ruptured my patellar tendon - any advice?

I'm a fit dude who's played pretty much all sports all my life and boom... just a freak injury accident and had to have emergency surgery to repair it.

Anyone here have anything similar? I never noticed knee pain, except for about 8 years ago where I had tendinitis and used ART to manage it... and eventually stopped playing CUSA soccer.

It was a pretty brutal injury, not the most painful I've had... but definitely one of the worst, especially when it comes to recovery timelines.

What I'm most worried about - even if everything goes well, is the muscle atrophy and the imbalance I will have, as I still do alot of leg day... mostly in prevention of re-injuring my back or hips

Also... who knows post-op protocols well? I just didn't do well on the tramaset, and so I'm just on advil (well barely) and just delt through the pain... but I'm getting really good swelling in the impacted area, especially under the knee that seems to feel like playdough.

I was told elevate (which I do) and do foot extensions, but also to get up to prevent clots or DVT... funny thing is, I'm getting advice both ways, and its kinda contradictory as I definitely do not want a clot, but also want to manage swelling.

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Originally Posted by r3ccOs

I'm a fit dude who's played pretty much all sports all my life and boom... just a freak injury accident and had to have emergency surgery to repair it.

Anyone here have anything similar? I never noticed knee pain, except for about 8 years ago where I had tendinitis and used ART to manage it... and eventually stopped playing CUSA soccer.

It was a pretty brutal injury, not the most painful I've had... but definitely one of the worst, especially when it comes to recovery timelines.

What I'm most worried about - even if everything goes well, is the muscle atrophy and the imbalance I will have, as I still do alot of leg day... mostly in prevention of re-injuring my back or hips

Also... who knows post-op protocols well? I just didn't do well on the tramaset, and so I'm just on advil (well barely) and just delt through the pain... but I'm getting really good swelling in the impacted area, especially under the knee that seems to feel like playdough.

I was told elevate (which I do) and do foot extensions, but also to get up to prevent clots or DVT... funny thing is, I'm getting advice both ways, and its kinda contradictory as I definitely do not want a clot, but also want to manage swelling.

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Tramecet is for pain, they should've given you something else for anti-inflammatory. When I had my last surgery I got Tramecet, and I would take 2 before bed, it was great to keep me sleeping and not tossing and turning to stay comfortable. Otherwise I'm more of a "suck it up" type when it comes to pain. I don't know how much Advil you're taking? But obviously any movement and whatnot is going to trigger swelling in the first few weeks.

I had surgery on my patellar tendon ~5 years ago for really bad patellar tendonitis. The tendon itself was almost shredded. I lived with it for a few years until it got so bad that I looked into the surgery route. I was skiing 1 month after which was pretty amazing. A lot of the recovery was just in strengthening the tendon and all the muscles around it. I'm sure rupturing it is even worse. Best advice I can give is don't push it. Listen to the advice of your physiotherapist. The last thing you want to do is tweak something and double the recovery time.

Agreed. Don't push it like asp said.
Elevate as much as you can. Watching TV, throw leg up on the couch or whatever is most comfortable.
Sadly, just take your time to heal and the muscles will come back quicker than you think once you're healed and body isn't repairing.
Being healthy, eating properly (non-inflammatory foods), going into surgery pretty fit will pay off for you.

I don't know much about knees. More on ankles and ankle surgeries. But possibly could look into compression leggings? As about them on your 1st follow up with your surgeon.

Cryo Cuff
Honestly, one of the best things for recovery. Thankfully I've never had to go through knee surgery, but I feel like 4 ankle surgeries makes me a little old-hat at this post-op recovery stuff.

1) As stated above, 110% listen to what physio says. Even if it sounds like "too slow" or "too easy", you don't want to push it and end up back at square one.

2) Totally understandable on the muscle atrophy, but it'll come back sooner than you think. Just make sure to focus a lot on core to ensure you don't end up with any imbalance-related issues like you mentioned above. Do lots of hip-flexor stuff and deep core/back exercises.

3) In regards to the tramaset, I feel you on that one. I'm allergic to pain meds so was stuck with the "here's a tylenol" from recovery room to home. It sucks, but it will get better. Just try to keep yourself distracted. Keeping the swelling down is also key to managing the pain.

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Originally Posted by klumsy_tumbler

Cryo Cuff
Honestly, one of the best things for recovery. Thankfully I've never had to go through knee surgery, but I feel like 4 ankle surgeries makes me a little old-hat at this post-op recovery stuff.

1) As stated above, 110% listen to what physio says. Even if it sounds like "too slow" or "too easy", you don't want to push it and end up back at square one.

