Quadriceps Tendon Rupture, Repair and Rehab

[50+ Year Skier]

I would hope that a bicep repair wouldn't be elective.

Well, no and yes.... with the Covid thing rampant in the Vail valley, any medical care was " elective". Thankfully mine hadn't retracted much at all so not quite as emergent. A couple weeks on, way better than the quads but still a ways to go. Yeah well, chicks dig scars........

 

[nighthiker]

Surgeon cleared me to lift 50 lbs. Slowly making progress. Tomorrow is measurement day.

I was walking 1 mile at a time a few weeks ago and the heel on my uninjured leg started to hurt. Now it bothers me all the time. PT told me to stop walking long distances for now. Anyone experience this? Also, my good knee hurts sometimes too. I thought I saw someone else mention this. I wonder if it is due to being sedentary. Perhaps it is just from getting old (sigh).

 

[The Last in Lin]

Surgeon cleared me to lift 50 lbs. Slowly making progress. Tomorrow is measurement day.

I was walking 1 mile at a time a few weeks ago and the heel on my uninjured leg started to hurt. Now it bothers me all the time. PT told me to stop walking long distances for now. Anyone experience this? Also, my good knee hurts sometimes too. I thought I saw someone else mention this. I wonder if it is due to being sedentary. Perhaps it is just from getting old (sigh).

I had problems with my back I attributed to being out of balance so to speak. I wasn't walking normally or sitting normally. My knee didn't like being bent for very long so I would keep it propped up on a chair or upside garbage can which had my hips twisted which made my back according to my theory. Do you think you're just putting more and uneven stress on your "good" leg?

 

[Kneale Brownson]

When I was in a boot after my last Achilles tendon repair, I developed heel discomfort. Surgeon said it was typical from flattening of the feet with age, especially after a period of inactivity. He put a little leather wedges into my shoe, it think on the outside edge of the heel, and that helped.

 

[nighthiker]

I had problems with my back I attributed to being out of balance so to speak. I wasn't walking normally or sitting normally. My knee didn't like being bent for very long so I would keep it propped up on a chair or upside garbage can which had my hips twisted which made my back according to my theory. Do you think you're just putting more and uneven stress on your "good" leg?

Yes, that is what the PT thinks. He says it should get better with time as I gain strength and flex and begin to walk normally with out a limp.

 

[Andy53]

So the unthinkable happened, we had snow on 4/2 and our north facing front steps got icy, took the garbage out that night and despite being careful I slipped, L leg went up, R leg deep bend as I contracted and felt the dreadful tear again, laid there at bottom of stairs in total shock, seriously thought life was over, knew I was starting over. Melissa dragged me in and we called the surgeon, who has become a friend, and he said get MRI and see him the next day, MRI confirmed repeat R quad tendon tear and a huge effusion, set up surgery which I had on my 54th birthday, 4/6. Surgeon said it torn clean off patella again and he fixed it the exact same way, said it came together nicely. Pain has been well controlled, I did have a femoral nerve block which really helped. Missed another week of work lying in bed and hobbling around. Had my staples out 3 days ago, he said it looks good and to stay in straight leg brace and follow up in 3 weeks. My gym/pool is closed so no early water therapy this time. Hard to express my devastation with tearing the quad tendon again, that first few days was misery, mental more than physical. Thank goodness for Melissa, my kids and my work colleagues, plus this forum. I wanted to just hide from everyone and I did for the first few days, but time tends to heal all wounds and I’m rebounding. So I’m now 13 days post-op repeat R quad tendon rupture and repair, starting over exactly 3 months after initial tear and 9 years after L quad tendon repair (luckily that one healed up well and is strong). I’ll get thru this one too, as will we all. Praying for all of us. Stay safe everyone, Andy.

 

[peter826]

I wanted to introduce myself and share details of my injury. I am not a skiier, but I found this forum and have enjoyed reading through the posts. I am 48 years old, male, a former runner/triathlete. I tore my quadriceps tendon while overseas in early March. I was still able to walk after the tear, which was a good thing because I was not in an area where getting medical attention would have been easy. I flew back to the USA, waited a day or two, then decided to go to the doctor. I thought perhaps I just had a very bad quad strain. He diagnosed me as a partial quadriceps tear, bad enough to need surgery.

