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davkt

Booting up
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Apr 25, 2017
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38
How is everyone doing? Last ski season didn't happen as my knee still had a tendency to give way rather fully and quickly, that seems sorted now so hopefully a bit of skiing or maybe snowboarding this winter. Managed to crew an offshore yacht race and ride the Eroica Britannia vintage bike event last year so think it back to full strength now. Still have the metalwork in my ankle but hopefully not for long as it seems a couple of the screws are working their way out, makes putting any sort of boots on 'interesting'!
 

Kevin_C

In the parking lot (formerly "At the base lodge")
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Feb 8, 2019
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14
I found this thread and read through all 10 pages. Fantastic information on here and some great recoveries. I am 13 weeks post op from a left QTR revision and am at 55 degrees active ROM. Therapist this morning measured me at 77 degrees passive ROM with him cranking on my leg and measuring. I am ambulating without the brace (only indoors), but with a cane mostly. Unless its first thing in the morning, seems like I have the most stability first thing in the morning and can walk without the brace, but as the day goes on and stretching occurs, I have to use the cane. I had a surgery in August, and during rehab or at some point I suffered a second rupture so did it all over again on 11/08/18.

ROM has been the biggest challenge for me. Every degree seems like a battle. This has been the most difficult 6 months I've ever gone through, but hoping that theres light at the end of this tunnel.

I've been doing half revolutions on the bicycle for 10 minute increments, each revolution pushing more on the pedal with my good leg. I almost made it around on a backwards revolution this morning, but not quite.
 

JodesMW

In the parking lot (formerly "At the base lodge")
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Feb 8, 2019
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2
I just found this blog today as well. Ruptured my quad tendon 11/19/18, had surgery 2 days later. Slipped on ice at work. I'm in my 11th week post-op, and i'm in my 2nd week out of the brace/crutches. I'm curious how you got your second rupture? I've been doing my PT 2x a week, and last time I was measured my range of motion was 105. Just started on the bike last week and can almost go all the way around, but not quite yet. I hope i'm not doing too much too fast because I've been noticing weakness when I walk at times (feels like the knee wants to buckle and starts to but then I manage to catch it). This is feeding into my fears and making me terrified to go down stairs. Did you notice any warning signs before your 2nd rupture? Thx.
 

Kevin_C

In the parking lot (formerly "At the base lodge")
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14
Hi Jodes. Looking back there maybe were warning signs but at the time they were being attributed to quad atrophy or major quad weakness. We don't know if this happened early on and didn't catch it or if it happened during rehab or the week 10 mark when it was discovered through MRI. When I was in therapy and doing a SLR with the 30 degree lag (week 7 mark) it was being attributed to the fact that my quadricep was so weak and that it would eventually get better. I never felt it re-tear or had any pain that I wouldn't normally have during recovery. I was making progress but could never get out of the brace because my quadricep couldn't hold my leg straight. It would buckle as soon as my foot hit the floor. One other very important warning sign which I had was a divot on top of my knee cap. I originally thought I was wearing the brace strap too tight on top of the knee, but turned out it was due to the tendon not being attached.

One thing to note is at the week 6 mark I was 44 degrees ROM and when I went back to my OS at the week 10 mark I was 123 degrees ROM. and getting very nice speed on a stationary bike with the seat down all the way just about. I made big jumps rather quickly, but I have no clue if that had anything to do with it.

That being said, my OS said that in 17 years of surgeries he's never seen one re-tear so it is very rare. Can you do a straight leg raise?
 

JodesMW

In the parking lot (formerly "At the base lodge")
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Hi Jodes. Looking back there maybe were warning signs but at the time they were being attributed to quad atrophy or major quad weakness. We don't know if this happened early on and didn't catch it or if it happened during rehab or the week 10 mark when it was discovered through MRI. When I was in therapy and doing a SLR with the 30 degree lag (week 7 mark) it was being attributed to the fact that my quadricep was so weak and that it would eventually get better. I never felt it re-tear or had any pain that I wouldn't normally have during recovery. I was making progress but could never get out of the brace because my quadricep couldn't hold my leg straight. It would buckle as soon as my foot hit the floor. One other very important warning sign which I had was a divot on top of my knee cap. I originally thought I was wearing the brace strap too tight on top of the knee, but turned out it was due to the tendon not being attached.

One thing to note is at the week 6 mark I was 44 degrees ROM and when I went back to my OS at the week 10 mark I was 123 degrees ROM. and getting very nice speed on a stationary bike with the seat down all the way just about. I made big jumps rather quickly, but I have no clue if that had anything to do with it.

That being said, my OS said that in 17 years of surgeries he's never seen one re-tear so it is very rare. Can you do a straight leg raise?


