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Old Runner Frank

Booting up
Skier
Joined
Jan 10, 2021
Posts
50
Location
New Jersey
Peter and Don, glad to hear you guys are doing well. I'm just past a year and a half post surgery, and while I feel like my strength is OK, I would gladly trade either of you some of it for a bit more range of motion. As I've noted, I'm quite functional, and able to do just about whatever I want, but despite frequent stretching, my injured leg just does not bend as much as the other one. All things considered, I'm happy to be where I am after where I was a year and a half ago. Wishing you both the best for continued progress and a normal, active life.
 

dontyler22

In the parking lot (formerly "At the base lodge")
Skier
Joined
Jul 6, 2022
Posts
2
Location
Milwaukee, WI
New member, not sure how to post. 69 year old in week 17 of ruptured quad recovery; able to bike 15 miles, swim 1 mile, walk 4 miles, elliptical at 12 minutes, stairs are ok not great, can’t I jogging at this point.



Question: anybody else had buckling of knee during walking or on treadmill? Cause? Does it go away?

Doing PT last few weeks to build strength.

Posts extremely helpful to gain perspective. Thanks!
 

dontyler22

In the parking lot (formerly "At the base lodge")
Skier
Joined
Jul 6, 2022
Posts
2
Location
Milwaukee, WI
Hey all-
I hope you guys are recovering well. 10 months post op. I've been doing some day-hiking this fall. Sometimes 10-13 miles at a time. Stiff and sore most of the time but manageable. Going up/down steps still hurts. At this time backpacking with 30-35 pounds is tough. 5 miles is my limit. I'm sure next year I can up that mileage. I think the pain I sometimes get (especially on steps) is joint pain. Hopefully that will get better too.
New here - 17 weeks into recovery from backpacking accident - would love to hear how you are doing.
 

martyg

Making fresh tracks
Industry Insider
Joined
Nov 24, 2017
Posts
2,216
New member, not sure how to post. 69 year old in week 17 of ruptured quad recovery; able to bike 15 miles, swim 1 mile, walk 4 miles, elliptical at 12 minutes, stairs are ok not great, can’t I jogging at this point.



Question: anybody else had buckling of knee during walking or on treadmill? Cause? Does it go away?

Doing PT last few weeks to build strength.

Posts extremely helpful to gain perspective. Thanks!

The aerobic work that you are doing yields wonderful benefits. Unfortunately, muscular hypertrophy is not on that list.

It will take a full 18 - 24 months for your knee to remodel. If you are interested in a performance outcome, that first 12 months you need to be in the gym pushing heavy weights to provide the stimulus for cell division. The most optimal load is 6 - 8 reps, at 85% of your one rep max. You are not in a position to push to that degree yet, but it should be your goal. Aerobic workouts should be executed only when you have sufficient gas, at a recovery HR, and not at the expense of resistance work. It is also helpful to measure your R and L quad circumference on a weekly basis.

See my previous posts on creating the best environment for cell division through optimizing diet and hormone levels by working with specialists in those respective fields. Your action plan will be based on blood draws, not an opinion posted on Google. We are all a study of one. If you want a performance outcome, you need data points that arer unique to your physiology.

Best to you.
 

Old Runner Frank

Booting up
Skier
Joined
Jan 10, 2021
Posts
50
Location
New Jersey
New member, not sure how to post. 69 year old in week 17 of ruptured quad recovery; able to bike 15 miles, swim 1 mile, walk 4 miles, elliptical at 12 minutes, stairs are ok not great, can’t I jogging at this point.



Question: anybody else had buckling of knee during walking or on treadmill? Cause? Does it go away?

Doing PT last few weeks to build strength.

Posts extremely helpful to gain perspective. Thanks!
Hi Don. I am currently approaching 20 months post injury/post-op, and I am fully functional. I am able to run, do some pretty strenuous workouts, play golf, go up and down stairs with no problem, and am not really limited al all. I did notice some "give" in my knee, generally when standing from a seated position, as recently as a few months ago, but have not experienced that in awhile.

Hope you and everyone else on here are continuing to progress.
 