2) Totally understandable on the muscle atrophy, but it'll come back sooner than you think. Just make sure to focus a lot on core to ensure you don't end up with any imbalance-related issues like you mentioned above. Do lots of hip-flexor stuff and deep core/back exercises.

3) In regards to the tramaset, I feel you on that one. I'm allergic to pain meds so was stuck with the "here's a tylenol" from recovery room to home. It sucks, but it will get better. Just try to keep yourself distracted. Keeping the swelling down is also key to managing the pain.

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Thanks guys for all the responses and support...

I was quite lucky that the pain outside of day 1 was reasonable and I only take Advil for inflammation and not pain, as well as Aspirin 81 to prevent clots.

Problem is, being an active and anxious guy about the surgery I was up and abouts alot by day 3 and 4, which resulted in much more swelling than I had anticipated, and as such have basically lived the last 3 days with my legs elevated.

I guess there isn't a "rush"... and I definitely need to make sure I recover properly...

One thing I'm not sure of is how many sutures were put in... I've seen a few different options dependent on how active the patient's lifestyle was before.

Unfortunately i've heard that if I only had 2, they are only good for 200lbs each, which means... forget heavy squats, or any kind of substantial loading such as aggressive skiing, hockey or basketball

The cryocuff is very nice, but I can't use the pneumatic functions until I get out of this zimmer device.

I’ve had a lot of sports injuries (including a broken spine) and the one thing I learned from them all is DO NOT rush your recovery. It’s really easy to think you’re feeling better, and overdo it and end up re-injuring yourself. It happens in a split second. It’s all too easy to want to push yourself to avoid atrophe, etc, but follow doctors advice and only start your recovery when you’re actually healed. Not just when you “feel better.”

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Originally Posted by r3ccOs

Unfortunately i've heard that if I only had 2, they are only good for 200lbs each, which means... forget heavy squats, or any kind of substantial loading ....

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Would they not have consulted with you about your lifestyle etc. prior to the repair? Or was it too emergent to allow for it?

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Originally Posted by JRSC00LUDE

Would they not have consulted with you about your lifestyle etc. prior to the repair? Or was it too emergent to allow for it?

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I kept mentioning I played sports, but the consultation was short as it was emergency...

so I have no idea what type of repair was completed :(

That's unfortunate, hopefully when they clarify to you it'll all be good.

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Originally Posted by klumsy_tumbler

4 ankle surgeries makes me a little old-hat at this post-op recovery stuff.

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4 ankle surgery club member right here!

I know what you're going through too, but every injury is different. I'm a 3 to 4 time a gym guy, Orange Theory once a week, and mountain biker summer and winter, softball every summer, was playing dodgeball for years until my shoulder couldn't handle that anymore. So I gave up on that to pick up basketball which was my go to sport in high school and collage. Well 4 months in, I drove to the hoop and had that 1 in 1000 landings where I fractured my tibial plateau which required a steel plate, 6 screws an 3.5 hours of surgery to repair. This all happen back in April, figured my sporting/fitness life was over. I was on crutches for 10 weeks and off work for 3 months. Fast forward to the middle of September I reach a huge goal that I thought was never going to happen, I was mountain biking in Moab and ahead of most of the 7 guys I went down with. So the story is have a goal, listen to physio, do your homework, eat good and you can be back to a normal life. My surgeon and physio was blown away on how my rehab as been going and this week I got to go ahead to start light jogging again.

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Originally Posted by Kjonus

I know what you're going through too, but every injury is different. I'm a 3 to 4 time a gym guy, Orange Theory once a week, and mountain biker summer and winter, softball every summer, was playing dodgeball for years until my shoulder couldn't handle that anymore. So I gave up on that to pick up basketball which was my go to sport in high school and collage. Well 4 months in, I drove to the hoop and had that 1 in 1000 landings where I fractured my tibial plateau which required a steel plate, 6 screws an 3.5 hours of surgery to repair. This all happen back in April, figured my sporting/fitness life was over. I was on crutches for 10 weeks and off work for 3 months. Fast forward to the middle of September I reach a huge goal that I thought was never going to happen, I was mountain biking in Moab and ahead of most of the 7 guys I went down with. So the story is have a goal, listen to physio, do your homework, eat good and you can be back to a normal life. My surgeon and physio was blown away on how my rehab as been going and this week I got to go ahead to start light jogging again.

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I think you're right, and I got some more clear timelines....

I can begin physio shortly, maybe next week once the doctor clears things, but its very pragmatic to prevent atrophy and slowly re-lengthening the tendon.

In short... just for pure healing, it takes 12 weeks for the Tendon to fully re-attach to my kneecap, and the sutures are just there to ensure that it does and added insurance as it will never head as strong as before.

That said, I was told in about a years time, with tenacious rehab, I should be back to 100% but, I think I need to tone down my workouts.

