitch” my quadriceps muscles which I do intermittently throughout the day.
Patrick,
Your experience sounds on par with mine. You should be “assigned” more basic PT exercises and eventually you will probably go to a PT for a more robust recovery. I was rather lucky in that my girlfriend had worked as a PT before going to grad school so she was very helpful.
Michael – I have found your blog and your book on ebay very informative. Thanks for all of the effort. I had an usual accident at BWI airport where I stumbled on the Southwest Airlines jetway and crashed into a wheelchair, ramming the knee of my left leg into something hard. Hurt like hell. After the emergency room found no fracture, I returned to home in Houston. My Orthopedist said only a partial quadriceps tear but after the MRI showed it 95% torn he thought surgery necessary. Surgery was four days ago and I am just now feeling somewhat human again. It has been tougher than I expected.
In addition, I’m having one other problem that you did not mention, nor did anyone raise with you — I have considerable difficulty in having a BM. Since my left leg must remain straight, I cannot sit on the commode without pain, and even then I’m not positioned very well to do anything. I got a raised toilet seat from a hospital supply place and titled the seat down making it easier on the leg. That has helped some but I’m still without much success. Did you not have difficulty sitting on a toilet seat and keeping one leg straight?
I feel like I must be doing something wrong since neither you or others have raised this problem, yet it is a major problem with me. If you have any suggestions, I would greatly appreciate them.
Thanks again for being so helpful to me and everyone suffering this injury. You write well and specific enough to satisfy a technically oriented lawyer like myself. I suspect you’re a good philosophy professor as well!
Thanks very much. Don
Don,
The challenge of the toilet was one of the worst aspects of the whole adventure. Fortunately, my house has two bathrooms, one of which has adequate leg room. I had to learn to lower myself with the one leg straight out. A small stool (no pun intended) could be handy for keeping the leg up. I think there are also some devices that can be installed, such as handles or a walker like device, that can make rising and lowering easier.
Don,
You are correct to raise this issue. I know that Michael did advise in his blog to “take the stool softeners” and that is exactly what I have been doing. It is still, as you say, difficult to maneuver oneself onto the toilet but if you have one of those extenders you are on the right track.
Eat grapes, Toast. Raisins. Prunes. I even have a bit of Metamucil as well. The problem in the case of our surgeries is twofold: one, we need to take the painkillers (which are opiate-based and cause constipation) because, at least in my case, the pain is intense, particularly at night and two, we are inactive thus, are bowels become lazy.
I try to do some “sit-ups” which really about to slight belly bends on the edge of the bed. I lift a small weight with my arms and I do leg lifts with my good leg. I also try to get up and sit in a chair a couple of times a day for about a half an hour. While not as “regular” as I was before the accident, I am still managing a bowel movement once every other day. Eat fiber. Eat fruit. Take the stool softeners and take a good book in there if you have to but DO NOT strain and push twenty-five feet of intestines just to uncork the end! Your next problem will be hemorrhoids.
I am in my 12th day of recovery after surgery from a complete quadriceps tear. I am 57 years old, I exercise and I am not overweight and I have NEVER had a knee problem in my life. It simply “went out,” on me — unfortunately as I was blithely walking down the stairs. I find that at this stage the pain in tolerable during the day, but at night it keeps me from sleeping. I now “average” just one Vicodin a day.
Hope all gets better for you, Don! Get some high-fiber cereal, some grapes and you should be fine.
Pat
And plenty of fluids. 🙂
Question for anyone still reading after all this time. I had a 70% full thickness tear repaired back in 02/2010. Went back to work full duty (mailman ) 08/2010 on a mounted or curbside (driving) route. During 03/2011 was transferred to a full walking route. Now after 6 months of serious walking everyday carrying the mail (6 hours plus daily) this past week I experienced what seemed like a major setback. Pain felt close to what I felt after original injury. Not working for 6 days has reduced swelling and range of motion and strength have improved but nowhere near what I was 2 weeks ago. What can I expect when I go into the doctor. I’m unbelievably scared of another surgery. Whats the chance of the quad tearing again in the same spot. Thanks
Matt,
If you can perform a leg lift (lay down on your back and try to lift the leg while keeping it straight), then your tendon is intact (or at least mostly so).
You could have torn it again, but it might be another problem. As a runner, I have had all sorts of injuries including ones that involve pain and swelling in the knee. With any luck, you just have a minor injury. I hope it goes well!
Thank you so much for sharing this! A family member just had a 60% tear and I had all sorts of questions running through my mind about the surgery that is planned.
Hi Michael,
What a wonderful site! Thank you for taking the time to share your experience and knowledge with the rest of the ‘torn quad tendon’ community, which I unhappily find myself a new member of.
I had surgery today (partial tear, about 80%). I had a ski accident in February, and this injury/surgery (today was the 4th) is just the latest in a series of very frustrating complications. I would love to read your “short book” on the subject, but don’t have a Kindle or Nook (I like a good, old-fashioned book!) Is your book available in any other format?
Thanks again. Hopefully your injury is a distant memory by now!
Shawn
Shawn,
Good luck with the recovery. My short book is only available in electronic format, but you can get Nook or Kindle software for free. It is available for the PC, Mac, Android and iOS (iPad/iPhone).
Mike
I had a fall while helping friends move (9/24/11) which resulted in a full quad tendon tear of the left leg and a partial tear (85%) of the right leg. I had the operations staggered with the left leg repaired first (10/10/11) and the right leg operated on as a complete tear 3.5 weeks later (11/2/11). I’m 5.5 weeks out from the second operation. It has been a struggle. Still wearing the brace on the left knee now adjusted to allow 40 degree flexion. Have an appointment next week during which I think the doctor will discontinue the brace. Have been receiving physical therapy in the home setting till now but will be conducting PT in an outpatient setting beginning next week. To add insult to injury I have temporary radial palsy induced by pushing myself off of the bed to a standing position with my fists balled and having the right hand collapse and fold under. This occurred 2 weeks ago and it appears that the nerve is healing itself very, very slowly. Will return to work next week.
Good luck with the recovery. Dealing with two injured legs must be extremely difficult!
Thanks. It has been difficult. The doctor took me off the brace during this week’s vilsit and encouraged me to begin walikng as much as possible without crutches. Fir the past two days I’ve been doing this and using a cane as well. Back to work tomorrow. I’m experiencing a little anxiety about returning to work but it feels so great to be on the mend.
Ulysses,
Good luck with the rest of your recovery. One thing you might experience when you are moving about is your knee “giving out”-that happened to me for quite some time after the recovery. It is a bit scary because it seems almost like the tendon is failing, but it is probably just a spasm sort of thing. I found that it happened less and less over time. It never occurred when I was back to running, but would happen when I was walking or standing.
My experience was similar to Michael, the knee gave out every once in a while for at least 6 months after surgery but now, 2 and 1/2 years, later, back to running, biking etc and it all works – its not pretty looking but it works!
Hello, this was an interesting blog……..I am 6 weeks out of surgery. Being a hockey player, I’ve had my share of scopes and minor surgeries, but this was a little more than I am used to. The surgery was not bad, though. I didn’t need any pain killers or muscle relaxers. 3 days after surgery I was able to walk without crutches or a walker. The biggest inconvenience is going for the blood tests every 3 days for my blood thinner readings. My cast is still on my leg for another 2 weeks, or so.
The muscles in my leg have really started to shrink. Rehab is going to be a challenge. When you rupture your quad tendon, since you cannot excersize, your entire leg basically goes “dead”. Your hip flexor muscles deteriorate as well as your thigh and calf muscles. The rehab isn’t just for the tendon, it is for your entire leg from the hip, down.
At 52 years old, this is a tough road to hoe. My doctor thinks I can be ready to be back on the ice in 8 months. I’m hoping that he is correct. This sitting around, sucks!!
Great to hear you are on the road to recovery. I had my surgery in October 2010 at age 54. I was in cast for two months and then two months of rehab. I found that it took me the greater part of a year for everything to settle down, so what I am really trying to say is, do not rush it to get back on the ice as I understand re-rupter is is quite possible with this injury. Good luck for the future.
Slim, thanks for the advice. I have been told by several physical therapists that this is worse than a total knee reconstruction. I am going to take my time, rehab correctly and make sure that when I do return to play, I will be at full strength and be able to handle the grind. I NEVER want to go through this again!!
Tom,
It is rather horrifying how quickly the muscle goes. After I was finally able to start exercising, I seemed to be quadless. But, it came back fairly quick. It helped that I was able to exercise in other ways (stationary bike and a Bowflex).
8 months sounds about right-I had my surgery at the start of April (2009) and ran my first at the start of September that year.
Good luck with the recovery!
Michael, thanks for your kind words. The thing that scares me is that although I ruptured my quad tendon playing hockey, I was just skating without incident when it ruptured. Nobody hit me, I didn’t make some fantastic move and score a goal, I didn’t fall awkwardly or lose an edge. I was just skating on the ice trying to gain some speed when it ruptured and dropped me like a bag of dirt. I’ve been skating since I was 7 years old………why did my tendon rupture at this time? My legs are very strong and I am in pretty good shape for 52 years old. Why did this happen? The better question is, how can I prevent this from ever happening, again?
I know I can rehab and get in top shape for my return in 8 months. However, my mental state will not be filled with confidence. I know I will be worrying about another injury everytime I take the ice. I’m pretty sure that the mental rehab will be worse than the physical rehab.
I think a common theme among most of us who have gone through this torn quad tendon business is . . . why? What were the outward signs? Why didn’t any of us see it coming? How “bad” was the tendon to begin with? Might it have been detected earlier with an MRI? Does tendonitis lead–immediately–to a quad tear? It does not appear that the surgeons have an answer. The literature is full of surgical “success” stories but not much else. I will be 58 in February. I tore my tendon fully in August of 2011. I am now walking well enough, without a limp, but if the light turns yellow at the intersection I stay put. No longer do I confidently scurry across the street. This “confidence building” period has been one of the toughest aspects of this injury. No one seems to have the answers. I did therapy for four weeks 2 to 3 times a week but at 45 bucks a session I could no longer afford that luxury. The problem for me has been gaining STRENGTH. Flexibility came relatively quickly. I practice “doing a flamingo” with my bad leg, hand on the counter, at home. It is the TOUGHEST exercise I do. And it saddens me that that knee is still so weak that I cannot bend it any more than a few degrees while bearing my entire body weight–without feeling pain.