LAQuad

In the parking lot (formerly "At the base lodge")
Skier
Joined
Aug 6, 2022
Posts
22
Location
Louisiana
New member here. On Jul 6 I was doing heavy leg press at the gym when my right knee popped, rep 3 near the bottom of the rep on the way up. When that happened all the weight shifted to my left leg and, pop.pop… after visiting a local ER and a trip the an ortho, I was diagnosed with a partial tear of the VMO and quad tendon at the VMO on my right. Also a meniscus tear. The left leg was a full rupture of the quad tendon.
had surgery 6 days later, left leg was repaired with drill holes in the patella and no 5 fiber wire (my doc is not a fan of suture anchors for athletes). Right leg was also repaired at the vmo along with meniscus and cartilage clean up.
I’m at week 5 now and doing basic heel slides, quad sets, hip, glute, and calf work.
Also, my doc started my full rupture in a hinged knee brace locked at 10 degrees (both ext and flex). Not sure why but he is very highly regarded in the south as a top notch surgeon. Use to work with an NFL team as the team doc. My right leg is now open to 70 degrees and my left at 0 ext and 20 flexion. Seems most folks lock in at 0 for six week but I’m listening to the doc. I lay around in the bed and couch 22 hrs of the day anyhow. Still on two crutches as well.

I’m curious - what is typically first to go? The braces or the crutches?
 

LAQuad

In the parking lot (formerly "At the base lodge")
Skier
Joined
Aug 6, 2022
Posts
22
Location
Louisiana
The aerobic work that you are doing yields wonderful benefits. Unfortunately, muscular hypertrophy is not on that list.

It will take a full 18 - 24 months for your knee to remodel. If you are interested in a performance outcome, that first 12 months you need to be in the gym pushing heavy weights to provide the stimulus for cell division. The most optimal load is 6 - 8 reps, at 85% of your one rep max. You are not in a position to push to that degree yet, but it should be your goal. Aerobic workouts should be executed only when you have sufficient gas, at a recovery HR, and not at the expense of resistance work. It is also helpful to measure your R and L quad circumference on a weekly basis.

See my previous posts on creating the best environment for cell division through optimizing diet and hormone levels by working with specialists in those respective fields. Your action plan will be based on blood draws, not an opinion posted on Google. We are all a study of one. If you want a performance outcome, you need data points that arer unique to your physiology.

Best to you.
At what month post surgery did you start your heavy lifting? I’m not familiar with the term “cell division” but I know you hit more hypertrophy in the 12-15 rep range. In fact, most wrestlers and fighter lift in the 6-8 range to increase strength without gaining weight and moving up weight classes. I can’t imagine going to 85% of max for some time, unless we’re talking my new, weak quad max… lol
 

Old Runner Frank

Booting up
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Jan 10, 2021
Posts
50
Location
New Jersey
Sorry to hear of your injury. I had no idea it could happen under a steady, heavy load. Mine was from a slip and a violent twist, with all the weight on one leg when I heard and felt the dreaded pop. You are correct, that most repairs are locked in the brace at 0 degrees for six weeks, but I'm sure your doc has good reasons for his protocol.

Marty is probably best equipped to answer your questions about resuming strength training. With your newfound free time, you would probably find it beneficial to read through this entire, lengthy discussion.

Good luck to you for a speedy recovery.
 

martyg

Making fresh tracks
Industry Insider
Joined
Nov 24, 2017
Posts
2,216
At what month post surgery did you start your heavy lifting? I’m not familiar with the term “cell division” but I know you hit more hypertrophy in the 12-15 rep range. In fact, most wrestlers and fighter lift in the 6-8 range to increase strength without gaining weight and moving up weight classes. I can’t imagine going to 85% of max for some time, unless we’re talking my new, weak quad max… lol

I guess it is how one defines "heavy". I think at 13 weeks after I was doing squats with 115 for 10. reps. I never go over 185 on squats, spending more time on more ski specific drills and balance. It will all be according to your new, weak quad protocol.

Best to seek out a top notch PT. You need a PT that is engineering performance outcomes.

Best to you.
 

LAQuad

In the parking lot (formerly "At the base lodge")
Skier
Joined
Aug 6, 2022
Posts
22
Location
Louisiana
I guess it is how one defines "heavy". I think at 13 weeks after I was doing squats with 115 for 10. reps. I never go over 185 on squats, spending more time on more ski specific drills and balance. It will all be according to your new, weak quad protocol.

Best to seek out a top notch PT. You need a PT that is engineering performance outcomes.