Thanks for your reply Kevin, that gives me food for thought, as well as some reassurance. 123 degrees ROM at the 10 week mark seems pretty impressive. Were you able to walk up/down stairs before your re-tear? Yes, I can do a straight leg raise with relative ease.
Around my 7-8 week mark I had a slip up on my garage steps, kept from falling on my butt but caught myself with my bad leg and put pretty much all my weight on it. Pain was an 11 on a 1-10 scale. I worried then I that I might have re-injured but I think I got lucky & didn't do any damage. But it helps to know what some of the signs may be. I have a slight divot on the bottom of my kneecap, so I am keeping an eye on that.
 

Kevin_C

In the parking lot (formerly "At the base lodge")
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Thanks for your reply Kevin, that gives me food for thought, as well as some reassurance. 123 degrees ROM at the 10 week mark seems pretty impressive. Were you able to walk up/down stairs before your re-tear? Yes, I can do a straight leg raise with relative ease.
Around my 7-8 week mark I had a slip up on my garage steps, kept from falling on my butt but caught myself with my bad leg and put pretty much all my weight on it. Pain was an 11 on a 1-10 scale. I worried then I that I might have re-injured but I think I got lucky & didn't do any damage. But it helps to know what some of the signs may be. I have a slight divot on the bottom of my kneecap, so I am keeping an eye on that.

Wow, that is scary that you fell like that. I'm glad you didn't do anything to it and it worked out. It sounds like your doing fantastic and are right where you should be.

As for stairs for me the first time, one step at a time both going up and down. Couldn't do em the normal way.
 

Kevin_C

In the parking lot (formerly "At the base lodge")
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Feb 8, 2019
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14
Im noticing that as I let my leg hang with gravity while sitting, when it gets to the end range, I'm having some discomfort in my hip flexor. As if that area needs to be released to get more ROM? Has anyone else experienced this?

I'm wondering if this is the top of the quad muscle that is tight and being stretched. When I palpate that area, my foot bounces up and down slightly.

My physio has been trying to suction the scar and patella hoping to get more range, it's been a bear. He feels the skin is glued down and there are some adhesions on the scar we have to break through. Has anyone noticed that tight quads was their reason for restricted range? I'm 13 weeks post op and around 55 active ROM.
 

davkt

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Apr 25, 2017
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38
Well went to see the doc yesterday and now have an appointment with the orthopaedic surgeons to see about getting the troublesome metalwork removed from my ankle, also she thinks the slight soreness in my repaired knee is down to a subconscious change in my gait to lighten the load on the troublesome ankle
 

The Last in Lin

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Apr 25, 2017
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I found this thread and read through all 10 pages. Fantastic information on here and some great recoveries. I am 13 weeks post op from a left QTR revision and am at 55 degrees active ROM. Therapist this morning measured me at 77 degrees passive ROM with him cranking on my leg and measuring. I am ambulating without the brace (only indoors), but with a cane mostly. Unless its first thing in the morning, seems like I have the most stability first thing in the morning and can walk without the brace, but as the day goes on and stretching occurs, I have to use the cane. I had a surgery in August, and during rehab or at some point I suffered a second rupture so did it all over again on 11/08/18.

ROM has been the biggest challenge for me. Every degree seems like a battle. This has been the most difficult 6 months I've ever gone through, but hoping that theres light at the end of this tunnel.

I've been doing half revolutions on the bicycle for 10 minute increments, each revolution pushing more on the pedal with my good leg. I almost made it around on a backwards revolution this morning, but not quite.
Here is a link to an archived forum from Epicski.com that has about 8 years of conversation on this subject.

http://web.archive.org/web/20170429...16/quadriceps-tendon-rupture-repair-and-rehab
 

davkt

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Apr 25, 2017
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That massive Epicski thread tell you everything you need to know about recovering from this injury and then some! Well worth wading through it.
 

Kevin_C

In the parking lot (formerly "At the base lodge")
Skier
Joined
Feb 8, 2019
Posts
14
I'm 18 weeks post op. Things are just starting to progress for me I feel. I'm around 85 degrees AROM and 100 Passive ROM. Still walking with a slight limp but I feel like I've made some nice progress in the last 4 weeks. I've been reading a lot about pool therapy and how helpful it is with people with this injury. 18 weeks in do you guys and gals think that I would benefit from it, or is this geared more for people in the early stages of this injury. I'm going to bring it up tomorrow to my physio but wanted to see if anyone here has any personal experience with it. Thanks.
 

Keith

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Joined
Mar 14, 2019
Posts
32
Location
Durham, United Kingdom
Hi all
So relieved to find this forum and the link to the fantastic archived forum. It's been a massive help and inspiration, through what is a brutal experience.