I am simply hoping that time and weight-training will help. I used to run a couple miles every day but now I do not have confidence for that. My aerobic exercise these days consists solely of “walking fast.”
Maybe I should get a stationary bike!
Great forum. Thank you all for your comments and suggestions.
Good questions. In my case, I think it was a previous running injury and then the fall off the roof. But it apparently “just happens” in some cases. I suspect it could be a past injury or accumulation of damage. Hmm, I should have gotten an MD instead of that PhD. 🙂
A bike is a great idea. I used one my friend Dave gave me (he had upgraded his wife’s bike to a fancier model) with one leg and then both legs. In fact, part of my PT involved using the bike at the sports med place.
You’ll want to be careful with the leg until it is properly healed, though. I eventually added leg lifts to the recovery and was able to use my Bowflex for that. That really helped rebuild the quad. I still do the exercises-they presumably still help strengthen the leg.
Like you, I was extra cautious-when I would get to crosswalks on campus I would be worried that I might get nailed before I could hobble across. But, as my strength returned, so did my confidence.
While I’m not a medical expert, I suspect that you might have suffered a previous injury that damaged the tendon. In my case, I had a bad fall during a race involving a hole hidden by leaves and that probably partially tore my tendon, allowing it to tear fully when I fell from the roof.
Alternatively, there might not have been a single injury that weakened it, but a gradually wearing down through small injuries and stresses and it finally gave out.
Once the repair is done, it should heal back very strong. Like you, I was a bit worried that it would just “pop” again (and the occasionally “going out” of the knee did not help). However, I was assured that with proper recovery I would have no problems-provided I didn’t fall off a roof again. I was very cautious at first, but my confidence came back through the physical recovery. As you might imagine, no one ever said anything about the mental aspects of the recovery-that was left to me. My advice would be to do what I did: recover smart by not pushing it too fast, find an alternative exercise activity to stay fit, and give yourself time to regain confidence in your legs.
Hello, again…….well, I am at 38 days post-surgery, today. My leg is still in a full cast, but I have no pain or discomfort. Today, for the first time, I was able to extend my injured leg in front of my body as I walked (limped) around. Usually, my leg would drag along side my body(almost like Festus on Gunsmoke….LOL). However, today it just feels really good. In 2 days I get my cast cut off and they will do an ultra-sound to make sure everything is healing properly. I believe that I will have a new cast put on for 2-3 more weeks.
I’d like to think that I am only a couple months away from lacing up the skates and playing hockey, again, but the reality is that I know the road ahead is rough. I hope I can skate by July or August, but I’m not going to push it. When I am ready, I will seize the moment. Until then, I need to work on my ROM and my strength. Since I have been laying around for 6 weeks, the lower half of my body has gone dead. I can’t wait to walk without dragging around a 15lb. cast, or ride my bike.
I thank the Lord that my children can run our business and take care of the day to day stuff because this is as debilitating injury as I have ever had. Hopefully, I can get back to a semi-normal life in the next 2-3 weeks.
Thanks for the postings and the encouragement!!
Tom,
In my case, they just put me in a soft cast and then an expensive brace (the insurance company deemed the brace “unnecessary”). I was out of work for two weeks, then allowed to go back on crutches.
After that, the recovery is a fairly slow process. They will most likely start you out on ROM exercises and balance. You’ll find that your knee will not want to bend and that your balance will be shot. You’ll also have to relearn to walk-that was a bit weird for me. You might, oddly enough, find it easier to skate than walk. When I was able to run again, I started up with no problems and my knee caused me no trouble-even though I still had problems with walking. I suspect that was because I’ve run thousands of miles.
I had a partial tear of my quad tendon in 2006 at the age of 25. I’m a volleyball player. The sport asks a lot of this tendon. I torn it during a tourney and played injured for two more tournies before accepting that I had a major issue. After a misdiagnosis from an orthopedic, i paid out of pocket to see the doctor for the New England Patriots. Got a real diagnosis and prognosis. Rest it, strengthen it, see how much you can gain back. There is no good surgery option for the tear I had. I trained for a year and got back to a point where I could jump decently again, but couldn’t shake the pain. I decided to give up indoor and only play beach. The soft landing makes all the difference. I’ve tested out the knee indoors each year with similar results, until this year…the winter of 2011/2012, five years after the injury. I’m actually getting through full tournaments without pain in the tendon. I had thought that day may never come. These are things I feel were important in the healing process…stay active, do as many activities and sports as possible that push the tendon without causing major pain; ride a bicycle, stationary bike, or spin…I ride most days and i think it helps; ice when it hurts; if you can’t do the sport you want, for now, find an alternative sport to channel you energy and keep yourself sane. Hope this helps.
Lucas,
Sorry to hear about your past injury, but it is great to hear that you able to make what seems to be a full recovery.
Hi! So I have a partial quad tendon tear right now (finally diagnosed it on March 25th) I am 26. It is now May 6th, and I am now about to go back to revisit the doctor to see how I am doing. I was told to rest my leg and start PT if I wanted to. 4-6 weeks no lower body sports. But can work on upper body. I’m highly active and haven’t been able to do anything truly since January (since I went to the doctors and they thought it was runners knee… so went through PT, a lot of trial and error haha, even a cortisone shot that felt great for about a week!). So this has been very frustrating. After receiving the diagnosis, I waited 3 weeks to try therapy again. And I actually felt so much better. Went through two weeks of therapy and after the second week of therapy, woke up on Saturday morning to some pain… and each day it got gradually worse. By Friday of the following week, felt like it was going to give out, so I put a brace on. Still was in pain… And PT they just did some massaging, and ultra sound stuff, but no strength training because he didn’t like how I felt the pain again. I am an ESL teacher and work in a district where all the buildings are connected. I teach K-12 (small groups) so I actually walk a lot for my job. I don’t think my doctor realizes this. He did say I can walk. It’s not like I’m power walking you know? But maybe that’s what’s aggravating it. I’m afraid it’s re injured. So my question is, how bad was your pain that you dealt with for the five years? The pain I have right now is bearable compared to what it was months ago. It’s just annoying how I felt great for a couple of weeks and then all of a sudden felt the soreness again and it’s not going away. I just want to get back to doing the stuff I love to do. Any advice would be greatly appreciated! I know not doing anything is probably the worst thing as well because of the muscle becoming weak. I’ll see what the doctor has to say… but any advice would be so helpful! Thanks!
Kathy,
You need to go to a different Orth Surgeon. A partial tear does not heal. The tendon does not reattach on its own. It only reattaches after surgery. The worst thing he couldve done is shoot you up with cortizone. Cortizone actually weakens the tendon and sets you up for a full tear. Get a second opinion. All the therapy and time will never heal a partially torn tendon….
Sorry to hear about your injury.
Based on my research, partial tears can sometimes be treated without surgery (the main test is the straight leg lift).
In other cases, the partial tear is bad enough for surgery to be required.
As you found out, misdiagnoses are common-I had to diagnose myself.
As Jesus said, a second opinion is a good idea. While it is best to avoid surgery when possible (cost, risk of infection, etc.) you certainly do not want to let the injury drag out needlessly.
Hi Kathy ,
I sustained a 50 per cent partial tear of my right quad last September. It required an MRI to diagnose. Was one performed for you? Unless it is torn all the way, I think it is sometimes difficult to diagnose. For several days after the injury I could not raise the leg at all. However, over a period of two weeks, it started improving, and I convinced my surgeon to try physical therapy first, as I was not too thrilled with the prospects of surgery.
He was pretty pessimistic, but agreed to give it a try. Over the next few weeks it continued to improve, and I was very hopeful of avoiding surgery, until my knee unexpectedly buckled in the middle of the night while I was going to the bathroom. I was unable to catch myself as I was half asleep, fell backward, and heard it tear on the way down. A couple of days later I visited my surgeon and he gave me an ultimatum—either have surgery immediately or find another doctor. He explained that if you wait more than six weeks after the injury to perform surgery, the results do not tend to be as good as the tendon has a tendency to retract over time, making the surgery more difficult.
I am glad he forced my hand. The surgery went well. The initial post-surgical pain was not as bad as I had read, as the anesthesiologist gave me a femoral artery block. I am around six months post-surgery and have almost full range of motion. The quad muscle is still weak—4 on a scale of 1 to 5, and I am still in physical therapy. Maximum medical recovery typically takes at least ten to twelve months, and sometimes longer. .
My surgeon advised me that depending on the location of the tear, partial tears can heal on their own, but they never heal as well as a surgical repair. He said he may have recommended forgoing surgery if I were older, but since I am 55 and still relatively active, he said surgery was my only realistic option.
You are young and active. I am surprised that your doctor did not recommend immediate surgery. You might have some continued success with physical therapy, but the chances of making a full recovery are miniscule without surgery. The extent of your recovery without surgery depends on whether the tendon tore away from the knee cap, or was instead within the tendon itself. If it tore away from the knee cap, the only way to repair is surgically. If it tore within the tendon, you will have some healing without surgery but your knee will never be the same.
If I were you I would seek a second opinion immediately. You and I were both lucky to have only partial tears. The recovery is not as bad as a full tear.
Good luck, and keep us posted.
Hi all. Sorry about that. Getting use to the site! So my MRI results that I got in March said that there was a slight partial tear. They could barely see it on the MRI. I remember when I think I had the injury. I’m not even sure because I’ve been going to the doctors for this since January. When I first went in it was just for pain whenever I went up and down the stairs. Nothing too bad and was diagnosed with runners knee. They gave me physical therapy for a month. With physical therapy they were teaching me how to do squats the right way, lunges, etc. However, I already knew how to do these the right way, basically I had the knee pain from doing too much activity. So while doing this I was still working out since they said it was okay. Two days after resting my knee I woke up and it hurt to even lift my leg. But within a couple of hours it got better and I was able to walk on it and lift it. Took the ibuprofen that they had given me and it helped. But that freaked me out so I went back to the doctors and he said to stop going to physical therapy and just do leg lefts for a month. So I still was trying to bike after letting it only rest for a couple of weeks (my own stupidity, but they also hadn’t diagnosed me). I had no swelling at all though. So went back and there was still pain, so they finally gave me the MRI which showed that there was a slight partial tear. They could barely see it. He said that just resting 4-6 with no lower body sports… physical therapy if I wanted to. But really resting was all that could help it. I didn’t do anything for 3 weeks and then went to physical therapy. He read the MRI and showed me that where the partial tear happened was within the tendon. He said it’s definitely one of those tears, like a hamstring, that you have great progress and then it’ll get aggravated a little again.