Best to you.
Thanks. I think he’s pretty good, he trained with Kevin Wilk at Champion Sports Medicine down in Birmingham for many years. We are actually following the same protocol used by Triple H (WWE) after his quad rupture.

for what it’s worth.. here are my ROM stats to date:

Week 4- August 11th 2022: 22*(lt), 62*(rt)

Week 5- August 15th 2022: 37*(lt), 68*(rt)

Week 5- August 19th 2022: 54*(lt), 76*(rt)
 

LAQuad

In the parking lot (formerly "At the base lodge")
Skier
Joined
Aug 6, 2022
Posts
22
Location
Louisiana
How long after surgery were you all able to do a straight leg raise? Extension?
I’m at seven weeks and no matter how hard I push the fully ruptured leg won’t move. The partial leg is moving great.
 

Old Runner Frank

Booting up
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Joined
Jan 10, 2021
Posts
50
Location
New Jersey
I don't exactly recall at what point I was able to do specific movements, but I remember my orthopedist saying that we have an unlimited time to regain strength, but only a window of six months or so to regain range of motion. So while we worked on strength, the focus was more on mobility in the early months.
 

LAQuad

In the parking lot (formerly "At the base lodge")
Skier
Joined
Aug 6, 2022
Posts
22
Location
Louisiana
I guess it is how one defines "heavy". I think at 13 weeks after I was doing squats with 115 for 10. reps. I never go over 185 on squats, spending more time on more ski specific drills and balance. It will all be according to your new, weak quad protocol.

Best to seek out a top notch PT. You need a PT that is engineering performance outcomes.

Best to you.
Martyg - how matimes a day did your PTs have you do your exercise routine? Also, did they tell you to take rest days and how often?

Mine takes about 1-1.5 hours to complete and I’m doing it 3x a day. Feeling like it may be to much. I’ll be at 8 weeks (bilateral) on Tuesday.
 

50+ Year Skier

Loving Loveland - 50+ yrs
Skier
Joined
Oct 27, 2019
Posts
9
Location
Colorado
New member here. On Jul 6 I was doing heavy leg press at the gym when my right knee popped, rep 3 near the bottom of the rep on the way up. When that happened all the weight shifted to my left leg and, pop.pop… after visiting a local ER and a trip the an ortho, I was diagnosed with a partial tear of the VMO and quad tendon at the VMO on my right. Also a meniscus tear. The left leg was a full rupture of the quad tendon.
had surgery 6 days later, left leg was repaired with drill holes in the patella and no 5 fiber wire (my doc is not a fan of suture anchors for athletes). Right leg was also repaired at the vmo along with meniscus and cartilage clean up.
I’m at week 5 now and doing basic heel slides, quad sets, hip, glute, and calf work.
Also, my doc started my full rupture in a hinged knee brace locked at 10 degrees (both ext and flex). Not sure why but he is very highly regarded in the south as a top notch surgeon. Use to work with an NFL team as the team doc. My right leg is now open to 70 degrees and my left at 0 ext and 20 flexion. Seems most folks lock in at 0 for six week but I’m listening to the doc. I lay around in the bed and couch 22 hrs of the day anyhow. Still on two crutches as well.

I’m curious - what is typically first to go? The braces or the crutches?
Sounds like you're doing really well based on the injury. One of my older posts in this thread - PATIENCE! It's a LOOOOOOONG recovery but you'll get there. I ruptured both quad tendons July 1 2019 walking to get a sandwich so I kind of know what you're dealing with. Same repair as well - drilled patelas with three runs of "cable". I was flat on my back with no weight bearing at all for 10 weeks post-surgery and only PT therapist movement in very limited range after the first four weeks post surgery. Other than the leg immobilizers, I was never put in any braces. I definitely like your doc's protocol better as at least you are able to do some work now.

I was able to get vertical at week 10 with the immobilizers and a walker and at week 12/13, was weight bearing and gingerly walking with just crutches. It took another three to four weeks before I had enough range of motion to get in a regular car and to drive very locally only. Lots of PT and lots of time in the gym slowly working up balance and strength and range of motion over the following year (COVID made this a real pain in the you-know-what!). I think I was back top prettywell full range of motion roughly six - eight months after surgery. Keep up with the PT protocols - this is one injury where you really need to follow the course of treatment, and where doing "more" is not necessarily better. I would guess I"m at about 85% - 90% of pre-injury strength; the knees are grumpy in the morning but I hike, mountain bike, hunt and do pretty much everything I did pre-injury, albeit at a little bit slower pace. FYI - if you like to hike etc, defintiely get a set of trekking poles - they are a life saver on descents!

