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Avatar universal

RUPTURED PATELLAR TENDON

I fell down three steps and ruptured my patellar tendon. My injury occurred 12/14/06, my surgery was 12/18/06 and they discharged me from the hospital on 12/19/06. 1/3/07 at the docs he said to do quad flex's 30 times twice a day and 10 heel toe points every hour. Next appointment on 1/18/07 I get the x-ray like usual then go into the exam room. He comes in, takes off my brace, throws it on the counter and then tells me to lay down. (i truly think he told me to lay down so I couldn't punch him when he did what he did next.) Next he grabs my knee cap and starts yanking it side to side and massaging my knee very roughly. He tells my wife she has to do this twice a day, ten to fifteen times and then pick up my knee so it bends a little 3 to 5 times. He then told me I couldn't have my brace back and sent us home with a script for Physical Therapy. I guess my question is, it has only been 4.5 weeks since my surgery and now i can't have the brace? Fast forward to today 1/31, only 6 weeks since surgery.  Doc had me put my leg off the edge of the table then proceeded to push down on it little by little until I was literally crying.  I'm a 39 year old big guy that doesn't cry. I'm really concerned that this guy is too agressive and he is going to rerupture it.  I'm a 350lb guy and I really don't want to have to go this surgery again.  Should I start looking for another doc?
217 Responses
Avatar universal
deffenetly not. agressive is what u want! u dont want someone to baby u and take baby steps. or ull never recover!
u cannot(!) rapture it again after surgery. it would also help a lot if ur physical therapy place would also be agressive.
u gota suck it up and do it through the pain. other vise ull be in pain for a loooooooong time.

sugestion: ask ur doctor for a pain killer (light) take it right before therapy or doin excersises. it will help u expand ur range of motion.

good luck
Avatar universal
How can you be so sure that it won't rupture again.  I have already learned of two people that reruptured again on the table.
Avatar universal
on what table?

ive seen many patients post op and post fx. they all baby their injury, afraid to move it. thinkin it will brake again. in the long run it causes more harm than good.
im saying dont go crazy. but u cant baby it. u have to do the range of motion excercises through the pain.

by the way, i would also consider loosin some weight. ur lookin at arthritis of knees within a few years, if u dont already have it. just a friendly sugestion
Avatar universal
The table in the doctors office, bed or whatever you call that table you have to get up on.

I can understand a little pain, but enough to make a grown man cry is a little too much.  I don't understand why it has to be so rushed.  Everything I have read online and in forums is that I should have a brace, I shouldn't be doing so much, all things totally opposite of what he has me doing.  

Why not take it slower, with less pain, and get to the same conclusion?
Avatar universal
Also, i'm seriously considering not going back to him.  I know that if the PT had done what he did yesterday, I wouldn't be going back to him.

Why would anyone in their right mind put themselves through that a second time.  Maybe I'll feel better in two weeks when I have to go back to him, but right now that is what i'm feeling.  Not going back.
Avatar universal
bone heales in 6-8 weeks.
u dont think ur tendon healed yet?
u dont need a brace. use ur leg. its gona take a year about to get 90-100% better. u keep wearing a brace and baby ur leg. ur never gona return full use/motion in ur leg. or at least not any time soon.

if u want, take ur time gettin better. hey, its ur body.