I was doing squats 2-3 times a week, deadlifts twice a week and with that, always ending with leg press and leg extensions. I told my PT, and he was like... yeah you're not giving your knees enough rest even if your quads or hammies can keep up.

I think its all relative, but I'm the retard that is does an aggressive 5x5 to trying a PR at least once a week on each lift... so I was DL 425 x 2 at least twice a week, and a 405 squat x 3 also for 2-3 times a week, finishing with an 8 plate leg press... and TBH, I definitely felt it in my knees.

Couple that with explosive sports, like Skiing, Hockey and soccer and no kidding I blew myself up in the 30's

My greatest fear is the atrophy developing an imbalance which may result in more impacts to a bad lower back and hips... I'm not going to lie, if I don't get some sort of steroid cycle for recovery for the leg, then I'll have to look to the grey market to solve that problem (and I'm not at all a juicer, never have been)

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Originally Posted by Maxx Mazda

I’ve had a lot of sports injuries (including a broken spine) and the one thing I learned from them all is DO NOT rush your recovery. It’s really easy to think you’re feeling better, and overdo it and end up re-injuring yourself. It happens in a split second. It’s all too easy to want to push yourself to avoid atrophe, etc, but follow doctors advice and only start your recovery when you’re actually healed. Not just when you “feel better.”

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I think there is a lot of merit to this, however a lot of journals I'm reading is saying to keep working on the range of motion in this period (not necessary strengthening yet) just to ensure elasticity

however my surgeon has told me to wait another 4 weeks (7 weeks total) before beginning therapy... meanwhile there are many many videos on youtube and articles indicating otherwise.

I think its a bit of doing things within reason, as I think the Surgeon's intent is to ensure the repair is 100% in order to ensure his work is successful, however I hear that prolonging range of motion (ROM) work is exponantially detrimental to recovery

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Originally Posted by r3ccOs

I think there is a lot of merit to this, however a lot of journals I'm reading is saying to keep working on the range of motion in this period (not necessary strengthening yet) just to ensure elasticity

however my surgeon has told me to wait another 4 weeks (7 weeks total) before beginning therapy... meanwhile there are many many videos on youtube and articles indicating otherwise.

I think its a bit of doing things within reason, as I think the Surgeon's intent is to ensure the repair is 100% in order to ensure his work is successful, however I hear that prolonging range of motion (ROM) work is exponantially detrimental to recovery

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Surgeon > YouTube

Honestly dude, you don't want to fudge something up because you pushed too hard, too fast. Ask your surgeon for their recommendation, express your end goals so that you can discuss that with them, and then just do what they tell you haha.

No wonder they hate athletes/fitness junkies so much :rofl:

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Originally Posted by klumsy_tumbler

Surgeon > YouTube

Honestly dude, you don't want to fudge something up because you pushed too hard, too fast. Ask your surgeon for their recommendation, express your end goals so that you can discuss that with them, and then just do what they tell you haha.

No wonder they hate athletes/fitness junkies so much :rofl:

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Update

I've been staying active, but not necessarily mobile, going to the gym and lifting as Cardio was out about 25 out of the 35 days I was down and out. Once the scar was healed, I began using some anti-inflammatory creams and a scar tissue kit to work the area "gently" meanwhile working on passive ROM activities.

I did the typical protcol I found in a number of journals as well as incorporated weighted calf raises, non-weighted partial squats and eventually walking stairs conventionally.

Though my brace was to be locked at 15deg, at my 5 week appointment they measured me at 110deg... and while looking at any atrophy or wasting, my surgeon said clearly there is some atrophy in quad size comparison, but you still have most of your bulk in your calves and legs...

Then he was like, um... lets try firing your hips, your flexion etc... and he was like, there is "Zero" lag... Now try walking... which I did

he then was like... you've been working on this haven't you... and he said, well it appears you did the "Right" things as you have ROM well beyond what we would expect and you don't appear to have any issues with normal walking.

So... next steps? He told me just to get rid of the brace, use a knee sleeve when working out... start on PT protocols right away.

By week 12, the tendon and repair should be 100%, it can take up to a year to get back to the same strength as before, but it is very likely in 3 months from now I can be back skating and skiing.


So there is merit clearly in moving early, getting blood flowing, persistent yet cautious early rehabilitation.

The only thing I am looking to do now, is to repair some tendons/ligaments that could also be in as bad of shape as this one, and I'm looking for a legal way to screen and go on a HGH regimin.

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Originally Posted by r3ccOs

Update
So there is merit clearly in moving early, getting blood flowing, persistent yet cautious early rehabilitation.

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Awesome to hear. I know it can be really frustrating when you feel like progress is slow while you're in the early stages, but you will be thanking yourself a few months from now. Trust me.