A little about myself and how I came to join this unfortunate band:
54 year old male, based in the North East of England, suffered a 100% quad tendon rupture of my left leg on 08 December 2018, whilst walking down some steps, got to the bottom and my left foot landed on loose gravel where the pathway had deteriorated. My leg hyperextended and I heard the dreaded popping sound and thought I'd broken my leg. Taken to hospital where I was immediately diagnosed with QTR. Corrective surgery performed 3 days later on 11 December, so I'm now 13 weeks and 3 days post operative. Brace was removed at week 12, but active PT started at week 6. I now have 110 degrees of active ROM, but seem to be really struggling to get beyond this. I'm currently spending 2-3 hours daily on rehab and physio exercises. Stationary bike and elliptical trainer introduced at week 12 and I'm managing 20 minutes on each every day. I'm walking around 3 miles daily but carry a walking pole to cope with uneven ground and the dreaded slopes.
I'm interested to hear what others have or are experiencing pain wise. Since my brace came off and intensity of physio has increased, I feel like I've taken a massive step backwards in terms of pain experienced. I've been med free since week 4, but am now having to reintroduce painkillers and anti inflammatories to cope with it. Majority of pain radiates out from the centre of my kneecap and there's been a return of some significant swelling, so I'm icing it daily again. Therapist says it's only to be expected as activity has been significantly increased, but still has me worried nonetheless.
Many thanks.
Keith
 

Kevin_C

In the parking lot (formerly "At the base lodge")
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Joined
Feb 8, 2019
Posts
14
Hi all
So relieved to find this forum and the link to the fantastic archived forum. It's been a massive help and inspiration, through what is a brutal experience.

A little about myself and how I came to join this unfortunate band:
54 year old male, based in the North East of England, suffered a 100% quad tendon rupture of my left leg on 08 December 2018, whilst walking down some steps, got to the bottom and my left foot landed on loose gravel where the pathway had deteriorated. My leg hyperextended and I heard the dreaded popping sound and thought I'd broken my leg. Taken to hospital where I was immediately diagnosed with QTR. Corrective surgery performed 3 days later on 11 December, so I'm now 13 weeks and 3 days post operative. Brace was removed at week 12, but active PT started at week 6. I now have 110 degrees of active ROM, but seem to be really struggling to get beyond this. I'm currently spending 2-3 hours daily on rehab and physio exercises. Stationary bike and elliptical trainer introduced at week 12 and I'm managing 20 minutes on each every day. I'm walking around 3 miles daily but carry a walking pole to cope with uneven ground and the dreaded slopes.
I'm interested to hear what others have or are experiencing pain wise. Since my brace came off and intensity of physio has increased, I feel like I've taken a massive step backwards in terms of pain experienced. I've been med free since week 4, but am now having to reintroduce painkillers and anti inflammatories to cope with it. Majority of pain radiates out from the centre of my kneecap and there's been a return of some significant swelling, so I'm icing it daily again. Therapist says it's only to be expected as activity has been significantly increased, but still has me worried nonetheless.
Many thanks.
Keith
Hi Keith,

Reading your post it sounds like your doing very well with your progress. I'm about 5 weeks ahead of you (18.5 complete) and am at around 90 active range of motion and 105 passive range of motion. Reading this massive thread shows me that everyone heals differently, is handled differently by physios and progresses differently, but we all have the same goal. I'm on my second QTR and I'll share with you what has worked best for me this time around. I was stuck between weeks 6 and 12 and wasn't making much progress at all as far as ROM. I found a website called bonesmart.org. They're philosophy is basically less pain and more gain. I ended up backing off pulling on my leg all day, started icing the crap out of it like 10x per day, even if it was just for 10 minutes at a clip. I'd sit at my desk in my office with ice wrapped around my knee. The swelling and soft tissue damage went down considerably. My knee didn't feel like it was so hot when I touched it. It was at that point when it started to move and range of motion increased.

I am not making big jumps in range like others have made on this thread, I'm averaging roughly 7 degrees per week, but it's something and far better and less work / pain than what I was getting beforehand. Again, everyone responds differently but that seemed to be the ticket for me to make some progress.

As far as pain goes, for me the worst pain I'm seeing is around a 4 or 5 on the pain scale at this point, and that's when its being stretched. I'll say this that when it was swollen and puffy and we were stretching the bejeeezus out of it, it was extremely painful. It felt like we were fighting against the knee, not giving it anywhere to move because it was so swollen and fighting past that started not to make sense. Only when I got the swelling down and the knee to sort of calm down did the pain begin to subside. After physical therapy I really don't experience much pain, other than when I'm there. Walking around from dinner time to bedtime seems to be the most challenging part of the day. I guess that'll get easier as it gets stronger, but that's yet to be seen.

Good luck with this terrible injury, sounds like your doing great and this is just a minor bump in the road for you.
 

