Injury question, not sure where to post this...

All apologies if this isn't an appropriate forum for this question, but I couldn't find an "injuries" sub-heading under any of the public forums. And lots of smart, knowledgeable people give feedback and answers here 

I probably have a ruptured quadriceps tendon in left leg.  I slipped on the grass 28 hours ago trying to show a kid on my sons's lacrosse team how to play defense, and fell back with my lower leg pinned below me and all my weight crashing down on that leg.  Knew it was bad when the other coaches would not let me look at my knee, and they wouldn't look at it either.  Emergency room, X-rays, ice, knee immobilized, crutches, ibuprofen, etc. Physician's assistant diagnosed a rupture from the X-ray before they sent me home (busy ER in a city hospital on a Friday night) and all but guarenteed that I'm looking at surgery and months of rehab.

 I have an appointment Monday with an orthopedist (it's late Saturday eastern USA as I type). I'm hoping for some guidance regarding questions to ask the orthopedist.  And general advice and guidance. I've never had a serious injury or surgery. Never used crutches before. I'm 45.

Should I seek an orthopedist specializing in knees? If it's a total rupture, what kind of recovery period am I looking at?  What sorts of questions do you ask an orthopedic surgeon if, say, you still have a dream of a single leg squat with your left leg? (And dreams of running 4-5 miles, playing occasional pickup basketball, etc)

thanks in advance for any thoughts, and sorry in advance if this is posted in wrong place. 

-Craig

I don't have and answers for you.  Just a note to say sorry that happened to you.  So many dads volunteer to help youth sports.  Sucks that happened.  Hope you are feeling better and on a road to recovery.

I also cannot give any specific advice, just wanted to say that I am sorry. For sure you'll have to be patient, but progress will come and probably your goals are within reach - this is not an expert opinion though. It is more than a year and half ago that I broke my left knee, and about six months afterwards I broke my left hip too. My left side is definitely behind, crunchy, and weak, but it keeps slowly improving. Most likely there will be periods in which you do not see any improvements, try not to get discouraged and keep steadily working on recover!

What was the outcome of the orthopaedic review?

Thanks for the replies, friends.

I had surgery 10 days ago to repair a completely ruptured quadriceps tendon. The orthopedic surgeon also said I had partially damaged the patella tendon (I'm getting clarification from him today on precisely what that means). Cast on leg for 4-5 more weeks, then a brace for 4 weeks probably. Then rehab. 

If my doctor approves, I plan on starting back with hinge rows and bench dips and elevated planche leans next week, with slight modifications on the iMs to account for cast on leg. SLS is out, and I'll have to go back to earlier progressions of SL and FL. My main concern, besides doing too much too fast, is sweating heavily and getting itchy or stinky inside the cast. 

That is a rare injury. Was the whole quads tendon torn so there was no quads attaching to the patella? Thankfully you sound like you are in good hands with the surgeon.

Mark:

yes, my surgeon told me yesterday that it was completely severed. A tiny piece of the patella chipped off. Besides reattaching the tendon to the patella with surgical Kevlar, he also said he had to   staple/suture a bunch of the surrounding connective tissue as well (he used a term to describe that other tissue which I forgot to write down). I'm lucky: this orthopedic surgeon is also my school's sports medicine consultant who comes to our school (a K-12 private school) every Monday afternoon, and we have an extensive athletic training department (3 full-time people) who will guide me through the rehab when that starts in a couple months. 

Yes, a rare injury. A neighbor is an otolaryngologist, and he said, "quad tendon rupture?  That's something only NFL and NBA guys get".  Yeah, if only :-)

Thanks for reaching out,

Craig

Hi, I also ruptured the quadriceps tendon in my left leg. I slipped on a diving board and my whole body weight landed on my left leg (in a "hurdler's stretch" kind of position). I heard the pop. As the cherry on top, I also tore my CFL and ATFL in the left ankle for a really good sprain.

Anyway, had surgery to reattach it. Surgery was handled by Dr. Bush-Joseph at Rush in Chicago who handles the Sox, Bulls, and some other Chicago sports teams. It was a full rupture. No other tendon in the knee was injured so luckily it was isolated.