Going back to the doctors yesterday, they said just another 4 weeks of resting it and physical therapy. But reading your responses- I have felt like it was going to give out on me because I walk a lot for work as a teacher. When that happens I put my brace on. The physical therapist said that it will take a good solid 6 months before I can get back to where I was at prior to the injury but didn’t need surgery. I go between a physician assistant- sports specialist as well as an orthopedic surgeon. The two of them have been working together giving me the options that they think best. They said surgery would be the last option if needed. An option he also gave me yesterday was to scope it, but he didn’t think that was necessary. He tested my leg lift and I can do that, I just have issues when I have to bend down to pick something up or get up and sit in chairs.
I will see if I can get a second opinion though just from reading everything. Thank you so much for your advice, it is really really helpful!
My surgeon told me that having a partial tear was like being “partially pregnant.” In other words, surgical intervention is necessary whether the tear is partial or full. On the other hand, it sounds like yours is very minimal, and perhaps you stand a good chance of recovery without surgery,.
I did a lot of research on the internet on partial tears, and there wasn’t much to find. Quad tendon injuries are fairly rare, and typically happen to older folks–age forty and up. Usually, the tear is complete and tears off at the knee cap, which requires some pretty painful bone work to repair it. They have to drill holes in the knee cap to reattach the tendon.
Since the injury is rare, especially a very slight tear to someone as young as you are, you might want to get a second opinion from a highly experienced surgeon who has seen more than a handful of these. My physical therapist has been working in hospitals for over ten years and this is only the third quad tendon tear she has treated.
Seems like the medical community is divided on treatment protocol. Some surgeons are very conservative and dictate little to no weight bearing for weeks and no movement of the knee. Others are more aggressive, and push partial weight bearing and knee movement and exercise within a few days of surgery. Studies have shown that recovery is easier with the more aggressive approach, and that the chance of a re-tear is pretty much the same regardless of approach. Given your young age and high level of activity, it sounds like you would do better with a surgeon who believes in the more aggressive approach.
The risks of this type of surgery are fairly minimal. It is usually done on an outpatient basis, so the risk of contracting a “super bug” infection is very very slight. The other risk is adverse reaction to the anesthesia. I was under for less than two hours, and it would appear that your small tear would be repaired in even less time. Given your age and presumed good health, its probably about as safe of a surgery with general anesthesia as you can get.
I found that icing the knee frequently helped tremendously in reducing the swellings and thus, the pain. Several times a day for no more than twenty minutes is the better approach, I have been told. Also, I understand it helps to keep your knee elevated whenever practicable.
Good luck.
Thank you for all of the advice it has been extremely helpful! It’s definitely a rare tear and research is so limited so it is really awesome to talk to people who have had the same problem! As you can see in my comment below, I’ve talked to my physical therapist and he explained to me why he didn’t think I needed surgery because of how slight the tear was, plus my age and how fast the body can heal at my age. I guess that is one benefit. I’m still scared about what could happen though. So it has definitely been helpful reading your comments about set backs and the other comments about taking it slow and listening to what they’re telling you to do. Even if they give me clearance to do anything I’m still going to be very very cautious! They said I could start swimming if I wanted to, but since last week it felt weak and the week before it was sore, I think I’m still going to wait until June when I go back to the doctors to do anything. I definitely don’t want to have something happen in the next year and then have to do the surgery. Thanks again 🙂
Caution is probably a good approach. When I was recovering, I pedaled a stationary bike with my good leg 1-2 hours a day and used my bow flex for my upper body. I also did pool running with an Aqua Jogger. I was in pretty good shape overall…other than my bad leg. 🙂 The exercise helped me stay sane and allowed me to avoid going onto a diet.
Good luck with the recovery. If the experts are confident that you’ll recover without the surgery, then avoiding it certainly makes sense.
Did they recommend immobilizing your leg?
Thank you for the reply. Everyone has been very helpful, I really appreciate it. I am being extremely cautious about doing anything! Which isn’t normally the case; last year I had a minor injury with my shoulder and it took longer to heal because I didn’t listen. This time I’m definitely listening to everything they’re telling me. Even if they’re giving me clearance to do things, I’m still waiting! Normally, you give me clearance and I go all out in trying everything. But reading everyones comments I am learning quite a bit about what to do. They have not immobilized it… On March 25th when I found out it was a tear, he said that the only thing I need to do is rest and not do any lower body sports. Physical therapy if I wanted to, but if that started to hurt then I’d have to stop. I didn’t stop going to physical therapy though because they do a massage on the area and ultra sound, and he stretches my leg himself, but I didn’t start doing quad work until yesterday. And that was just 10 leg raises. I talked to the physical therapist yesterday and told him about my concerns and he said that from my symptoms and pain level, it was definitely a slight partial tear and he read the MRI and showed me where it was. He said if it was in a different spot I would have definitely needed surgery. Gave me some reassurance. If I wanted to get a second opinion I could, but he really didn’t think my case was a surgery case. Quad tears and hamstring tears really just take a long time to heal so just have to be patient. If I have another set back when I go back to the doctors in a month, he said I’d definitely have to talk other options. Hoping nothing happens! Thanks again 🙂
Hi! So I have a partial quad tendon tear right now (finally diagnosed it on March 25th) I am 26. It is now May 6th, and I am now about to go back to revisit the doctor to see how I am doing. I was told to rest my leg and start PT if I wanted to. 4-6 weeks no lower body sports. But can work on upper body. I’m highly active and haven’t been able to do anything truly since January (since I went to the doctors and they thought it was runners knee… so went through PT, a lot of trial and error haha, even a cortisone shot that felt great for about a week!). So this has been very frustrating. After receiving the diagnosis, I waited 3 weeks to try therapy again. And I actually felt so much better. Went through two weeks of therapy and after the second week of therapy, woke up on Saturday morning to some pain… and each day it got gradually worse. By Friday of the following week, felt like it was going to give out, so I put a brace on. Still was in pain… And PT they just did some massaging, and ultra sound stuff, but no strength training because he didn’t like how I felt the pain again. I am an ESL teacher and work in a district where all the buildings are connected. I teach K-12 (small groups) so I actually walk a lot for my job. I don’t think my doctor realizes this. He did say I can walk. It’s not like I’m power walking you know? But maybe that’s what’s aggravating it. I’m afraid it’s re injured. So my question is, how bad was your pain that you dealt with for the five years? The pain I have right now is bearable compared to what it was months ago. It’s just annoying how I felt great for a couple of weeks and then all of a sudden felt the soreness again and it’s not going away. I just want to get back to doing the stuff I love to do. Any advice would be greatly appreciated! I know not doing anything is probably the worst thing as well because of the muscle becoming weak. I’ll see what the doctor has to say… but any advice would be so helpful! Thanks!
Kathy,
I went through a partial tear in the fall of 2009, but it showed up clearly on an MRI and the ortho said it was a “major tear”, and that surgery was the recommended approach. I was able to lift my leg even right after the injury, and over the next 4 weeks I improved steadily to the point that the doctor said to me that it was possible that the tear was only to some of the connective tissue and not the tendon. However, the only way to find out was to open me up, so I chose the surgical option, and it turned out I had an 80% tear. Age played a factor in the decision too – I was 57 at the time, and the thought of skipping surgery at the time only to have it forced on me a year or two later was a consideration.
At the 3 1/2 year mark, I still feel that the knee is not quite what it was before the surgery, but I’m convinced I did the right thing. At your age, and with a significantly smaller tear, you have more options. The surgery and recovery is not a picnic; I had a total hip replacement last fall and it was nothing compared to the QTR repair! Best of luck!
Dave
Thank you for the information. This is all so helpful! When I go to PT today, I am going to talk to him about this site and see what he has to say. I go back to the doctors on June 3rd (probably about the 6th time going in!) and will also tell him about this research. They know that I’m highly active, and I understand that even if I don’t get surgery, I’m not going to be fully able to do anything until probably the winter, but I’m afraid of scar tissue or just getting the clearance and having the same problem a year later! Thanks again. I will keep you posted as well!
I’ll second Dave on the surgery-it was the toughest thing I faced in my life. Worse even than grad school. 🙂
Michael, I was just thinking, today, about how it will be when my cast comes off. Will I be able to walk, like before? Will I have to relearn how to walk? Will my balance be off? All these questions will be answered in the near future, I am sure. Tonight, my cast will be cut off and they will do an ultra-sound to see how it’s healing. My doctor will make his decision on having the cast re-fit, or just have a knee immobilizer. Either way, my leg feels very good, at this time.
All my teammates are urging me to get the cast off and hit the ice, but I think their wishes are a bit premature. Originally, when I heard a total of 8-9 months for 100% healing time and rehab, I was very scared. However, I’m thinking of more like 5-6 months and a hefty brace on my leg to skate, somewhere around July. Hearing that you run with no major problems makes me feel RELIEVED!! I hear horror stories about this injury and I am glad to hear from a guy who is athletic and a “quick healer”, like me.
Tom,
You’ll most likely need to relearn how to walk and balance. It will probably be a bit weird when you are doing that-but I found it best to be conservative in my recovery. I also developed a fear of stairs and falling-but this soon passed as I regained balance and strength.
You should be back to 100% and able to skate like before. The first time you get back on the ice you will probably get a twinge of worry, but that should pass quickly.
When I was recovering, I’d have nightmares about running and having my leg go out or even fall off. The mind is a strange thing. 🙂
Michael, I just got back from my first rehad. I have 40 degree ROM and they have me doing very minimal leg excersizes, at this time. My left leg is really “dead”. I cannot lift it off of the table from a laying position. I also still have 6cm of swelling, so my ROM should increase as the swelling goes down.
I completely understand how your mental state can overtake a physical injury like this. My biggest fear, right now, are stairs. I can’t imagine even getting back on the ice, right now. I’m sure as the rehab progresses I will gain strength, ROM and confidence. Better days are ahead.
