A year ago, 21 December 2018, I went through a surgery for a Quadriceps Tendon Rupture – QTR.
You can read more about the rehab process in previous posts.
I started inlines practice in May. Done some long tours and participated in Berlin Inline Marathon in September. Running is still a little bit of a challenge but #gettingthere.
My nice physiotherapist, Kasper at Virum Fys, have suggested some exercises that I’ve done several times a week. His last advice was to keep on with the rehab training don’t stop just because you stop at the phys, apparently a common situation…
Twice everyday I have massaged the scar with different remedies – 98% Aloe Gel, Locobase Repair cream, Aloe Vera Rub or Blue Hors Hot & Cool. The goal was that the scar should be gone after a year, nearly there:
Last week I was skiing in Davos, Switzerland, both on and off the piste. Have to admit, I was a bit nervous at times, how should this work out but it turned out well. The knee got some TLC in the evening and was happy 🙂
The 30 August I had a check up for a “disability certificate”, to the insurance company.
Made a visit to Malmö Hospital where the ortoped examined the knee, measured ROM – range of motion and muscle loss.
Range of motion (normal 0/140): Right: 0/120 | Left: 0/140
Thigh: (circumference 10 cm over the knee cap): Right: 42,5 cm | Left: 46 cm
Knee cap: Right: 41 cm | Left: 39 cm
Conclusion: It looks good, little less power and ROM in the knee and leg but keep on with the rehab…
It’s been 18 weeks since I had the surgery for Quadriceps Tendon Rupture.
27 March i started rehab training at Virum Physiotherapy, Kasper.
Mads, phys. at work, still helps me with stretching and ROM (Range of Motion).
The program is to do a selection of the exercises below for 45 – 60 min. every second day and ROM every day.
Squats: 3 x 15
Alternative 1: Using elastic band around the knees
Alternative 2: Using weights
Lunges: 3 x 20 (10 on each leg)
Alternative 1: Using weights
Alternative 2 : Using a Bosu
One leg balance on BOSU:
Side lying clams: 3 x 15 on each side
Sideway steps: 3 x 20 steps
TRX Lean back squat: 3 x 15
Side leg raises: 3 x 15 on each leg
Straight leg raises: 3 x 15 on each leg
Prone straight leg raises: 3 x 15 on each leg
Hip lift: 3 x 15 on each leg.
Alternative 1: Press the foot on the floor against the wall. Hold position 10-15 sek. Rest the same time.
Alternativ 2: Place the foot on the floor on a ball.
Alternative 3: Use a fitness ball
Wall squats: 3 x 45 sec. increase time if possible
Press ball against wall: Put the heel against the wall. Place a soft ball or a small pillow in the hollow of the knee, press 3-5 sec. relax. 3 x 15 on each leg
Lunges with soft ball: Press the ball against the wall when doing the lunges.3 x 15 on each leg
Bike: Warm up 5 min.
Leg extension: Use one leg at a time. 3 x 15 on each leg
Today, 19 March, I visited the doctor and phys to get rid of my knee brace
Been wearing it for exactly three months after I stumbled on a stairway and ruptured my right quadriceps tendon
The knee looks nice and the scar has healed very well and is hardly visible at all. Nice job Jesper the surgeon and with some post surgery healing help from Locobase Repair, Aloe vera 98% and coconut oil.
Still some swelling and scar tissue that needs to be treated.
The phys approved the exercises I have done so far and added one for ROM (Range of Motion) to the series:
Stand next to a chair. Place the foot on the injured knee on the chair. Move the knee forward. Hold for a few seconds, relax. Repeat 20 times, 2 sets.
Two products are added to the remedy list, Hot & Cool massage creme (for horses).
and Serrapeptese, “an unusual enzyme comes from Serratia, a bioactive group of bacteria that live inside silkworms. Serratia are essential to the silkworm’s survival. After it weaves a silk cocoon and begins transforming into a moth, it releases Serratia bacteria from its gut. The Serratia produce serrapeptase, an enzyme that eats through protein. The serrapeptase dissolves the silk cocoon, opening it up for the silkmoth to emerge.” [[Source]
Both to help removing scar tissue in the knee and leg.
Next step – finding a physiotherapist to start some serious rehab…
Take care everybody out there, where ever you are 🙂
Last Thursday, 7 March, the knee brace was adjusted to 90 degrees and I manage to move the leg to 75 degrees directly after, iiha!
I recently came across this video that explains clearly what QTR is, how it happens and how it’s repaired (surgery).
During the weekend I tried a Chinese “magic” plaster I got from a Chinese colleague, thanks Kevin :-).
The plaster contains some sort of concentrated Tiger balm, that’s what it smells like anyway. The first couple of minutes it creates a kind of burning sensation. It suppose to help against swelling and pain. I am not sure it made much difference but it was an interesting experience trying – “What doesn’t hurt you makes you stronger“.
Monday I visited our “local” physiotherapist at work, Mads, (Frb. Osteopati), He created this fantastic piece of Kinesio tape art work.
