Patellar Tendon Rupture.....

[ChiCitySoccer]

Hi all,

Thanks for starting this forum/thread. When I had my injury I really liked hearing everyone's story and recovery. It made me feel better and I had never heard of this type of injury before. Always ACL/MCL etc.

I tore my right PT while running down some stairs, caught a stair bouncing straight legged and immediately felt my kneecap displace. (Had left knee cap dislocation 7-8 times while playing sports in jr. high - hs with no repercussions besides some minor meniscus tearing) When I couldn't put any weight on it or extend my knee, I knew it was something major. I went to the hospital that night, (wed 3/16/11) and waited until sat (3/19/11) to have surgery.

Was in and out the same day with at home care (Thanks GF/Mom/Sisters/etc) First few weeks were a blur, and time to get the second cast put on (Casted for 6 weeks, although reading about other techniques on this forum was interesting!) Almost passed out when they took the staples out as I was used to my tree-like quads (Football, Rugby, Cycling) and saw a noddle with a really big incision! kind of funny from such a "tough guy".

I was probably not able to drive until week 8 or 9 post surgery, and then just barely could I get in the car! Leg still really stiff until about week 12-18 when I could ride a bike! I didn't start running until maybe 5-6 months post surgery, and still felt wobbly while walking around town. Up until 8 months I had some pain that was mostly around bending the knee for extended periods of time.

Today, However, I can happily report I just traveled 6 hours by bus each way to Columbus, oh, and managed very little pain with extended 90 degree + bending of the knee, and in addition, I fly every week for 2-3 hours.

Really big thanks to my physio who helped me through all the ROM & Pain for 36 weeks! I think finding a good physio was the most important part of my process and sticking with the plan they made for me even when I was really busy.

If I had it to do over again, I would take extended leave of absence from work. I should have heeded the advice of the forum members and really thought about the long term and taken that time off. (I was eligible for extended leave from insurance) I ended only taking 13 weeks off, and should have done 5-6 months as the injury did impact the work I was working on from not being able to focus to just getting to physio appointments etc.

Also, pretty amazing to hear some of the high profile people that have this injury and would like to hear their stories specifically the coach from the New Orleans Saints organization.

Again, Thanks to everyone here who shared their stories over the past year. It really helped me along seeing all of you move forward especially when I only had 10-20 degrees ROM and lots of knee pain in the early days!

[vicledsome]

I have been reading posts. I am the exception to this injury. I am a 50 something woman. On June 5, 2012 I had total knee replacement. On June 6 fell in hospital. Broke my wrist and did not realize I had Patellar Tendon Rupture. My OS thought I was having quad issues. Now at 5 weeks he scheduled me for surgery next Weds. I have been walking on this leg but can't lift it straight up more than 7 inches. OS is going to drill holes in knee cap and put cable.
I am not sure what to expect. I have fought for ROM with TKR and now going to back to the beginning. Anyone have any tips or advice for me?

[Rob N]

Vicledsome:
Definitely a difficult situation that is a circumstance I haven't heard of before. I had surgery 5.5 weeks post-injury and things worked out well in the end. The cable may allow you to weight bear a lot earlier than in my situation since I had a hamstring graft and needed quite a long period of minimal weight bearing to allow my graft to heal. I experienced considerable muscle atrophy that took a lot of rehab and training to resolve - and I anticipate that you will have challenges somewhat similar to what I experienced. It's good that your surgery is coming soon. Just follow the instructions of your surgeon and physio carefully and things should work out fine.

We are here to help you were we can, to support you, and to give you a place to discuss any issues or concerns that you may have. Your recovery is also an important precedent that hopefully can assist others with similar circumstances. Please stay in touch and I wish you all the best for your upcoming surgery.
Rob N

[vicledsome]

Since my last post the worst has happened. Infection. PICC line, IV drip every day 6 weeks. Just lucky was not MRSA. Had total revision of knee and placed cable again. I am able to weight bare. Still bent at 25%. Tomorrow will make 1 month since surgery. I was in brace for 3 weeks. Now no brace. Not all I thought it would be. Can't sit for any lenght of time. ROM not great. Thinking around 60. Will take cable out 2 to 3 more weeks. No PT until after that. Guess this is a marathon not a sprint.