Tom,
Congratulations on the ROM. It is a slow process, but getting to 40 is a major step.
Your leg will be “dead” for a while. I remember trying to get off the table at the doctor’s office without my brace and that was a bit scary-I had no control over the lower part of the leg and had this notion that it would just flop off. Fortunately, that eventually passes.
Stairs are rather scary at that stage-when I went back to teaching, I had four flights of stairs to my office (the elevator had caught fire or something one day) and getting from class to class involved 4-8 flights of outdoor stairs. I came close to falling a few times, but the constant stair walking did help build confidence.
Things will continue to improve and one day you’ll look back and say “I’m glad that is over!”
Michael, I guess since we got 8″ of snow, last night, that today is going to be a challenge. Not only walking through the snow, but making sure that I do not slip on a wet floor or slip of the edge of a wet stair. I am watching every step that I take.
Tom,
Good luck with that-dealing with ice is enough of a challenge even with two good legs. Luckily I didn’t have to face snow or ice here in Florida-just rain.
Michael,
Want to thank you for this quad tendon rupture blog. Just had Sx on 1/16. Being a basketball player until my right Achilles ruptured and a tournament tennis player until the first Rotator Cuff sx I have some experience with rehab. So while this looks like a long recovery I have done it before and will do it again.
I was the CEO of a diagnostic imaging company so I know a bit about medicine. I can tell you your blog communicates in a wildly better way the issues with this injury than what I would expect from my MD partners.
Because I can’t play the great sports I used to enjoy I now play senior golf tournaments. Do you know how successful Chuck was in getting back to golf?
I tried to send this message via Facebook but I obviously don’t know what I am doing in the medium.
Thanks again,
Terry Fowler
Sun Valley, Idaho
Terry,
I’m not sure how things turned out for Chuck-well I hope.
I was back to running in September after my April surgery, so you should be back golfing in about the same time frame. Of course, you can still putt even with the one working leg. 🙂 Based on my own experience and what I have heard from others, the recovery from the surgery is generally complete-that is, you’ll most likely be back to the way you were. In my own case, I actually gained a bit of ROM from all the exercise and the change in training (“smarter”) actually improved my running times. I also do Tae Kwon Do and my leg is fine for kicks and such-so you should be good for the power swings in golf (one of my instructors was a big golfer-he said golfing and martial arts are very similar).
I was in a softball tournament in Las Vegas this weekend when it happened. During a game Sunday afternoon, there was a runner on 2nd with 2 outs and the batter hit a ball to right center. I saw the runner round 3rd as the right fielder picked up the ball so I took 2 steps to my left and got into my catching crouch when I felt a pop and a burning sensation above the knee and on both sides of it about 3 seconds before he crashed into me so I know it happened before the play. He was out on the play but I was done for the tournament.
I got back to NY Wednesday morning and went to my doctor that afternoon. He did some tests and thinks I have a partial tear. He thinks it’s partial because I can straighten my leg to about 160* and there is no pain when he twists and turns the leg. We’ll know more in the next day or two and then I’ll figure out what’s next. It’s frustrating. I do (did) squats in the gym and thought my legs were the least of my worries. Now I may miss the season. I’m 47 and in good shape, but I guess not good enough. The doctor told me it is often a non contact injury but as you get older the chances of this injury goes up. So how do I get past this frustration?
Darryl,
Sorry to hear about your injury. If you have a partial tear, that should mean a much faster recovery and less inconvenience.
When I was hurt, I switched from running to alternative exercises: I used a stationary bike (one legged) and a Bowflex (since I could not use my leg, picking up free weights was a bad idea). As I recovered, I added water running. I’d suggest a similar sort of approach: add (or expand) exercises that you can do to compensate for what you cannot do now. That way you’ll still be in good shape when the leg is back in action.
Mike
I just got home from the doctor. He took x-rays and nothing is broken and he doesn’t think an MRI is necessary but they sent my file to the orthopedic department and they will call me next week to discuss PT. The doctor thinks I need to restrict activity for 6-8 weeks and combined with rehab I should be ready for my softball season in April. I’ll keep you posted.
Darryl,
Good luck. If you have good insurance, you might want to consider an MRI anyway to determine the extent of the tissue damage. An x-ray will give an indication of a full tear (the knee cap will be significantly displaced) but won’t show soft tissue damage. I had to see three doctors before I got a correct diagnosis on my injury (although I diagnosed it correctly myself), so it can be a good idea to be extra careful.
OK, here’s my situation. I had my appointment with the orthopedist on Wednesday (February 8) and after talking to me and looking at the knee, the doctor said the quad is torn and I need to take it easy for now and to come back in 6 weeks to see how it is doing. I pointed out the instability in the knee and the clicking I feel and he said that because the quad is torn the kneecap is not being pulled evenly by all 4 muscles so it is moving a little to the side as well as up and down and that is what I feel, and that in a few days it should go away on its own. I pointed out the problem with scar tissue and told him I was stretching the knee and he said “keep doing what you’re doing but don’t overdo it”!
So I am depending on myself until I get to physical therapy. I do my own stretching every day and ride the bike for an hour. I went swimming today and stretched in the hot tub as well and think I will do that until I go back to the doctor. I’ve had enough injuries and gone through enough rehab to know the difference between pain and discomfort and I think I can at least improve range of motion. I can’t really walk up a flight of stairs right now so that is my short term goal, then two steps at a time will be my next goal. I’ll keep you posted.
Anonymous,
If the kneecap is still in the normal place and if you can do a straight leg lift, then it would definitely be a partial tear. From my research, people can recover from those without surgery, which is good.
You are wise to take care with the tear-it could easily become a full tear.
Partial tears can be problematic. If you have a major (+70%) tear, you may be better off having it surgically repaired, as a tear of that magnitude is likely to give way completely in the future. At some degree below that, rehab may be a better approach. This is a decision to be made with your orthopedist. I walked out of the ER with a diagnosis of a “strain” since I could still lift my leg and keep it straight. The MRI showed a “major” tear; the orthopedist said that it could be that the tear was of the surface tissue, but he couldn’t tell until he opened it up. It turned out that I had an 80% tear and needed the full surgical treatment.
Best of luck – I’m 2+ years removed and more active than I was before the surgery (which says more about my prior level of activity than anything else!).
Dave,
Glad to hear about your recovery. It does make sense to have a severe partial tear fixed-after all, it will probably end up tearing fully at some point.
Finally, after all the delays (remember, I tore it January 15) my rehab starts on Tuesday. I will be going twice a week (Tuesday and Friday) for the next 4 weeks. After a re-evaluation at that time, they will either continue with twice a week, cut it to once a week, or order an MRI to determine why there is no improvement. I’ve been stretching it and riding the bike in the gym every day and swimming on weekends and can feel the improvement. I can walk up the stairs with no pain and a couple days ago I went up 2 stairs at a time without thinking about it.
Anyway, noting atrophy in the muscle, the PT gave me “homework” – a series of strengthening exercises to begin before we meet next week. I’ll keep you posted. I may make it back for the end of softball season after all!
Darryl,
Good luck with the rehab process. It will be both slow and challenging-but also well forth the effort.
Darryl, after studying this injury, asking my doctor a thousand questions and speaking to other doctors and orthapedic surgeons, I have come to the conclusion that it DOESN’T MATTER what kind of shape you are in when this happens. “It happens because it happens” is the explanation I get from the doctors. Usually, it happens to active men over 40 who have played, or are still playing, active sports (skiing, hockey, soccer, baseball, etc.). I spoke with a surgeon who said that over the years, the tendon will shred and weaken without any pain or discomfort. Basically, it wears down from use. Then, POW!! It ruptures or tears when you least expect it. There is no warning, it just goes. I am 9 weeks post-surgery and into rehab. My entire leg from the hip-flexor to my ankle was dead. Now, after just 3 weeks of rehab, I can lift my leg, my ROM is coming back and my knee cap is starting to release itself and get back to normal. They say that getting from 0 to 90 degrees of ROM is pretty easy. It’s getting from 90 degrees to full ROM that takes time.
Whatever you do, don’t stop playing baseball and being active. I’m 52 and I will stop playing ice hockey when they take my stick from my cold, dead hand!!! Rehab—–recover——return!!! Good luck, Darryl!!!
Well said!
The last few days I have been goingstir crazy. I am used to going to the gym 5 times a week and between my tournament and then this injury, I hadn’t been to the gym in 2 weeks! So on Thursday I went to the gym to just do a little overall body stretching (very cautiously) and testing the leg to see how it stacked up in terms of strength and range of motion. I rode the stationary bike for 5 minutes and had no problem so I guess next week I will go to the gym for abs, stretching and 10-15 mins on the bike. I see my doctor on Feb 1 and the orthopedist on Feb 8 and don’t won’t my leg to freeze up before they see me – 3 weeks after the initial injury! Guess a lot of guys are getting hurt these days!
I know what you mean Tom. I was especially frustrated because I spent the 6 weeks between Thanksgiving and my tournamnet paying a bating coach twice a week to work on my swing. The day before I left even my bad swings were going 300 feet! I couldn’t wait to get to Vegas. Now, I can’t put weight on my right leg so I will lose everything I worked on! I know it’ll come back, but I don’t even know if I can play this year and if I do I may have to move from catcher to DH. Is this what Jorge Posada went thru last year? 🙂
Darryl,
I know what you mean-I’m a runner and my injury robbed me of running for months. I avoided going crazy (and getting fat) by coming up with alternative exercises.
If you don’t mind the stationary bike, it can be worth it to check around and find a used (or free) one. People often buy them and just never use them. Biking will help keep the muscle and cardio from declining too much.
You can also look into pool exercises-I was in the pool long before I could run. While you won’t be able to bat properly, you might be able to come up with some batting like exercises for the pool that can work everything but the bad leg. When I got my AquaJogger, the DVD and booklet that came with it had all sorts of strength exercises for the legs and upper body.
Good luck with the recovery!
Well, Saturday will be 3 weeks ago that I tore the quad (it seems so much longer). I am in the gym every day just stretching it (not as painful as when I started and increased range of motion) and riding the stationary bike for 45 minutes. It sounds like it’s improving, but I still can’t straighten it ti 180* and I feel a popping in it when I try, I can’t walk up a flight of stairs, my knee suddenly buckles without warning when I walk down the street, and tonight it gave out and I fell off the bed. I was just standing on the bed reaching up to change a light and a slight backstep and it gave out. I don’t get to see my doctor until Wednesday and I hope it isn’t worse than I think. ANyone else have this problem?