all the best
Avatar universal
I am 34 years old and am a pretty active individual. I play flag football 2X a week, and softball 3 X a week. This past Saturday 3/3 I ruptured my pattellar tendon playing flag football.  The only way I can explain the pain is that someone threw a rock at me and hit me square in the knee. I have never felt pain like that before. I had my appointment today 3/5, to schedule my surgery which will be on 3/7. I had ACL surgery 8 years ago, and from what I remember I was back on my feet with most of my motion and playing sports in no time. From what I have been reading I am in for the long haul. I guess my question is will I at least be back on the softball field by the summer, and as far as PT bring it on? I welcome that kind of aggressiveness. Can someone please offer me some support and answers to this particular injury?  
Avatar universal
From: patella rupture from tibia:
I am 33 years old.  I ruptured my patella tendon on 12/17/07 playing basketball with friends just about 2 weeks after I began playing again.  I was driving past a relative, planted hard to take off and dunk on him, and felt and heard a snap that shocked me more than it hurt.  I was more upset that I knew I was in for a setback than hurt.  The pain came 10 mins later and when it came it was pretty intense.  My 12/19/07 appointment with my specialist made way for my 12/21/07 surgery date.  The pain after surgery was unlike any other physical pain I've had in my life.  They had to give me the maximum amount of morphine and demoral (sp) to stabilize my pain for several hours, only to haunt me again on and off for another week and a half.  After that I ceased taking meds and have been on a fairly steady road to recovery.  Since my injury was more severe with my tendon rupturing by ripping from the bone, my healing time was pushed to 6 weeks rather than the typical 4 as stated by my doctor.  He had to use bone anchors to reattach the tendon to my tibia.  On 1/30/08 my doctor stated we'll start movement and take off the brace.  I get little pains here and there while lifting the leg to the bed or putting it on the floor.  It feels like its getting stronger and more stable.  I'm not quite sure what to expect as far as the physical therapy script goes but I welcome the challenge as I frequently work out and have always been an athlete in school.   I'm 6'5 and weigh 240 and have lost about 10 pounds while I've been off my feet in efforts to make my therapy go smoother at a lighter weight than when I injured it.  
I also would like to know if someone could help shed some light timeline wise as to what to expect with recovery time, when I'll be able to resume normal athletic activity, and what to expect.  I had surgery on a partially torn rotator cuff 5 years ago and gained full strength within approximately 4 months.  
Avatar universal
Hi,
Patellar tendon rupture is a disruption of the segment of the extensor mechanism extending from the inferior aspect of the patella to the tibial tubercle.
Patellar tendon ruptures require operative repair. Patients with acute ruptures should be placed in a knee immobilizer for comfort and should be referred to an orthopedist for surgical treatment.
With regards your physical exercises you should be doing quadriceps strengthening and ROM exercises. Begin with straight-leg raises and quadriceps sets. Allow early ROM within the limits of tension of surgical repair. May bear weight as tolerated with the knee locked in extension.
Core strengthening should be done after 6 weeks, advanced ROM and strength training as tolerated.
Most patients treated with early patellar tendon repair have good or excellent results. Chronic tendon ruptures are more difficult to repair, but repair provides better results than nonoperative treatment.
Hope this helps you.
Bye.
Avatar universal
on 12 /18/07 I ruptered my patellar tendon, the rupture occured from the knee, taring away a bit of bone. It was the holidays and everyone was on vacation, surgeon's were scarce. I finally was refered to the hospital for special surgery in NYC. The surgery took place and the doctors were excellent. Immediatley post op they had my leg in a CAM machine movement to 30 degrees. The pain post op was enourmous for about two weeks. My Cam movement is on 80 degrees now and am walking well cruthches outdoors, and when needed. Started therapy for a week. Things are feeling better. Still have the brace and quad strength is horrible. The process is very weird everyone has a different opinion on the surgery and therapy. My knee is feeling better overall but from what I see and have educated myself on it's a long haul untill 100%. Wish everyone best of luck on their rehabilitation.
Avatar universal
It's good to see a forum for this.  I was playing basketball on 2/7/08 when I felt like I got kicked in the knee.  When I looked at it, the kneecap was up into my thigh, and I couldn't straighten my leg.  I had surgery on 2/8/08, and just came home today.  I'm home alone all week, and wondered if anyone else experienced this.  It's worse than I could have imagined trying to get by on my own...any suggestions would help.  Thanks and good luck to all.