They drilled some holes into my patella to reattach the (frayed) tendon. Was on crutches for a few days but now am just walking around with an immobilizer brace. Surgery was nearly 2 weeks ago. Tomorrow I get the remainder of my staples removed and begin rehab. Right now the brace is dialed in to give me 30 degrees of flexion. I'm told that I should be able to add 15 degrees of additional flexion per week until we get to 90 degrees in 6 weeks or so. 12 weeks for full movement.

For the past 15 months or so I have been doing the front and middle split stretches. Interestingly, I never had good luck in getting my quads and hip flexors to stretch. I referring specifically to the "vertical shin" stretch in the front-split series. I was one of those people that had a difficult time getting my butt to touch the wall with my knee placed all the way at the joint of the wall & floor. My hamstrings were pretty flexible after all of that work as were my calves & achilles tendon.

After I get some strength and mobility back, I'm going to start back up on the front-split stretches. It will be months before I am ready to do that, but I now have a powerful motivation to make these muscles strong and supple. And when I inevitably plateau again, I'll be back here looking for advice on how to break on through to the other side.

If anyone has suggestions for add-on work that I can do with my rehab, I am all ears. Yes, I know you aren't doctors, I won't take it as medical advice, etc... just looking for anything to help shorten recovery.

@Charles RemesYou're too soon out of surgery to give any specific advice other than be as proactive as possible in dealing with your Surgeon, therapist etc. so you can get the best advice and help from them possible. They know the specifics of your case and will be able to help you better than anyone else.

Charles:  I feel your pain.  I'm 4 months post-surgery.  If you look on-line at post-surgical protocols for rehab for quad tendon rupture, you'll see a timeline for rehab that can be 40-50 weeks duration.  There's no rushing back from this.  For instance:  April injury for me, and there is only a tiny chance that I will be running slowly by Thanksgiving (says my PT).  

One bit of good news:  although I can't do any SLS progressions, the other 6 foundational exercise progressions can be done, if I'm super careful and alter some things slightly (you won't be doing anything involving a bent leg for a LOOONNNGG time).

DM me if you have any questions about work-arounds, ways to scale/modify the progressions, etc. 

Good luck.  Stay safe.  

@Craig Copeland

Thanks for the offer. I'll probably ping you when I hit the 6-week mark.. that's supposed to be the point where the tendon is doing most of the work and the sutures are no longer bearing the load. Had my first rehab appointment yesterday and it went well. I've been walking with a brace and without crutches for a week, so the rehab guy said I was already a week ahead of the normal progression. We'll see how it goes. The real trick will be to figure out how to continue working on stretching my right leg quad and hip flexors while the left side heals...

So I'm back. Since my last post on Aug 24 I had a bit of a setback. In mid-September I slipped while walking my dogs and dislocated the kneecap on my left leg (the leg that had surgery). It shut down my quad muscle again so I essentially went back to square 1 for reactivating the muscles. The good news was that I did not tear any ligaments or tendons and the quad tendon was about 7 weeks healed (6 weeks is needed for it to reattach to the bone).

I'm doing good rehab work with a rehab tech at Athletic twice per week. Twice more per week I am doing my own rehab which primarily consists of stationary cycle, lunges in the pool, walking the track, and doing some stair work. The eccentric movements (e.g. walking *down* the stairs) is the most difficult movement. My muscle tone is improving but it's clear to see a 25% volume difference in my left thigh versus right thigh.

I'm starting to sit seiza again. I can't get my bum to my heels yet but I'm working on it. The left knee has about 130 degrees of flexion, but I need 135 to get my butt to heels. To get bum to floor will probably require 145 degrees.

As soon as I can safely do lunges and a deep (bum to almost-floor) squat then I'll begin the front-split series work again.

I'm very motivated.

Welcome back Charles!

I literally feel that pain Charles.  Seems like your ROM is coming back pretty quickly (I'm at about 135 degrees but my injury was in April). Good luck. 

Nice work guys and good luck with the rehab. I just spoke with a friend who's Dad had similar injury with ~135 degrees now.