Anonymous,
The good news is that your recovery sounds normal. It took me a long time to be able to regain range of motion (I remember feeling like a champion when I hit 20 degrees). Stairs were my enemy for a long time and my knee did the buckle thing for quite some time. So, you are most likely right on track.
So for the last week I have been going to my Bally’s gym with a pool. I can’t do strokes because of the torn tricep (it really was quite a play at the plate) so I go to the “deep” end (5.5 feet), hold the lane ropes with each hand, and while face down I kick. Then I turn over on my back and continue to kick. When I finally stop I stand in the water and jump off one leg then the other. After that I kick some more and finally I go to the hot tub and stretch. I can tell the difference in range of motion and I think the water work really works the leg muscules.
Something strange happened today. Last week the doctor made my next appointment for 6 weeks from now but I got a call from the PT today and he gave me his earliest date – March 7. Then, just before he hung up the phone, he noticed he had an opening tomorrow at 10:45! I hope this means I may actually be back to play softball this year!
Darryl,
That sounds like a good recovery plan. I spent a lot of time in the pool after my injury and found that very useful-it was good not having to worry about falling, plus the water running really helped with my cardio (and sanity).
I do wonder if the appointment dates are set by the medical facts or merely scheduling convenience. But, it is good that you got in earlier-good luck with the recovery.
Thanks for a great blog Michael. Got several tips. Early tomorrow morning Doc is going to put things back together. Nice to know what’s ahead. Got your book to review also. I hate those wet ladders too.
Rex,
Good luck with the recovery!
Okay boys…….I’m 70 days out of surgery. Rehab is 2-3 times a week, depending on my work schedule. I do a ton of rehab at home, on my own. There is a ton of scar tissue around my knee, so I do alot of massaging and trying to keep it loose. Once I start moving my knee and getting my leg going, things are great. It’s getting through the initial bending and stretching that’s a little uncomfortable.
I’ve been working on stairs, lately. Going up and down is a challenge with my injured leg being the “lead” leg. But the more I do it, the better my leg feels and my balance is much better. Although the rehab docs are telling me that I have 6-8 more months of rehab left, I feel that I’ll be back on the ice by May or June. I see improvement, everyday.
This is a tough surgery and rehab, though. I want to build my leg strength, so I walk around my neighborhood and I pull a tire that is attached to a rope around my waist. As I get stronger, I will stack more tires on the pile and pull more weight. Hopefully, this will get me back to full speed very quickly.
Hi Tom, far be it for me to give out advice, but I do know a guy who got way out ahead of his doctor’s recommendation and ended up with a second rupture. The rehab is long and slow and scar tissue is a major concern. I had to have a second surgery – arthroscopic – to clean out the scar tissue but it all works now so was worth it.
Tom,
Throughout my life I have had a tendency to not listen to people when they told me to do things. But, when it came to my rehab for my surgery, I shocked my family and friends by listening and actually doing what I was supposed to do. This was not because of any new wisdom on my part, but the realization that overdoing it could put me back in surgery and perhaps do some irreparable damage. So, I’d suggest following the suggested plan-but you should check with the experts to see if you can do more based on your condition.
I can assure you that it took a lot of willpower to not exercise like I wanted. 🙂
Mike
Hi. My name is Ron (61 years old and 205 lbs.) and I severed/ruptured my quadriceps tendon 11 months ago in March of 2011. Today I seem like I’m 90% to 95% recovered. I go to the gym 3 to 4 times per week and do 5 mi. on the tread mill using a very brisk walk with some jogging for .10 to .25 mi. interspersed and lift weights for my upper body. The only negative effects remaining from the injury is occasional tightness and an inability to jog or run on uneven surfaces. I’m currently attempting to get my weight under 200 lbs. following the inactivity period of healing. I would like to be able to jog at 11 minute miles by this summer. Is this a realistic goal?
Ron,
That should be doable-there guys who are 60+ in my track club who have recovered from surgery and run sub 7 minute miles (and faster).
Based on my own experience, your knee will probably be a bit “tricky” for a while. However, you should probably be able to re-adapt to uneven surfaces with some practice. What sort of trouble do you have with those surfaces? Does the knee seem unstable or something else?
Wow, I’ve received more info from this blog, than from any medical websites that I’ve visited. I am a 41 year old UPS package car driver. On 1/4/12 I silpped on a patch on snow/ice and tore my right quad tendon. Had surgery on 1/11. About 3 weeks post-op I was able to bend to about 40 drgrees and able to lift leg and hold it in position for about 10 seconds. I’ll be starting PT on 2/15. I’m also a former college football player, and have remained physically active since my playing days ended. I always thought of myself as indestructable, but this injury has given me a “glimpse of my mortality”.I have spent the past 90 minutes or so reading through this blog and have found the comments to be very heplful as well as inspirational. You are all tough guys in my book. I hope I can recover enough to go back to work soon as I have a 7 yr old daughter and a 3 yr old son and would like to be able to play with them as well as support them. Good luck and best wishes to all. I’ll continue to follow this for sure!
Bob
Bob, from the way you describe your surgery and recovery, you didn’t have a complete 100% tear, or rupture, which is great news. If you did, you are superman. I was in a cast for 7 weeks and couldn’t lift my leg until 2 weeks after my cast was off. This is NOT a common injury, but it is a very frustrating one to rehab. Just like you, I thought I was indestructable. I’ve had knee scopes, ankle scopes, knee surgery and other injuries, but this one is the worst. This injury makes you think how complicated, yet simple, the human body really is. Just think, a piece of tissue attaches to a bone and makes the bottom of your leg lift up and lock into place. Without that little piece of tissue, we are crippled. Amazing.
Keep massaging the area to keep that scar tissue healing. You’ll be fine and be running with your kids in the summer.
I was like all of you with quadriceps Tendon Repair back in March of 10. I agree with you that this has to be one of the worst surgeries because I’ve had rotator cuff surgery (3 times), achillies tendon surgery on the ankle, and two knee replacements, but unfortunately last year I found one that was even worse. I had 4 herninated discs from L2-4 and then had to have a spinal fusion of L4-5 with a rod and braces. This is about 300 times worse than the quadriceps surgery.All that I can tell you is to listen to the Doctors, do the therapy and keep as active as possible. It will get better but it takes time and if you don’t listen to the Doctors and the therapists you will be back in the hospital for more surgery. If you try to do things that you are not suppose to you will retear it and have to start back at square one. I worked in PT. You will get back to where you want to get but give it the time to heal. Just think about all the cutting and such that had to be done. Not only does your quad have to heal but also the muscles, skin, nerves, muscles, tendons and ligaments also. Nerves only regenerate at 1 cmm per month so guys give it time!!!!
Rosemarie,
Sorry to hear about the discs-that does sound rather painful. Good luck with your recovery.
Tom,
The doctor did tell me that this is one of the worst knee related injuries. That certainly was not what I wanted to hear.
Bob,
Sorry to hear about your injury. It does sound like you are making a good recovery. The main challenge you’ll face with getting back to driving will be the flexibility. I was back at work 2 weeks after surgery, but I could not get into my truck for quite a long time after that. Fortunately, my girlfriend was able to drive me (I’d sit the long way across the back seats).
Michael, that is exactly how my daughter drove me around!! I’d sit across the backseat and felt like a dog going to the vet!! Now, I’m 77 days out of surgery, I walk with a slight limp, but I can drive myself around and walk pretty well. Rehab is going well and it seems that every visit I have more and more strength and balance. I do a ton of rehab on my own, at home. I was told that my knee cap is nice and loose and the scar tissue is disolving. Going up and down stairs is still a challenge, but it is getting better every day. I can almost get the pedals around on the stationary bike, maybe by next week, I hope.
Tom,
It is a great way to travel.
I remember my struggle with the pedals very well-it was a great feeling to finally be able to make a complete rotation. Funny how an injury like that can reset one’s view of things.
Hi Mike,
Thanks for the response regarding my recovery. I continue to get a little pain and a feeling of weakness when I run to catch a baseball or go out to catch a pass when throwing a football around. Recently, I had a little pain when I did a partial knee bend as I was doing a project around the house. Normal use is fine except that I get a little tightness when it’s particularly cold outdoors, i.e., below freezing. Those are the remaining issues coming up on a year after my surgery.
Ron
Ron,
Based on my experience (I’m about three years out from my injury), the repaired knee will always have a few problems. Of course, I can’t say for sure how much is due to the repair and how much is due to 45 years of wear! 🙂
Michael;
I had a distal bicep tear 6 months ago, very experienced with the nature of this sort of thing. i got my injury from slipping off a ladder 2 days ago holding one end of a 100 pound glass backboard and jamming my foot into the ground with tremendous force on the knee. In the emergency room I was able to straighten and bemd my knee, but have a huge indentation at the top of my knee. I had thought there was more than one anchor point of the quad muscle group, because it seems like the patella area is detached but visually the muscle kinda looks normal. With my bicep it went popeye and shot up my arm like rubber band.
Anyway MRI tomorrow 3 days out, surgery next week if needed 1.5 weeks out. Time is of the essence. I can stand on my leg and the joint seems to be able to bear weight, but is painful to bend it.
I am wondering from surgery how long will it take to walk on crutches. Within a few days? my biggest fear would be falling but if the knee is locked the rest of your body can take the hit.
Man what an ordeal this is going to be….I just got over my arm being messed up. It is only beginning to be like my other arm. Thanks all, Mike.
Michael C.,
I was able to use crutches the day of the surgery, but was not allowed back at work for two weeks. I tend to think that the two week thing is generic, though. By the time I was back at work, I was pretty good on the crutches-the doctor and PA said that I should use them often, since it would actually help to have some weight on the leg.
Getting around will probably be a bit scary at first-I was worried that I would fall and tear up my leg. Stairs are especially scary.
Okay, we’re 97 days post-surgery. Rehab has gotten me to full ROM, but my quad muscle is still weak. I am riding my stationary bike and my leg is feeling great. I just had to relearn how to walk down stairs without falling over myself. My balance is starting to come back and my confidence in this leg is starting to get better.