[Rob N]

Vicledsome:
Sounds like you are through the worst of it. Pretty good if you are weight bearing under the circumstances. I didn't weight bear due to the hamstring graft for about 8 weeks post-surgery - so in that respect you are doing better than I did. Also impressive that you are out of the brace so quickly. I used a brace for about 3 months post surgery. Your ROM will likely improve quickly once the wire is taken out. It actually sounds like you are doing well after getting over that infection issue. Just stick to the program and things likely will end up working out fine.
Rob N

[twinchouche]

Hi dwhyte85
I hope your recovery is progressing well. I was wondering if you could update us on how you're getting on?
I also live in the UK and had to wait 19 days before having surgery on my ruptured patellar tendon. I would have had to wait much longer if it wasn't for the fact that I insisted to see another doctor. The doctor who looked at my knee the day after the injury had told me to come back in 4 weeks!! because the knee was too swollen for a MRI!!!
I am now 6 weeks post surgery and my ROM is 70 deg (with pain). I still have the wire loop in. I can walk (well limp) without the splint.
I saw my surgeon last week, and though he was pleased with the mechanical repair, he wasn't really pleased with my ROM and the fact that the wire loop hadn't broken yet. I was quite surprised because I thought 70 deg ROM was OK at week 5 post surgery.

[Rob N]

twinchouche:
Definitely keep plugging away at improving your ROM as per your physio and surgeon's instructions. It certainly is key to your recovery. I hope you have some sort of brace on your leg until you can strengthen things up at a later point.
Rob N

[twinchouche]

Hi Rob N
First of all, I would like to say that this forum is really great for people who needs to access and share information on this injury and that you're doing a great job of keeping us informed.
My surgeon said I don't need to use the brace anymore. I'm still using 1 crutch though when going out for a walk. I have lost a bit of strength in the leg but not that much. I think my main problem right now is getting more ROM. I am doing ROM exercises but I don't really like the pain you can get when you go over the "limit". Have you got any advice on how to bear the pain?
Also, could you explain why the stiffness in the knee? Is it due to scar tissue building up? Do we break this scar tissue by bending the knee often? Sorry for asking all these questions!

[Rob N]

twinchouche:
I can only respond based on how things went for me which may help you formulate questions - the only rehab advice you should take is from your physio and surgeon since they know your specific circumstances. The VMO portion of your quad is the first to atrophy and the most difficult to rebuild post surgery. As you vmo strengthens, my understanding is that your patella tracks better and it was my experience that my knee started to feel and function more normally as the vmo strength increased. I takes several months for the tendon to heal before you are typically allowed to hit the training phase of your recovery. Once your tendon has healed and the surgeon allows you to do formal gym training, I recommend that you pay a kinesiologist to give you and demonstrate a training plan which likely will include some vmo strengthening exercises (elliptical machine elevated upward, lots of ball exercises/squats).

Yes, there typically is some scar tissue to work through. I took a notepad in with me to the physio, recorded all the exercises I was suppose to do and their frequency, and generally did most of my exercises at home. It is key to log the exercises and then you can show your physio your activity which they can assess against your status to determine improvement, etc. In my circumstance, I did ROM exercises 3X per day.

At one point, my ROM had not progressed as expected. I was bending my knee to the point of resistance and then holding for 20-30 seconds, etc. In my circumstance, my physio said I had to be more aggressive with my bend. I did a sample bend and he demonstrated that I needed to push it a fair bit further - so he showed me exactly how much to bend the knee around the resistance point. I was surprised at the increased pressure I was to use. I started to make more progress after I got the hang of it. It was more uncomfortable to do, but it worked. In other words, I am suggesting you spend some time with your physio establishing just how aggressive you should be in your circumstance with your ROM exercises (and the number of reps, sets and frequency per day). Hopefully your level of discomfort will subside as you work your way through the scar tissue.

Rob N

[twinchouche]

Thanks a lot Rob N for your advice.