The tape is put on while the knee is bent and the tape is stretched. When straiten the leg, the thin strips lift up the the skin and that should help the blood and fluid in the knee and leg to circulate easier and that should reduce the swelling. It looks cool anyway, thanks Mads 🙂
The golf ball, used for “foot massage”, has been swapped with a “spikey” ball.
“Foot-valve-massage” is really good, it stimulates the many trigger points and help removing “waste” under the foot.
Today, Friday 1 March, it’s 10 weeks since QTR surgery.
Learnings: Quadriceps Tendon Rupture is an uncommon injury with an incidence of 1.37/100,000 patients per year. More frequent on men than women and people over 40 years of age.
The quadriceps tendon ruptures typically occur during an eccentric contraction where the quadriceps muscle is contracting, but the knee is being straightened. When this occurs, the sudden, opposing forces can exceed the strength of the quadriceps tendon. An eccentric contraction can occur with injuries such as a slip on wet ground or a sports injury. [Source]
You know the feeling when you step in a hole you haven’t noticed or step of the sidewalk without looking, miss a step…I thought it was caused by an extreme bend of the knee.
Thursday, 21 February, I visited the physiotherapist and got the knee brace adjusted to 60 degrees and got a new exercise: Put a pillow under the knee – stretch 5 sek. – relax 5 sek. 15 times, 3 sets.
I wanted to try Kinesio taping and while searching for information I came across the Facebook page Bilatural Quad Tendon Rupture, created by a physiotherapist from Colorado, who suffered from a QTR in both knees!!! in 2015. On his page you find photos and videos with personal experiences, tip on taping and exercises.
Kinesio tape is supposed to target different receptors within the somatosensory system, alleviates pain and facilitates lymphatic drainage by microscopically lifting the skin. This lifting affect forms convolutions in the skin thus increasing interstitial space and allowing for a decrease in inflammation of the affected areas. [Source]
I test it to relieve pain, increase blood circulation and speed up recovery. It’s not really a documented “science” and there are different opinions of the effect out there on the net.
For the same reason, increase circulation, I also ordered and received a pair of Modetro knee sleeves from Amazon to be tested as well. Compression sleeves made of Bamboo charcoal fibers!
A physiotherapist suggested to use a golf ball under the foot to massage the foot arch as some sort of zone therapy. My own phys. suggested an exercise to sit on a chair and using e.g. a towel on the floor and move the foot back and forth. I now combine the two and switched the towel with the golf ball – exercise and massage at the same time 🙂
I have added magnesium to the list of dietary supplements. Magnesium build up bones and muscles, has anti inflammatory benefits, it boost exercise performance and metabolize vitamin D, among other things.
Wednesday 6 February it was check up time and removing band-aid…
and adjusting the knee brace so I can “bend” the knee 30 degrees the next 2 weeks. Source
The doctor recommended against travelling by flight at least for the next month, that means no trip to Cyprus 🙁
The insurance company also told me that the insurance don’t cover if something should happen with the knee on a journey the next three months.
After the visit at the doctor, I got a first appointment with a physiotherapist. She said it was a mistake that wasn’t any after the surgery. Probably coz of Christmas time…
She approved the exercises I found on the internet and gave me two new ones:
Sit on e.g. a chair, stretch leg 5 sec. – relax with bent knee in 5 sec.
Similar but opposite – Sit with leg stretched out on the sofa – bend knee 5 sec. – relax with stretched leg 5 sec.
15 times, 3 set. each. Source
Switched the ice pack ice therapy to heat therapy. Put the bag in a bowl with boiling water, after a few minutes it’s ready to use. Put it on the knee, nice and soothing…
Tuesday 8 January I visited Doctor Anna at Malmö Hospital, surgery dept., to remove the stitches. (forgot to take the “after” picture”)
Doctor Anna told me it looked fine and explained in detail what happened in the knee and Quadriceps Tendon Rupture is quite a rare injury but when it happens it’s quite common that it happens when the body-and-mind is not prepared for an extreme sudden “trauma contraction”, like walking down a stair, stepping out of a car or bus, tripping on the sidewalk, slipping on ice etc.
The next 4 weeks I keep the knee brace on all the time with 0 degrees angle and the recovery phase can begin.
Exercises to improve the healing:
Other things that I do to help the body recover are:
Ice pack to reduce swelling – 10-20 min. 2-3 times a day with leg elevated
Foot roll with a golf ball
Walkabouts in the hood
Spike mat – improve blood circulation and stimulate the nerves in the spine and the rest of the body
What to eat and drink that to improve the healing:
Calories – the body need more calories to create new tissue to repair the tendons, muscles and bones
Protein – the building bricks of the body. After an injury the body use more protein than it creates. If you don’t get enough protein could mean the muscles breaks down instead of rebuilding. Get enough protein at every meal.
Omega 3 – an important fat acid for heart and joints. Contain anti inflammatory properties that hurry up the healing process.
Vitamin D – key player in rebuilding the bone structure and tissue.
Quercetin – a potent antioxidant to reduce the number of inflammatory markers.
Tumeric – powerful anti-inflammatory effects and a very strong antioxidant.
Fresh lemon juice – powerful antibacterial properties, lemon juice helps fight infections