In two weeks I am going to put on my skates and just take a few laps around the rink. My target date for going back to playing hockey is June 1st. My doctor did a great job and the rehab doc’s are great, too. I just need to take it easy and not push it. There is no pain at all and all the things that I used to have to think about doing are now second nature.
To all those people who are having a tough time with this injury, give it time. Every injury and every body is different. Improvement is sometimes weekly and sometimes daily. The one thing I learned is that you’re better off taking it slow and not pushing it. Oh yea, listen to your doctor!!
Tom,
Congratulations on getting the ROM back. I bet you’ll be happy to get back on the ice-I still remember the day I was able to return to running.
Michael, I know that I am not 100%. My quad muscle has hardly any strength, at all. But the only way I can get to 100% is to do what I do best, play hockey. Playing hockey builds those leg muscles and gets you stronger. i can ride my bike and pull my tire to try and build up some strength, but I need to get on the ice and get moving, again. I’m sure that you didn’t run a marathon when you returned to running, right away, so I’m going to just take it slow and do a little more, every week.
I’ll be honest with everyone, when I got my cast off, 8 weeks ago, I NEVER envisioned even putting on a pair of hockey skates for a year. My leg was skinny, the swelling around my knee was unbelieveable and I had no ROM and no strength. I couldn’t even lift my leg 2″ off of a table. But over the days and weeks, little things started to change and soon I was able to lift my leg, walk a little better and get down the stairs.
The human body is fantastic!! Even today, I feel a little better than yesterday. I can’t wait for tomorrow.
Tom,
Seeing that slack and skinny leg is a scary thing. I remember when I finally had my brace and bandages off-my leg was pudding like. It was horrifying to see how fast years of training just vanished.
But, as you said, getting back to the activities is what brings that muscle back. Like you, I was impressed by how quickly I got back what I had lost. I’m actually stronger now than before-I kept the quadriceps exercises as part of my workout.
Enjoy the skating!
Michael;
Mike C here again. I got an MRI yesterday, I see the knee surgeon tomorrow. I cannot do a straight leg raise, but I can stand/walk slowly with an immobilizer on. After the surgery which I assume I will need I am sure I will be taken out for a week.
I have a ride to work, a desk job where I sit on my *ss all day, and elevators to get me there. What I am nervous about is getting in and out of the car, and getting around on crutches with no weight on my leg.
I have read that some people are out from work for months. I just got assigned a great position and I cannot lose it, if I do it will be like a punch in the face in additional to being crippled.
How long before I can bear weight on the knee?
Again I am wondering after the first week if i might be able to hobble into work. What a mess. Mike.
Michael C. , after tendon surgery, you should be in a cast from your hip to your ankle for 6-8 weeks. There’s not much pain, just a little discomfort. I didn’t have to take any pain pills and I never used crutches. My cast held me up pretty well.
The reason you can’t do a leg lift is because the quad tendon is ruptured. After I got my cast off, it was 4 weeks before I could do a straight leg lift. You’ll be okay. I’m 99 days out of surgery and although I have a slight limp, my leg feels pretty good. A few more weeks and I’ll be back playing hockey. Originally, I was told that I wouldn’t be able to skate for about a year. I’ll cut that time in half.
Oh yea, once the cast is off, your balance will be a little “off”. But that will come back as you go up and down stairs. Good luck. Ask any questions you want. We’re all here to help.
Tom,
They put me in a soft cast and then a $500 brace (BC/BS decided that the brace was not “medically necessary”). But, some docs go with a cast. I was glad to have the brace-I could open it up when lying down so I could clean my leg and enjoy a little coolness.
Michael/Tom;
Yeah there is no denial I know it is torn. I am 39, I don’t even feel bad that I tore my bicep and now quad because I was doing two very risky things, wasn’t because getting weaker or some degenerative disease (at least I hope!) Live and learn, will tone it down a bit.
Tom what your saying makes sense because now, with my leg locked straight, and no quadricep, I can walk no crutches. I have no problem with crutches, but the thing is if you walk with crutches with no pressure on the bad leg, i would think the quad repair is at risk because it takes the quad to lift your leg up in the air to clear it with the ground on the crutches. It is easier putting your bad leg down just for balance with no load.
My bicep after 6 months feels very good also, almost even looks the same as before.
Suually people get hurt in bball coming down from the backboard, not with the backboard.
I am working out a way to try and shower putting a plastic bag on the bad leg or something. My threshold for a shower is about 1 week, then it becomes unpleasant.
These leg casts, is it plaster or a cloth cast? I would hope you could not bend your knee at all. On the toilet I notice my knee bends slightly from the stress of going up and down, because my current cast flexes slightly if not exactly all the way up my leg. It is ok now, but man don’t want that to happen after the repair.
I looked at my leg, now that the swelling has gone down a bit, it is deformed a bit. Again also I can do a side leg raise, so there are other muscles in that monster thigh muscle group still attached. I guess this would have to be or else any weight on the leg would result in collapse.
This thread is great, gives me confidence as to know what to expect, thanks all! Mike.
Michael C,
At first I just washed my hair at the sink and used wash cloth for the rest of me. When the doc told me that I could take off the brace to shower, but he also said that if I fell, it could tear the repair and set me back to square one. So, I decided to not take the brace off. My “trick” was to stand in the shower stall with my good leg and cover the braced leg with Glad bags. I have one of those shower heads with the hose connector, so I could hose myself down without soaking the brace. To clean the bad leg, I’d lie on my bed, remove the brace and then use washcloth (I had a tuperware container of water and another with soapy water). I was using my exercise bike one legged everyday, so I really needed to shower everyday (at least according to my girlfriend).
I was in a soft cast at first and then in a brace at week two.
The quad allows you to do a straight leg lift, but other muscles handle side leg raises and so on. I was actually walking around after my injury, although I did fall from time to time.
Michael;
Yes agreed, I would not take off the brace for a shower, I will do what you did. I just got back from the DR, surgery wednesday 3/14 one and a half weeks out from injury. He said I could put weight on it after surgery so long as it keeps straight, similar to what Tom said. I will be in the straight leg cast. I plan on using crutches anyway for balance and to take the stress of the repair. I won’t even look at stairs for awhile.
Even with all of the knee swelling during the MRI, you could clearly see the quad is detached in the MRI. The Dr did seem like dude this is a simple surgery, rehab is the worst part.
Will let you guys know how it goes. Thanks again all! Mike C.
Michael C,
Yup-the surgery is simple: cut, drill, sew, close. The rehab is the ordeal. Stairs are a scary thing, but they will be good for rehab-I spent a lot of time going up and down stairs to retrain my leg (initially holding the railing). I started practicing in the pool-that way if I fell, it was just into water.
Mike C., good luck with the surgery. The straight cast will take time to get used to, but you’ll be okay. Like Michael said, this is a real “inconvenience” injury. You have to rely on everyone for help. Since it is all soft tissue damage, there is really no pain after surgery. They gave me 25 pain pills and I never needed any.
Taking a shower will be a challenge, but you’ll figure it out. Sitting on a toilet takes some jockeying around, but you’ll figure that out, too. By July 4th you’ll be walking around with a limp, but you’ll be walking.
Because of the cast, you’ll probably be on blood thinners. I thought that I would NEVER play hockey, again. Today, I’m at 100 days post-surgery, and I’m ready to begin some light skating, next week. You’ll make it!!
Listen to the doctors and the rehab techs.
I was lucky in one regard-my “guest” bathroom has plenty of leg room, and I used a bucket to prop up my leg. I added a bit of upper body strength doing the bowl lifting. 🙂
Michael and Tom, glad to hear you are doing so well. I am 2 months post op after a complete tear. I have normal ROM almost, and little pain. I was given a neoprene sleeve brace 2 weeks ago to replace the hinge brace. I can walk normally on flat surfaces, but have no strength to go up steps on bad leg. My balance is not very good, and my leg buckles if I put too much weight on it or stop suddenly.This is a work injury and company’s insurance reps are calling me. They want to send a nurse along with me on my next Dr. visit. I’m a little nervous to tell you the truth. I am able to drive myself finally but don’t know if I should be. Never know when “Big Brother” may be watching. I am going to tell Dr. on my next visit that I need to be able to go up and down steps for9-10 hrs a day to be able to perform normal job functions. Anyone have any ideas/suggestions/ experience with this?
Bob, I am 101 days post-surgery and I am JUST starting to get used to going up and down stairs with confidence. Going up isn’t bad, but going down the stairs is very challenging. So far, my leg is doing well and the strength is slowwwwwwly coming back. Driving gets easier, everyday.
This is a 10 month injury-surgery-recovery-rehab. “Big brother” can watch all they want, everyone heals differently with different time tables. Don’t get frustrated, though. It takes time and patience to get over this.
Good luck, brother. You’ll be fine in a few months.
Everyone does indeed heal at their own pace. It gets frustrating to watch other people do things that you can’t but take your time, listen to the Doctors, Physical Therapists and most of all your body and you will get there. Don’t compare yourself to how someone else heals because it doesn’t work that way, I know I have been there.
Tom,
Quite right-the recovery is a slow adventure in slow slowness.
All;
I am wondering if you guys can answer two questions. First, presurgery, I can walk on both legs no crutches with the brace….but after a week my hip is starting to get fried. It just hurts. Crutches helps, but it just wears on you with the leg straight constantly. If I rest it is does get better, but for 6-8 weeks this is going to be absolute torture. Has anyone had any hip issues?
Also, is it safe to say, with the leg locked straight post surgery, is there any danger of re-rupture? Say you flex your quad, which would pull against the sutures…could that tear it? I wouldn’t think so the sutures have to be at least a little strong. What about weight on it? Does it basically on re-reupture when an active load/active bending is placed on the quad before tendon healing? Thanks! Michael C.
Michael C,
I didn’t have any hip problems, as I recall. But, I used the crutches to get about. That might be a factor. My guess is that you are stressing those muscles to do work that is supposed to be done by other muscles.
There is always the risk of a tear, but the stitching should be strong enough to hold against most “normal” occurrences. I had the same worry as you-I’d sometimes wake up at night after having some nightmare (about running and having my leg tear apart) and my quad would be firing away. That worried me-but it held up.