I missed the 2019/20 ski season but was back in 2020/21 and have been pretty well back to whatever I want to ski. I have self-limited out of trees and really steep, un-groomed chutes, etc as the risk is just not worth the reward. Oh, and bumps are still on the agenda, just not as aggressive as in the past. Point is, you can get back but I would personally say - don't plan on skiing this season. It sucks BUT better to be fully healed than to risk further damage. Keep up the hard work and good luck!
 

martyg

Making fresh tracks
Industry Insider
Joined
Nov 24, 2017
Posts
2,216
Martyg - how matimes a day did your PTs have you do your exercise routine? Also, did they tell you to take rest days and how often?

Mine takes about 1-1.5 hours to complete and I’m doing it 3x a day. Feeling like it may be to much. I’ll be at 8 weeks (bilateral) on Tuesday.

Everyone is different. It will, in large part, depend on your commitment to optimizing recovery.

My core drills to rebuild the quad and tendon was once per day in the early stages. You can't introduce heavy intensity, so making up for it with duration to achieve a training stimulus makes sense. I also did a second workout every day of core / upper body, and / or mobility work later in the day.

The most that your body can tolerate, of really intense, heavy, to failure workouts is generally two per week for any given body part. After that, the peer reviewed scientific literature shows a rate of diminished returns and going into over training territory. Over training will slow muscle hypertrophy. Not so much of an injury thing - that has its own set of precursors.

So when I got out of the "rehab" phase, and more into muscle hypertrophy, it was two killer leg workouts per week, one lighter one. On no-gym days 2 hours on a road bike at my recovery HR pace. Those heavy leg workouts might have been barbell squats, split squats, Bulgarian split squats, lunges, one leg squats. Later I worked in plyometrics - jumping squats and jumping lunges. Not all on the same day.

My rest days were generally scheduled as three days on, one day off. That is just what my body responds well to. On days off it was still "active rest". An easy hour on the bike, an easy 90 minutes hike, etc. I also had one deep tissue massage per week, and used electro-stim on my quads once per day.

I'm 19 months out. I don't even think about my quad anymore. I have, however been spending a bit more time in the weight room than on the bike this summer. It is not driven by anything in particular. Just where my head is at.

Enjoy.
 

n0ragrace

On the slopes once again
Skier
Joined
Mar 23, 2020
Posts
17
Location
Washington, DC
Hi folks,

Glad to hear of everyone's continued recovery! Frank, that's exactly what my orthopedist said, too, but he put a little more 'fear of God' in his statement... "You can hit the gym any time you like in life, but if you don't get your range of motion back in the first three months, you're never gonna get it." Yikes!

One of the things I did was when I could bend to even, say, 30 degrees, I'd lock my hinge brace into that position and try to sit with it for a few minutes, then release. After a few reps of this, my leg would naturally be able to allow an extra 5 or so degrees at a time. It's a journey, but at one point, it'll all click. The first 90 degrees felt impossible for me, but after I hit the 100 mark, it seemed like the rest came back in a week or two without me even noticing it!

Some bad news from my end. While imaging shows that my quads tendon is fully healed(!), Doc says I definitely need a second surgery. I've been intermittently experiencing a huge swelling of my knee every couple of months that reduces my mobility pretty heavily. I've been in a new round of PT, but we just did another MRI when it was swollen, and the suture anchor that they initially used in surgery has found its way all the way through my patella, so there is a tunnel leading from the top to the bottom. The joint seems to be constantly reacting negatively to the seemingly foreign body constantly being in there. Dr says we need to take it out from the bottom and fill the hole in the bone so the inflammation stops.

I'm curious about everyone's surgery -- did you have suture anchors? 2 or 3? Did anyone have an arthroscopic procedure for an acute tear? Have you had any follow up imaging that shows the anchor, its resorption?
 

50+ Year Skier

Loving Loveland - 50+ yrs
Skier
Joined
Oct 27, 2019
Posts
9
Location
Colorado
Hi folks,

Glad to hear of everyone's continued recovery! Frank, that's exactly what my orthopedist said, too, but he put a little more 'fear of God' in his statement... "You can hit the gym any time you like in life, but if you don't get your range of motion back in the first three months, you're never gonna get it." Yikes!

One of the things I did was when I could bend to even, say, 30 degrees, I'd lock my hinge brace into that position and try to sit with it for a few minutes, then release. After a few reps of this, my leg would naturally be able to allow an extra 5 or so degrees at a time. It's a journey, but at one point, it'll all click. The first 90 degrees felt impossible for me, but after I hit the 100 mark, it seemed like the rest came back in a week or two without me even noticing it!