Keith

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Hi Kevin

Many thanks for your response, much appreciated.
I'm pleased you're on the road to recovery and admire you're resolve as this is your second QTR!!
You're exactly right, there's no "normal" with this injury or rehab. I've never seen so many different approaches or protocols for an injury before. Thankfully, my PT at the moment has seen the injury before and has experience in dealing with it. However, the previous 2 really had no idea, which wasn't helpful.
There's so much fantastic information on these boards but it can be a little overwhelming in deciding what's best for yourself. I'm pleased with my progress regarding ROM, but hadn't prepared myself for the return of the significant pain. Trying to walk with a normal gait also seems a long way off and it's causing me a lot of lower back and hip pain. I guess thats down to the lack of strength in the quad muscles at this point.
I'm definitely going to try your icing regime and it makes complete sense. Guys at my gym can't understand how the quads can redevelop efficiently if you're thrashing them with exercises every day, as this just breaks down the muscle fibre. They say I should be having rest days between quad strengthening exercises to allow the muscle to build.
Good luck and strength to you in your recovery.
 

Kevin_C

In the parking lot (formerly "At the base lodge")
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Keith, we are very similar with this journey and I can totally sympathize with you. I'm on my 4th physio, it seems like there knowledge / protocols are equally as important than the surgeon was. It shows when they have absolutely no clue how to handle it or have never seen it before.

I'm getting some hip and back pain also, my PT said there's no reason I should have a slight limp because my quad is firing well. He thinks it's part mental and I'm protecting it or nursing it. He's telling me longer, faster strides and striking that heel down and rolling onto the toe if that helps you. Easier said than done!

He has me doing strength every other day, so I'll do one day of the exercises w weights (1 lb ankle weight) (30 lb leg press) and then the next day no weights, and so on....This is the first week we've introduced weight so I don't have any feedback yet on how I'm responding to that. He did mention recovery days were important.
 

Keith

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So, just a little update. After Kevin posted regarding his Icing regime, I've been constantly icing the knee and in just 2 days the swelling had noticeably reduced. The only exercises I've done over last 3 days have been daily walks of around 3 miles without using a walking aid. At physio appointment yesterday, my ROM was measured at 115 degrees!! Go figure!
PT says that as this injury is so infrequent, there's not a lot of reference data for them to work with and it really is a "suck it and see" scenario.
Still struggling with the awkward gait, feels like I'm just planting my left leg all the time and there's no fluidity to my stride. I'm hoping that as strength returns to the quads my natural gait will return, as they'll be able to carry the leg better.
 

Kevin_C

In the parking lot (formerly "At the base lodge")
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So, just a little update. After Kevin posted regarding his Icing regime, I've been constantly icing the knee and in just 2 days the swelling had noticeably reduced. The only exercises I've done over last 3 days have been daily walks of around 3 miles without using a walking aid. At physio appointment yesterday, my ROM was measured at 115 degrees!! Go figure!
PT says that as this injury is so infrequent, there's not a lot of reference data for them to work with and it really is a "suck it and see" scenario.
Still struggling with the awkward gait, feels like I'm just planting my left leg all the time and there's no fluidity to my stride. I'm hoping that as strength returns to the quads my natural gait will return, as they'll be able to carry the leg better.
That's great news! Keep it up bud!
Like you, I'm struggling with the stride / awkward gait thing. Yesterday the physio prescribed balancing on the bad leg with knee NOT locked out. Ever so slight bend in the knee. He said that would improve my walking. Been doing it a bunch and well see what happens. When I walk I'm in such a defensive position and I'm so rigid, he told me to swing my arms more than usual and lower my shoulders to make it "normal" again. Quad is firing fine so he believes it could be more of a mental thing because it's been so long.

Also, got to 110 passive yesterday, stoked about that!! Keep in touch.
Kevin
 

Keith

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Well done on the ROM progress, fantastic news. Keep it going buddy.
Interesting comments you make about about the mental approach being as important as the physical. It's fair to say that I have no confidence yet in my damaged leg and this is definitely reflected in my walking and general moving around. Had a real bad day today with hip and lower back pain and I'm sure it's resulting from me overcompensating when walking.
 

Frank M

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Mar 28, 2019
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New guy on the Blog...this coming Monday "April Fools Day" I start PT to rehab the knee/leg. I will be 4 weeks and 5 days since surgery. Seems little fast to start rehab. Anyone have any thoughts or experience in when to start??? Thanks
 

Keith

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Hi Frank

Welcome to the club that no one wants to join!!
I'm now 14 weeks post-op and PT started for me at 6 weeks. Prior to that, I was just doing Quad presses and attempting leg raises to get the quad to fire up. My brace was set at 30 degrees at that point so I was also doing heel slides for ROM.
There's some fantastic info on this forum, but you'll find although our injuries are more or less the same, there are numerous approaches to rehab.
If you don't mind me asking, How'd yours happen? Is your brace fixed or do you have some ROM?
Best of luck with the injury. Best piece of advice I've been given is recovery is a marathon not a sprint and you eventually get to cross that finish line.
 

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