I was warned that a fall could tear it-so it is a good idea to be careful about that.
Michael, I’m having the same problem walking. Use the crutches even though they are a pain. My hip and lower back ache from not being able to distribute my weght normally on both legs. My good knee is also bothering me from overuse. I don’t know if flexing the quad will do any damage. For a few weeks after surgery I would try, but got no response. Just had to give it time before there was muscle activity in my quad. I’m 2 months out of surgery and I’m still not able to put any weight on it while bending.
Michael C. and Bob, because of the injury and the leg being immobilized, your hips are going to be “out of wack”. Your good knee is going to ache because of all the weight on it. Believe me, my good knee STILL hurts and I’m over 100 days post-surgery.
Everything will heal in good time. Remember, most doctors will tell you that this is a 8-12 month surgery-rehab-recovery. Bob, It is still hard for me to put all my weight on my leg, but it’s coming around. LISTEN to your rehab doctors, too. The tendon will heal in a couple of months, but it’s the muscle that needs to regain it’s strength. That is what takes all the time. Getting the muscle to where it used to be is what takes the longest.
Michael C. , with your leg locked and in a cast, there is always the possibility of a re-rupture, but, as it was explained to me, the newly attached tendon is not under any strain. All the weight is on the cast, not on the leg, or tendon, so it’s pretty safe. They use fishing line for sutures, so they won’t let go. If you have a hip to ankle cast, you won’t be able to bend your leg, anyway. If you have a leg immobilizer, the doctor will tell you to not even try bending your leg. You won’t be able to bend it, anyway, because of the swelling. Just be careful going down stairs!! After surgery, you shouldn’t have alot of pain, either. Your scar will be about a 6″-8″ vertical incision right over your knee. 2-3 weeks after surgery they will remove the staples from your wound and then 4-5 weeks after that the cast will come off and you’ll go to rehab. You guys will be walking around really well in July.
Before I had this injury, I NEVER heard of a “quad rupture”. Now, I woudn’t wish this on my worst enemy.
All;
I can walk comfortably on one crutch like dr house does, hip pain has been alleviated. You know people have been saying to me, take a month off! why stress your leg!….and that is true, you risk not walking ever again…but the other side of it is the more you stay out of society the more your life deteriorates…if i stayed home from work for a month I would almost be “phased out” because I need to stay on top of things day to day. I need to find the point where the risk is acceptable to get to work so I have a job to go back to.
The repair to my bicep was the endobutton, the tendon had a metal clip on it which held it against the bone through a hole on the other side. Very strong, low risk of tear, today 6 months later it is 80% strength of the other one simply because muscle had to be redeveloped.
Tying such a huge muscle as a quad to a bone with some sutures seems not very strong, but I guess thats the best medicine has to offer right now.
the thing that is killing me is what I should have done to stop this injury. Bad judgement and rushing things too fast.
Michael, Tom, when you got into a car to get home after surgery, how did that happen? right now I am forcing my torn quad leg in the front seat by discombobulating myself with stress on the leg and back and arms to get in and out of a car. how is that done where your leg cannot be stressed at all? the toilet I noticed my knee wants to bend badly sitting down, I would have to hold myself up like a ring gymnast the whole time. It seems tough enough to get the leg on a bucket.
When walking even on crutches getting your repaired leg forward involves a quad. mine is disconnected now but I feel it firing as if it is trying to work, and i can feel it. I guess thats why time in bed is important.
All I know right now life asI used to know it is over until I get pieced back together in the operating room with the surgeon (the most critical person on the planet to me right now) tomorrow at 10:45.
Enough talk on my part. Lets do this. See you guys on the other side. Michael C.
Michael C,
For quite a while I was a back seat passenger-luckily my girlfriend was willing to drive me to and from work. It was quite a while before I could sit in my truck (that was the only time I thought it would be better to have a car).
My trick was to lower myself so my butt was on the seat, then I’d slide back using my hands. When I had to get out, I’d slide forward and stand up using my crutches or the door. I got pretty good at that.
Michael C. I don’t know about anyone else, but my wife had to lift my leg into the car. I would put my left leg in, and she would pick up the right and get it inside. I would slide it over once I was in.I could not bend my knee well enough to drive until 7 weeks after surgery.
I would use a crutch as a tool to lift my leg. I turned it upside down and slid my foot under the pad that goes under the arm. then I would grab the botton skinny part of the crutch and lift my leg into bed, or up on the ottoman in the living room. I would take a crutch into the bathroom and hold onto it while I was sitting down. I would extend my repaired leg out as far as I could and slowly lower myself by only bending the good leg. After a while, the good leg began to hurt from added stress. This was the most difficult part, after a few weeks you find that you are able to lift your leg, which makes getting in and out of the car, and getting in and out of bed easier.
It is still difficult for me to sit in the bathroom, still have to lower myself slowly, but at least I can bend repaired knee somewhat normally. I too, am very concerned about returning to work. I’m a UPS driver, and need to be able to carry packages up and down steps 9-10 hrs a day every day. I’m only 41 and have two little kids, 7 and 3. I worry about being able to support them. Been at UPS for 16 years, don’t know of another career where I would make similar money and benefits. Wish I had an office job. This surgery is difficult at first, but you will adapt well. Don’t push it too hard,rest and ice work well after surgery. Best wishes to you.
Michael C. , good luck with the surgery, brother, I’m sure you’ll be fine. This is not an easy injury to rehab, but it can be done and you’ll do it, I’m sure.
Bob, I’m 104 days out of surgery and was just told by my doctor to return to some light skating. The only way to strengthen my leg is to use it, so I will take it easy, but work my leg back into shape. You should be able to start going up and down steps in the next 2-3 weeks. The one thing that amazed me about my recovery was how quickly I progressed after 60 days, post surgery. You’ll be able to walk and use the stairs, but you’ll just be EXTRA CAREFUL. My doctor just told me that in 3 months I won’t even remember which leg is bad.
There is probably some tightness right above your knee. That will slowwwwwly begin to release and losen up over the next couple of weeks. That’s where all the stitching is done. If you can ride an excersize bike, do it!! Walk up and down stairs, slowly. In 2 months you’ll be working overtime with no problems. You’ll be a little uncomfortable, but you’ll be able to work, brother. Keep working on it and you’ll be fine.
thanks Tom
Tom,
Enjoy the skating. Being from Maine, I miss the ice-no skating here in Tallahassee.
As you said, the knee will have that weird tightness. Heck, mine still has that and my surgery was 3 years ago. But, the knee works fine and that is what matters. Plus, I have a cool scar and the chicks dig a man with cool scar. 🙂
All;
I just got home from the hospital, I made it safely into my ez boy recliner. When I woke up from surgery i had no nerve block and no pain meds, man
that was very painful. The doctor said I had a clean tear, pretty much textbook, repair went smoothly.
it has been 4 hours since surgery, Tom had said he didn’t need meds. Your a littler tougher than me Tom, I had to have a percocet. With the percocet the pain is pretty much gone. It is starting to wear off, but the pain is tolerable. I want to take as little as possible, pain seems to be getting better.
I am just so happy to have my quad back, the moral is so high right now because I know I can move forward.
In the hospital before surgery i tried bending my knee, it was painful past 40 degrees. Hoping that was because kneecap and whatever else in there was out of alignment.
Again this is an awesome thread, appreciate everryone filling me in on their experiences. Outstanding. Best of luck to everyone healing. I am 3 hours into it, long road ahead. Mike C.
Mike C,
Glad to hear you made it through the surgery smoothly.
One thing you will find is that a big challenge is getting the knee to bend, once you are ready to do that. Many of your PT exercises will be aimed at restoring flexion. I was surprised by this myself, but in retrospect it made sense: the tendon had been repaired and had been locked in place for a long time. It was a bit scary working on it-I always worried that the tendon would just go “pop.” Eventually I got all the flexion back.
All;
It has been almost 24 hours since the surgery, i have been off the percocets since 9:50 pm last night, the pain has gotten too bad, i had to pop 2.
i don’t know how you guys did this, it is insane. I walked twice on crutches very carefully, I can’t put weight on it, I have to walk backwards….
I am dreading having to sit down to go to the bathroom, it is going to suck so bad. I have been taking colace every so often, not eating a whole lot, but i have severe constipation problems with painkillers. I know it has less than 24 hours, but this is rough. It has to get better.
i am hoping the tenderness and 0% confidence in my completely useless right leg goes away within a week or so.
The dr told me to take aspirin for blood clotting, I have been moving my feet and have a compression sock for the clotting.
Much respect to you friends and Michael creating this thread, knowing you got through it is giving me confidence I will make it through this. The bicep tear i had doesn’t even compare to this. Man I really went and did it good this time. Michael C.
I had the same problems Michael C. They gave me a spinal block plus femoral blocks. I had no feeling below the waist for about 10 hrs after surgery. Stayed overnight at the hospital because I was unable to wiggle my foot for about 3 hours post op. Pain hit my like a train the next day. I used the pain killers for maybe a week after surgery, mostly at night to help me sleep. It’s difficult to sleep in that brace, it’s like being shackled. There will be tenderness around the incision for some time. They gave me presciption aspirin to prevent blood clotting. Try to stay off your feet if possible, the brace caused my calf and ankle to swell if I stood too much, or didn’t elevate leg. The first week post op is the worst, but you’ll see improvements soon.
60 hours post op, i am starting to not need the painkillers, my primary focus right now is the toilet. The pain has gone away enough such that i can walk there, I don’t need to have my wife empty my pee container. I had chest soreness from the anesthesia, that is starting to go away.
i haven’t been eating that much, but every percocet i take i pop a colace. Following Michael’s advice to get that first bowel movement in.
i had said i wanted to go back to work Monday. That plan is out the window. i will be happy if i go back the following Monday at almost the 2 week mark. As a matter of fact work is not too important right now, i am focusing on trying to just be able to be mobile with some stabilty.
Being off percocets means constipation will end. Sounds pathetic but this is one of my life’s goals right now.
i tell you what, without my wife taking care of me I wouldn’t say my life is in danger, but the repair would and i would have a really hard time.
You guys are so right, my surgeon, although a master knee surgeon with 22 years experience, doesn’t volunteer any information. The best advice is hearing people actually going through this psychotic injury. I tore my arm up, again i just left it alone for 6-8 weeks and it healed and i rehabbed it and at the 6 month mark was lifting 80 pound bags of cement with it.