This was just as the covid-19 stuff was really starting to ramp up. Because I had been overseas, I was unable to get some of the appointments I needed. They made me wait until I had been home two weeks to let me into the hospital. So after 2.5 weeks, I was finally able to have surgery. Doc said I had about 85% of the tendon torn, and it was sort of an L-shaped tear. The tear went across the tendon and then up into the muscle. I had little pain after the surgery, did not need narcotics, and got by with just tylenol. I didn't even need that after 4-5 days. I've been in the locked leg brace since the surgery.

Tomorrow is four weeks since surgery. I started physical therapy last week on the three week anniversary of surgery. The goal was to be at 60 degrees range of motion by the end of the fourth week. I got there on my second visit, last week. They want me at 90 degrees at the end of six weeks. I was at 73 degrees yesterday. They think I will recover faster because my tear was not complete. However, I am being told not to rush it. I'm able to walk with just one crutch at this point, haven't tried walking without.

Most of my athlete days are behind me, but I do like to walk. Sometimes, 6 miles a day or more. So my main goal is to get back to being able to do that without any issues.

It's been really nice reading others progression here, it's a great topic.

 

[Brad J]

So the unthinkable happened

so sorry , that was my biggest fear post op for the first 5 months, thought about slipping in the shower mostly. hope you recover fast.

 

[nighthiker]

Andy, so sorry to hear that. I hope you recover quickly. Stay strong. Lean on your wife and kids as needed. My wife and daughters helped me tremendously. That and prayer.

Peter, glad to hear you are coming along. Good for you they are starting range of motion already. I was locked straight for 6 weeks. Rehab has been tough, but I tested 110 degrees yesterday (17 weeks post op). I have another month of rehab scheduled.

 

[peter826]

Nighthiker, it has been really interesting reading the varied approaches to treatment. I am already in my third week of PT and my surgery was five weeks ago. My PT is all about heel slides, heel slides, and more heel slides. He told me Monday that I wasn't progressing as fast as he hoped (I'm at 75 degrees) and to start doing 2 sets of 10, five times per day. He really wants me at 90 degrees by early next week, even if I have to use a strap around the ankle to pull myself there. My place of work is closed, so I have time to be doing this. When we re-open, it will be harder to do the exercises.

I'm still locked in the brace except for PT, and showering. Though, I have started taking it off when I'm sitting on the couch and letting the leg dangle a bit to stretch it out as well. I'm told they may open it up a bit in a week, so six weeks after surgery.

 

[nighthiker]

Peter, hang in there. The flex will come, especially if you are working at it on your own time. I just graduated from heel slides last week. I'm using the same strap around my foot, laying on my stomach, pulling my foot towards my butt.

The manual flexion had been getting easier for the last few weeks. This week the PTs must have thought they were taking it easy on me and gave me some excruciatingly painful manual flexion. I like those guys, but man they can really be tough at times. They are doing it for my own good as I want to be back to 100%..

It was also just 2 or 3 weeks ago that I could bring the stationary bike pedals around the whole way. It still is a little tough when I first start, but gets better as I warm up.

If you are at 75 degrees on week 3, that is where I was. I think that is pretty good, but PTs always push hard. They want to see you better. They probably realize you are an active guy and are pushing you harder. Keep at it.

Andy, how is your recovery going.

 

[peter826]

Nighthiker, thank you. I hit 90 degrees on Monday, and had my six week follow up Weds. The brace was opened to 30 degrees during my visit, so moving forward! Drove for the first time in 7 weeks.

The physical therapists have been working an A and B rotation shift due to Covid, so I see one person one week, and a different the other. One's been pushing me harder, and as the rotation system is ending, I think I will stay with him.

 

[Andy53]

First official PT visit today, 4 1/2 weeks since repeat R quad tendon rupture and repair. Things seem to be going well, similar to last time. 96 degrees ROM. Like last time we started with lots of quad contractions with electronic stimulator and then straight leg raises, very gentle stretching, ice and compression treatment. Still in brace just opened to 40 degrees. This time I had more swelling after the re-tear and after surgery, had knee drained once before surgery and twice after surgery during first week post-op. Swelling better now. No pain just stiff and weak. Mentally I’m doing better, I’m getting better, we’re all getting better. Andy.