One last thing, I'm afraid to put weight on it this soon, although the doctor said it was ok.  Has anyone had adverse reactions to putting weight on their leg so soon?
Avatar universal
Hi,
How are you feeling?
I assume you had Patella dislocation; hence you had surgery for correction.
Patellar dislocation usually refers to lateral displacement of the patella out of its normal alignment in the trochlear groove of the femur.
Participation in football, basketball, baseball, gymnastics, or dancing is one of the many risk factors associated with Patellar dislocation.
Complications associated with the surgery are recurrent dislocations, chronic anterior knee pain, and reflex sympathetic dystrophy, Haemarthrosis with a lateral release, Patello-femoral arthritis, and osteo-chondral fractures.
Early weight bearing can have one of the complications. You can consult a physiotherapist to guide you regarding immediate weight bearing and further training.
I would like to know what the doctor say and what the result of imaging studied was.
Keep me informed if you have any queries.
Bye.
Avatar universal
I am 39, healthy, fit, BMI 23 etc etc, and ruptured my patella ligament yesterday trying to pull a wheelie on my 7-yr olds bike. My left knee/outer lower quads exploded in pain and I fell to the ground clutching it in agony, and had to pull it out straight. Never had pain like it, and have had a ruptured ACL on the other side before and prolapsed intervertebral disc, and #tibia before. Entonox from paramedic crew was amazing as it reduced the spasm and pain and then they immobilised it in a splint. Idiots in accident & emergency came to the conclusion that I had "jared" my knee, even though I said I thought I had ruptured the patella tendon or dislocated-relocated it! I bought the x-rays home and confirmed it myself by comparing it to a picture of an x-ray on google! Luckily I am a surgeon and the Orthopaedic knee specialsit in Leeds saw me thia morning, and the musckuloskeletal radiologist did an USS and confirmed a complete ruptured patella ligament . Surgery is going to be this Wed am. Feel very worried to see som many comments from the forum that it is all so painful post surgery and recovery is so long. I don't do being an invaild very well. My intention was to walk on a straight leg brace straightaway, drive my car (which is automatic) as I can get my leg into the foot-well in a straight position, and hopefully get back operating, if I can hobble about without crutches around an operating table, and do my clinics. Would be good to hear from anyone whether this sounds in any way possible or is it pie-in-the-sky. The only thing I have done today is cancelled my routine for this week, and our family holiday to Orlando, which is just 4-weeks away, as thought the plane ride would be imposs, and couldn't lift suitcases or keep up with my family if they were walking miles in Disney World!

Advice gratefully received

Philip
***@****
Avatar universal
Hi,
Patellar tendon rupture is a disruption of the segment of the extensor mechanism extending from the inferior aspect of the patella to the tibial tubercle.
Ruptures usually result from trauma in which a violent quadriceps muscle contraction occurs against resistance in the flexed knee.
I think this is true in your case too.
Patellar tendon ruptures require operative repair and patients may bear weight as tolerated as long as the knee is locked in extension.
The surgery protocol varies from hospital to hospital and is one those surgeries which will be painful. But as you might know modern day surgeries are been attempted to be pain free.
Early repair allows for maintenance of patellar tendon length and better functional results.
Patients usually are treated with an above-the-knee cast or a knee brace locked in extension for ~6 weeks after surgery.
Most patients treated with early patellar tendon repair have well to excellent results.
Physiotherapy is a must and hence it has to be planned.
What have they mentioned regarding physiotherapy?
Keep me informed if you have any queries and would like to know the progress.
Bye.
Avatar universal
Actually, I had a complete rupture of my right Patellar Tendon.  Today has been a little easier, but I think it's just because I'm getting used to moving around on the crutches.  It still hurts like crazy once I'm moving around on it, but I know I'm going to have to get used to that for now.

Thanks for commenting.
Avatar universal
Hi Fritzy,
If you had Patellar tendon rupture then I think the above mentioned post for turton would give limited but essential information regarding patellar tendon rupture.
I would like to know whether they have put you on any physiotherapy. If yes, what kind of exercise they have planned for you?
Keep me informed.
Bye.
Avatar universal
My next appointment with the doctor is next Monday.  Until then, I was told to just bear weight as much as possible, and keep it up with ice.  I was told physiotherapy would be discussed at this next appointment.  

Thanks.
Avatar universal
Hi,
Physical therapy could be planned as follows;
You may require physical therapy for quadriceps strengthening and ROM exercises.
Begin with straight-leg raises and quadriceps sets. Allow early ROM within the limits of tension of surgical repair.
May bear weight as tolerated with the knee locked in extension
Core strengthening should begin after 6 weeks, advanced ROM and strength training as tolerated.
Keep me informed about your appointment with the doctor.
Bye.
Avatar universal
Timeframe currently:

2/7/08        Ruptured Patellar Tendon (Torn from kneecap)
2/8/08        Surgery (tendon sutured to kneecap by drilling 3 holes in kneecap)
2/19/08       First follow-up with doctor  - Stay in straight-legged brace until next appointment on 3/20/08 to allow tendon to heal to bone.  Should be able to start rehab after the 3/20 appointment.  
Avatar universal
Hi,
So you have been given a timeframe for recovery. I am sure this timeframe is in place for the entire patient group with same bone pathology and same intervention. Orthopedic department would have planned such a time frame after following large number of cases.
I think this should help you in all further intervention.
Keep me posted if you have any queries.
Bye.
Avatar universal
I am soooo happy to see this blog-site.    I comlpetely severed my Patella tendon on Jan. 4th, surgery was a week later, and all went well.   This is a workers comp injury, and I am being treatedly farly well at this point.   I live in an upstairs, end-unit Condo here in Irvine, CA.   The good news about this injury is that it's ok to be weight bearing on my injured left knee, I just (always) have a brace on when moving around, etc.    OMG this Dr. has been great for me, the staples came out 2 weeks after surgery, and after 6 weeks I have been cleared for Physical Therapy.     I agree that re-hab does NOT need to be an excruciatingly painful "Let's get you healed asap" kind of endeavour.   Slow it down a little for crying out loud, and go with the flow.    PT will indeed be painful, but better to err on the side of caution.    My thought is this:   I stepped wrong while doing Maintenance coming off a slight incline and my tendon completely ruptured, soooooooo if it ruptured that easily, ehy naot take every step in PT to allow my body to fully accept the repair that was done.   It would just literally kill me if some well-meaning Therapist overworked me and my tendon ruptured again.   This injury is an extremely uncommon one, and limited rehab info is available at this point ..... well, that's my understanding.    My Dr. has informed me that at 53, I will get 80-90% full recovery, but will have much difficulty when trying to work down on my knees.    For those who are newly injured, hold your head up high, allow SIX weeks minimum before trying to do any stretching, etc.    Thank God for Doctors who have (patience) with their patients, and thank God for a forum where can get some pertinent info, and re-assurance.    
Healing .... but slowly
Frank in Irvine, CA
Avatar universal
I am also recoverying from a fully ruptured right patellar tendon from the patellar.  My injury was on Dec 20th, 2007, surgery Dec 31, 2007.  I was told this was possibly the worst injury a person could sustain in their lifetime.  I could not agree more being that I am a 35 year old mother of 2 young children and very active in the outdoors.  I would like to encourage those not to see this as a lide sentence but a reason to rehab your body for life. I have been more committed to stay in good health.  I have lost 15 pounds and more aware of what I put in my mouth.  My kids have been my motivator to be a good role model too.  I have had time to also put things in perspective.  Since surgery I have started PT 6 weeks post op.  I have had more than 86 degeres of active range of motion restored and I am at 92 degress passive range of motion restored 64 days post op.  My PT is awesome, we work through the burn but not the pain.  I believe this allows for a more thorough recovery, your body tends not to resist as much.  I am concerned because I cannot do straight leg raises or drive a car. But I can do the recumbent bike, some ball excersise and leg presses. Listen to your body, don't compete with the injury...work through it instead.  In the long run you will be glad you were patient.  Any input would be appreciated.  Good luck to your healthy recovery.  
Avatar universal
Thanks for that valuable input of working through the "burn", but not the pain.   I was given the PT go ahead Wednesday, and I have been ssssstttrrreeetching my leg/knee till I feel maximum "burn".   Getting myself a little ready for Therapy on Monday, it's gonna hurt, ouch!.     Believe it or not, I drove home in my truck the day that I was injured, and got myself up the stairs to our condo somehow.     I have been driving ever since I sustained this injury, except for the week of my surgery.     Just like you, I am haveing severe difficulty in Leg Raises, they are extremely painful, and I feel as though I am gonna rip something again, grrrrrrrrr.      I have not been on any meds, and hope to go back on 800mg Ibuproffen during PT.     If that doesn't cut it, it means taking Darvoset, and NOT driving.     Being a non-drinking Italian, I am finding joy and comfort with a small glass of Merlot a few times a week, my Grandpa would be soooo proud of me, lol.    OMG, it would feel wonderful to pedal a bike again!     I am hoping to see a post from JainMD soon, her info is direct, to the point, and in laymans terms.    Hang in there Staying Positive, have you in our thoughts and prayers.  
                                                                              (also) Staying Positive,
                                                                              Frank in Irvine, CA
Avatar universal
Was searching around and found this forum, very nice. I recently ruptured my patella tendon as well, unlike most folks, this is actually my second rupture. Ruptured the left one 16 years ago and my right one 03/13/08 almost to the same day.

I have to agree you want to it be aggressive and work through the pain, my first one was horrible, and with the lessons learned I truly hope to get full flexibility with my right one.

Hang in there.

Semper Fi


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