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Just Ruptured Both Quad Tendons...What do?

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  • Just Ruptured Both Quad Tendons...What do?

    Hey docs. Just had an unfortunate fall on icy stairs on Thursday. Both knees shot forward and down and I ruptured both quad tendons. I knew it as soon as I went down. Had surgery on Friday afternoon as soon as they saw the MRI. My legs are locked straight in these braces for 6 weeks then PT progression starts with ROM all the way through to return to sport/activity over a period of months.

    I'm just looking for experiences and any advice that can be offered, not specifically for me, just in general with this injury. My post-op follow up is in 2 weeks. I’m a firefighter and active/competitive lifter. I have 6 months to get back to work so I’m looking to optimize rehab/recovery. ROM, strength and function are my goals. Maybe this will finally get rid of my chronic tendinitis (sarcasm).

    Thank you in advance for any advice you can offer. I know I need to follow my doctor’s orders and I will.

    Stay safe and watch your step!

  • #2
    Hey Jeff,
    I have rehabbed a few individuals with this injury. The first 6 weeks of rehab are....boring. You'll be doing a lot of simple range of motion work and normally the goals are to be over 90 degrees by 6 weeks and 110 by about 8. Due to the nature of healing with the surgery, you are going to be bored. This is an instance where if you can find a PT who has access to some blood flow restriction training equipment in can help out with retarding atrophy. Once you are out of your braces, it becomes a game of building back quadriceps (and overall lower extremity) strength. Typically we compare strength side to side for an index but obviously that is out in this instance. Instead we're better off taking an approach of tracking strength gains overall. If you are working with a PT in person, it's good to test this with a dynamometer but you can also track with something like a knee extension machine. In the beginning though, you're going to find even doing a long arc quad (sitting on the edge of a bed and kicking your leg straight out) is going to be a challenge.

    As you return back to some semblance of training you are going to be frustrated, and that is okay. Your strength will return and it is often helpful to think of those first 2 months back as a volume block. Moving in different ways, making sure you are getting in some quadriceps strengthening, and getting back in shape are the important steps. Anecdotally, a lot of athletes coming back from a quad tendon repair report a different feeling with fatigue. Instead of the normal "pump" you get with training it more just feels "empty" like you are doing reps and your leg just won't go anymore. If this happens, you are normal. If you have any questions, feel free to reach out and I'll do my best to give you some advice. You're probably hard pressed to find any PT in the country who has seen >5 of these bilateral. You'll get back to doing what you want to do though, it's just going to take some time and work.