 

[The Last in Lin]

I feel for you guys going through rehab now. When I tore mine I did extra therapy at my gym. Our gyms have just opened up as of today.

 

[peter826]

8 weeks out from surgery. I'm at 105 degrees on my own, can pull it a bit further with a strap. Brace is open to 60 degrees, therapist said to open it to 90 in a few days, then maybe 120. He wants me off it in two weeks. No more crutch, either.

Unfortunately it looks like my insurance won't give me more than 20 physical therapy visits, anyone run into that problem? I'm at 11 or 12 now. I may go down to once a week instead of 2x a week to stretch it out. I could pay out of pocket, but I have no idea what the visits cost, haven't gotten that bill yet.

 

[nighthiker]

Andy, good to hear you are progressing. Keep at it! Stay strong.

Peter, if you have your choice of therapists, go with the more aggressive one. It hurts like crazy but I think you are better off in the long run as you'll see results faster. I know for me it hurts like a son-of-a-gun when they bend my leg. I measured at 119 degrees Tuesday (yesterday). I'd spread out your visits if I were in your situation. You can probably make some progress on your own. Time helps too. Inflammation goes down over time.

The one blessing out of this is that I fell on company time. All of this is covered under workman's comp.

 

[peter826]

Nighthiker, the PT had me drop my leg off the table yesterday and then he pushed his body against the knee and further down. Man that hurt, but was kind of funny, we're both wearing masks, and he said, does this hurt? I said sure, of course you can't see me grimacing because of the mask..

Did your heel problem resolve itself? I definitely feel like my gait is pretty bad, I'd like to go around the block but a bit concerned about throwing something else out of whack because my gait is so messed at the moment.

 

[Rich716]

Hello everyone, Rich here. I tore my right quad tendon on 5/20 and surgery is on for tomorrow (5/29). I'm 57 and in pretty decent shape, perhaps a bit (or more) overweight. While I wasn't a gym rat before the accident I did make it there at least 3 times a week and managed to do the elliptical for 30 minutes a day. From what I've been reading, this looks like a long journey.

 

[peter826]

Rich, welcome to the club no one wants to be in. I hope your surgery goes well tomorrow. Things that made my recovery better included getting a nerve block before surgery (keeps pain at bay for ~24 hours). I was also given a "pain ball" that had lidocaine (or something similar) in it that slowly dripped out over the first 4-5 days. I didn't have much pain, but maybe one bad night. I went pretty heavy on the tylenol and didn't need much in the way of narcotics.

Probably a good idea to pick up some crutches if don't already, and a raised toilet seat with handles comes in really handy. I got one at Walgreens. It was really overpriced but a godsend.

It's a long process but there is a light at the end of the tunnel. I'm 9 weeks post surgery and can walk a bit without my brace. Knee is still very weak, but I can feel it getting stronger every day. It just takes time, and persistence with the exercises they'll give you.

 

[The Last in Lin]

Hello everyone, Rich here. I tore my right quad tendon on 5/20 and surgery is on for tomorrow (5/29). I'm 57 and in pretty decent shape, perhaps a bit (or more) overweight. While I wasn't a gym rat before the accident I did make it there at least 3 times a week and managed to do the elliptical for 30 minutes a day. From what I've been reading, this looks like a long journey.

Your biggest challenge will be to get through the first 3 to 5 days after surgery. Here are a few tips in no particular order.

1. Set up a nest in front of a TV with snacks, power supplies for your phone, magazines etc. You'll be there a while though you've probably entered this stage. I lived for 3 weeks in a recliner
2. Plan for how you will go to the bathroom. If you have patient support teams ask about a urinal but you're probably already learned this as well.
3. If you have a nerve block you will be fine for a while but when it wears off the fun will start. Take your pain pills as scheduled even if you're not in any pain If you do have a nerve block. You DO NOT want to wait the pain to start before you take them.
4. Don't be afraid to ask your Dr. to take more if the pain is bad enough.
5. Ice helps a lot but you'll have your immobilizer and a lot of bandages. The brace has two rails on either side of your knee which will minimize contact with the ice. Ask if it's ok to open up the immobilizer so you can get more contact with the ice.