Having to use your leg to walk on really screws up the entire healing process. Michael C.
As one of my Doctors told me, if we would have told you ahead of time how bad it would be after would you have gone through the operation? You need to have it done and unfortunately when people find out about the recovery after if the Doctor comes out and tells them about how bad it is they won’t do it. I have had 3 rotator cuff surgeries, 4 knee surgeries, an ankle surgery and I know that the quad surgery was worse than any of them but this last year I had back surgery and I’ll tell you what guys that tops them all. I have an extremely high pain tolerance level and this sure beats the quad surgery. To move your bowels try also taking prunes, prune juice and anything with fiber in it. Don’t try straining because that will really make your leg hurt. You will get there, it just takes time and you have to do the PT and listen to your Doctor because you don’t want to have to go through this again.
Rosemarie
Rosemarie,
I’d still have done it, but it might have worried me a bit more. 🙂
Michael C,
You are wise to keep dosing yourself with Colace. My whole life I have been as regular as a clock, but the medication had the predicted side effects and that was rather unpleasant. It also helps to hydrate regularly and eat foods that promote such activity. Not being constipated was actually a major milestone for me-it is funny how life goals can change like that. 🙂
My girlfriend and friends really helped me out with my recovery-going it alone would have been…horrible.
Med schools are supposedly trying to teach new doctors to inform their patients about procedures and so on, but even if they do this it will be quite a while before that change significantly impacts the system.
So I’ve been doing rehab for 2 weeks and let me tell you it is NOT fun! The two most difficult are stepping up on a stair and standing on a stair on the bad leg (right), lowering the left leg until the heel touches the floor, then standing straight up again. My right leg has NO strength in it! But as frustrating as it is, I do them every night at the gym after work (plus twice a week before work at rehab), 3 one minute isometric squats, 3 minutes on the balance board, one legged leg press and 30-45 minutes on the bike. Fortunately the train staion near my house and the one near my job both have escalators so I had no problem getting to/from work. Now I take the stairs and though it hurts a little, it hurts a little lessevery day as the leg gets stronger. I know longer have it go out on me as I walk down the street and I am hoping to return for the last month of my softball season (August). Of course, playing catcher as I do, I think I may have to change positions for the rest of this year (1st?, 3rd?, DH?) but next year I want my old position back.
Bottom line is, the first few days in rehab are hell but you will see improvement daily if you work hard at it.
Darryl,
Once you get the flexion and strength back you should be good for catching. I had my surgery on April 3 (2009) and started running (2.3 miles) at the start of September. That was a good day.
I’m pretty sure I’ve made quite a bit of progress. I can now walk up or down a flight of stairs without holding onto the handrail and am not afraid the leg will give out. In fact, it only happens every once in a while now. It’s just the frustration of the leg always being sore. As I am better able to do an exercise I either add more weight, increase the height of the stair to make it more difficult, increase the time of the isometric squats, etc. I know it is making the leg stronger but I can’t help but get tired of feeling the pain every time I get out of my chair, walk up/down a stair, or seeing a bus/train already at the stop before I get there and know I have to get the next one because I can’t run for it.
Plus, my softball team had a team meeting today to set up our tournaments for the year. I will miss playing in tournaments in Connecticut and Phoenix (April), Atlanta (May), Philadelphia (June) and Boston (July). Minneapolis (August) and Chicago (September) are my goal now. I’m hoping I can have Michael’s success and make it back by the fall. Keep your fingers crossed, I know I will!
Darryl,
Sitting on the sidelines is a hard thing. When I was able to get up and about, I volunteered at some races. It was nice being back in the events, although I could not compete. Being part of a team/club does help-it is nice to still be a part of something even while recovering.
You’ll be back out there, good as new. Maybe even better. 🙂
On Tuesday I went to my PT for the first time in 10 days (she was away last week). She gave me a series of exercises to do as homework and I did it and a few more every day. She was very impressed with the progress I’ve made and changed 3 of the exercises to make them more challenging. I thought they were tough before but when I was finished with my session I was exhausted, drenched in sweat and just wanted to go someplace quiet and lay down. It was 9:30 am and I had to go to work!
These are so tough she told me no exercising until we meet on Friday. These will be every other day but I am going to try and do them every day. The quad will not retear and the image I know we all have in the back of our mind of it retearing during rehab will not happen. The orthopedist saw me today and said the Easter tournament is ut but Memorial Day is very possible and 4th of July is likely if I keep making progress. So I won’t miss much more than half the season after all.
Darryl,
It is great to hear that your PT is going along well. It is amazing how hard it is to rebuild the leg and get back things like being able to walk.
sorry about the typos 🙂
Rosemarie;
Basically without this operation you can’t really ever walk again so I definetly would have done this surgery even without anesthesia! (allthough that I might regret!)
The thing that makes me nervous is once in a while I will get a quad spasm…i was sleeping peacefully, then all of a sudden i wake up in a jolt and my quad tightens and spasms against the knee. Oh boy do i know it is connected, I could feel it yanking on it.
Again this only lasted a second and is an involuntary muscle spasm, i would hope the sutures and the repair was designed well enough to withstand this type of thing. Michael had said his quad would fire away now and then, I am nervous because i am only 3 days into this. Of course there is no load so the sutures should hold up to the flexing of he muscle. Funny I search the entire internet now metion of this type of thing at all. Hopefully because it is a non issue.
72 hours out now, there is no pain now but when i walk around on crutches no load it gets painful and i have to lay down again for the pain to subside.
Michael, I had quite a bit of muscle spasms and they told me that it was quite normal. It is scary when it happens. Make sure that you drink liquids because my therapists told me that keeping hydrated does help some. I know it is quite scary because no one tells you what to expect and when the strange things happen you do start to wonder if this is normal or not. I wish with all of my surgeries that I would have know what to expect because I think that would have put my mind at ease when they happened. Like my one therapist told me expect the unexpected!!!
Friends;
It has been almost exactly 4 days since they cut me open, I had a major milestone this morning, has lifted a huge burden off of me. After taking about i would say 20 colace and 2 laxatives, i was able to have a bowel movement, painful and slow, but definitive. I can’t even imagine if i didnt take laxatives what would happen. But now that i am off the percocets, and i will keep pounding laxatives, it should get easier….
thus stuff sounds funny/ridiculous, but it is very real and even worse than the surgery for me. i can at least get to the toilet and sit down fairly quickly, and stay in a comfortable postition. Outstanding.
Also rosemarie, very true what you said, i have been pounding water also, i get a spasm once in a while, but when i do i always feel the slight tug on my knee. Have to also realize that muscle at this point is probably so weak it has no strength to pull off anything. Again my bicep healed to a point where I don’t even know i injured it, i expect the same with this, although i am sure much more work. good stuff.
Michael C.,
Having been there myself, I know how you feel. Unfortunately for folks who go through surgeries, they are often not told about all the “little things” that are actually a big deal when you are living through them. Like dealing with the toilet.
When I was going through my experience, I was surprised at the lack of information available-the web certainly is very helpful for learning all those important but overlooked details.
Michael C. and Darryl, glad to hear you’re both doing well. At 108 days post-surgery, I was able to get out and skate a little with my hockey team. Although my tendon is 100% healed, my quad muscle is very weak. I couldn’t skate with any authority, but I was able to manuever around and stretch out my leg. The game was followed by an ice bag and a good night sleep. The day after was a bit of a struggle, though. BOTH knees are really hurting, but my flexibility and manueverability are progressing.
Riding my bike REALLY helps to regulate the pain. Riding stretches everything out and takes the pressure off of the knee joint and the rest of the muscles. I was told by my doctor that I wouldn’t be able to hit the ice until June or July, so this is nothing short of a miracle, for me.
When you’re rehabbing, don’t be afraid to “push” it, a little. As soon as you can, ride a stationary bike and practice walking up and down stairs, very slowly, forward and backward. My doctor told me that the biggest problem with rehabbing is that people tend to stop when the pain gets too much. Guys, you have to work through the pain, push through it. Then, ice the crap out of it to reduce the swelling when you are done.
When I was skating, my leg hurt like hell, but as I skated more and more, things started to feel more tolerable. Plus, my teammates would not let me down. They encouraged me to keep skating and work through the pain. By the end of the game, I felt pain, swelling, throbbing and discomfort. But it was a HUGE victory for me, personally.
Everyday is a victory for all of us, boys!!
I know the feeling. I had a partial tear and riding the bike is the only thing I can do in the gym so before I started rehab I went to the gym just to stretch and after all my stretching I would ride the bike for 45-65 minutes. I knew I should stretch it to help break up the scar tissue and since riding the bike wasn’t painful, I do it every day. I’ve been “pushing it” since I started rehab, adding exercises to my workout she never gave me and telling her about them to make sure it wasn’t harmful. I’ve added isometric squats, single leg presses and now single leg extensions (20lbs!) right now, I was loooking at the hack squat machine today and tried one with no weight – DON’T try this at home…or the gym!
I know I have to do it, the alternative (quitting) is not an option!
I know I haven’t written for a while, sorry about that. I had to shut it down for a few days. It seems I was overtraining a bit. I would do to rehab in the morning before work, do the exercises, go to work and then go to the gym after work and do them again. I also do them in the gym on my non rehab days. I was doing side to side shuffles like basketball players do (works on lateral stability) and I felt the hamstring go so I stopped right away. I told the PT and she said I was doing too much quad work and needed to dial it back. On Monday (9pm) and Tuesday (9am and 9pm) and Thursday (9pm) and Friday (9am and 9pm) I was doing it 3 times in a 24 hour period.
Plus, we’ve added exercises over the course of rehab and instead of replacing the old ones I just add the new ones. Without a doubt the most difficult is the one that simulates walking down a stair. With all the weight on the bad leg, I have to lower the other leg, touch the heel to the floor and straighten the leg again. WOW! It hurts now but it HURT when I started doing it 2 weeks ago.
I have a funny story about Tuesday’s rehab. The PT laid a bunch of straps on the floor about 3 feet apart and told me to jump over the first one. I thought she meant to jump over the space between the straps so I did. I landed and the PT and her other client in the room were staring at me. I asked what was wrong and she said