Some bad news from my end. While imaging shows that my quads tendon is fully healed(!), Doc says I definitely need a second surgery. I've been intermittently experiencing a huge swelling of my knee every couple of months that reduces my mobility pretty heavily. I've been in a new round of PT, but we just did another MRI when it was swollen, and the suture anchor that they initially used in surgery has found its way all the way through my patella, so there is a tunnel leading from the top to the bottom. The joint seems to be constantly reacting negatively to the seemingly foreign body constantly being in there. Dr says we need to take it out from the bottom and fill the hole in the bone so the inflammation stops.

I'm curious about everyone's surgery -- did you have suture anchors? 2 or 3? Did anyone have an arthroscopic procedure for an acute tear? Have you had any follow up imaging that shows the anchor, its resorption?
Yeesh! I am sorry to hear of your migrating anchor. My repairs seem to have held up - each knee had three anchors. I had some ultra-sound imaging done about six - eight months after the surgery to check on tendon integrity, etc. Doc said it looked good and intact although I'll never have the nice clean parallel lines of a healthy tendons. So far so good, three+ years out. I hope your "repair" of the repair is pretty non-eventful and solves your current issue. Hopefully everything else is holding in good shape.......
 

LAQuad

In the parking lot (formerly "At the base lodge")
Skier
Joined
Aug 6, 2022
Posts
22
Location
Louisiana
Flexion starting to get much better, stats below. I also have graduated to short brace on both legs.
Week 4- Aug 11th 2022: 22*(lt), 62*(rt)

Week 5- Aug 15th 2022: 37*(lt), 68*(rt)

Week 5- Aug 19th 2022: 54*(lt), 76*(rt)

Week 6- Aug 24th 2022: 70*(lt), 78*(rt)

Week 6- Aug 26th 2022: 73*(lt), 80*(rt)

Week 7- Sep 5th 2022: 75*(lt), 93*(rt)

Week 9- Sep 13th 2022: 89*(lt), 104*(rt)

Week 10- Sep 20th 2022: 101*(lt), 117*(rt)

Week 11- Sep 27th 2022: 106*(lt), 130*(rt)

Week 12- Oct 4th 2022: 111*(lt), 133*(rt)
 

n0ragrace

On the slopes once again
Skier
Joined
Mar 23, 2020
Posts
17
Location
Washington, DC
Yeesh! I am sorry to hear of your migrating anchor. My repairs seem to have held up - each knee had three anchors. I had some ultra-sound imaging done about six - eight months after the surgery to check on tendon integrity, etc. Doc said it looked good and intact although I'll never have the nice clean parallel lines of a healthy tendons. So far so good, three+ years out. I hope your "repair" of the repair is pretty non-eventful and solves your current issue. Hopefully everything else is holding in good shape.......
Appreciate the sentiment! Luckily the recovery will be smoother than the original quads tendon tear (which I think we can all quite simply say is hell!). I'll be going straight into physical therapy and 40 degree flexion right off the bat and back to full ROM by the end of 8 weeks.

Fantastic that they did imaging to check on the progress, and sounds like ultrasound is an easier in-office deal than going out for a CT or MRI. Hope this becomes the norm with follow-ups to surgery.
 

LAQuad

In the parking lot (formerly "At the base lodge")
Skier
Joined
Aug 6, 2022
Posts
22
Location
Louisiana
Almost there!!


Week 4- Aug 11th 2022: 22*(lt), 62*(rt)

Week 5- Aug 15th 2022: 37*(lt), 68*(rt)

Week 5- Aug 19th 2022: 54*(lt), 76*(rt)

Week 6- Aug 24th 2022: 70*(lt), 78*(rt)

Week 6- Aug 26th 2022: 73*(lt), 80*(rt)

Week 7- Sep 5th 2022: 75*(lt), 93*(rt)

Week 9- Sep 13th 2022: 89*(lt), 104*(rt)

Week 10- Sep 20th 2022: 101*(lt), 117*(rt)

Week 11- Sep 27th 2022: 106*(lt), 130*(rt)

Week 12- Oct 4th 2022: 111*(lt), 133*(rt)

Week 13- Oct 11th 2022: 121*(lt),135*(rt)

Week 14- Oct 21st 2022: 125*(lt), 138*(rt)

Week 16- Nov 1st 2022: 133*(lt), 144*(rt)

Week 16 - Nov 9th 2022: 139*(lt), max*(rt)
 

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