Quad tendon tear from the start

Januar

September 26, 2016: While hiking in Colorado at Maroon Bells, I was trying to get that perfect picture and since no one was around back where I was, I decided to set up the tripod and camera timer to take it.  The camera only had a 10 second timer as the longest setting and I had to hit it and run to get up on the large rock for the photo.  When I jumped up onto the rock, I felt a snap and instant pain as I pushed and twisted to get up.  The next few hours were painful and walking was a struggle.  I eventually made it back to the tour bus and back to my hotel in Snowmass.  Ice was applied for remainder of night and I was flying back home the next morning.
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October 1, 2016: Saw Dr Nemickas and had x-ray performed to find Right quadriceps probable partial tear.  Discussed options and further tests to have MRI performed prior to Chicago Marathon.  MRI shows small joint effusion present.

October 3, 2016: Follow up with MD after MRI and results were read to find to show intrasubstance signal change noted withing quadriceps tendon.  At this point, we opted to try cortisone injection for pain relief. (Ethyl Chloride anesthetic followed up with 2 ml Celestone 6mg/ml and 3ml of 1% Lidocaine).
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October 9, 2016: Against my doctor’s advice, I decided to run the Chicago Marathon.  I’ve been trying to get in for a while and when I finally did, I get injured!  Thankfully, the doctor gave me that Cortisone injection to buy some time so I could attempt my first marathon.  I didn’t have a great race of course because of the quad tear but the pain didn’t really affect me until mile 7-8.  I should have been smart about not running but that’s the stubborn man in me.
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November 9, 2016: Went for further testing at 3T Imaging for Dynamic Ultrasound with results as follows: Right quadriceps tendon subtle disruption 3mm x 2mm x 1.5mm involving central one third of tendon along deep border at insertion into superior pole of patella.

November 18, 2016: MD scheduled surgery after realizing that I could not get up from flexion greater than 90 degrees without substantial pain or assistance.

November 29, 2016: Surgery was scheduled for 10:30am and I was requested to be there by 9:30am.  The surgery was scheduled at the Hawthorn Surgical Center and the staff was great.  I was placed into the pre-op area and placed into a gown, socks, and ugly surgery hat.  I was given an IV with Normal Saline at TKO and awaited the visit from the MD and Anesthesiologist.  I was checked on frequently and all “unknowns and uh-ohs” were discussed per procedure.  I was also going to have a nerve block to assist with post op pain and the anesthesiologist was discussing this with all of the equipment at the ready.  Next thing I know, I was already done with the surgery.  The only problem is that I am a huge post anesthesia baby and don’t come out quickly.  The nurses stated that it took me awhile and I had tons of involuntary twitching while they were trying to wake me.  After finally becoming lucid enough to go home, I was assisted to the car and off I went crutches in hand.
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November 29, 2016: Received Game Ready Cold Compression Unit as this was scheduled prior to the surgery to be in hand a couple of hours after the surgery.  The machine rep came out and showed its operation and we put it to good use.  See my review on the Game Ready here!
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November 30-December 6: Continued with pain meds and Advil.  Sleeping was horrible as no position was comfortable.  Game Ready used every day multiple times for extreme relief.  Each day has gotten better and weaning myself off of pain meds.
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December 7, 2016: Visit with Dr. Nemickas PA Chuck to have the initial immobilizer removed and bandages taken off.  They believed the wound to be healing nicely and explained what they actually saw during surgery which made more sense than the post op notes.  I was fitted with the TROM brace and told to keep it locked out at 90 degrees but only weight bearing at 0 degrees.  I was also given the suggestion to do some passive range of motion up to 90 degrees depending on pain tolerance.  They did not want me to do any active range of motion as of yet.  I was asked to be re-seen at the office in mid January after more progress and scheduling of PT.  Every week, I was to be given another 10 degrees of flexion up to 90.  Physical Therapy is to begin on December 28th.
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December 8, 2016: I slept initially with the brace and then had some discomfort around 2am and decided to sleep with the brace off.  (Probably not a great idea)  But, I had some much needed good sleep and no pain through the rest of the night.  Woke to shower and put brace back on.  Slight pain and swelling around 3pm.

December 9, 2016: I was given a small TENS unit to use at home and put it on twice to help contract the quad muscles during exercise.  The unit goes on for 10 minutes at a time and I had it set at 25ma which goes on for 5 seconds and off for 10.  During the 5 seconds on, you’re supposed to hold your flex to activate the quad to “reteach” the muscle how to activate properly.  I didn’t have much discomfort and used it twice.
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December 13, 2016: Things were going well.  I was up to just over 60 degrees of passive flexion and more than likely overdid it.  I awoke at 2am to throbbing pain and had to wear the brace again to get back to sleep along with pain meds.  Lesson learned to be smarter about the plan.  Also, found out I got into the 2017 Chicago Marathon!
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December 15, 2016: Having friends in high places…I get to keep the Game Ready for 2 more weeks for free!  That is unbelievable and I am grateful!  Today I start my immobilizer at 30 degree flexion for the next 2 weeks before hitting 60.  Nights are still painful but most of the day is good.
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December 25, 2016:  Brace is now set to 40 degrees and pain is pretty minimal.  I’m able to get 90 degrees of passive range of motion and able to do leg lifts with little dip.

December 28, 2016:  Had my first physical therapy visit and everything went well.  I was first tested on my range of motion to see if I could hit my 90 degrees.  Then, I was shown some basic exercises according to a timeline schedule.  We worked on heel slides, abduction/adduction lifts, some hamstring exercises, electric stimulation, and then finished with cold compress ice therapy.  The PT also worked on methods of showing me how to minimize my scar to eliminate the scar tissue.  Everything went well so we decreased PT to once a week.
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January 3, 2017:  Had my second physical therapy visit and I’m definitely seeing some strides for week 5.  I’m supposed to be in the brace at 70 degrees for every day use and I feel it tight at the last few degrees.  The PT is actually pretty easy for now but tiring and I know we have to follow a strict plan by the orthopedic surgeon but I’m impatient.  We worked on hamstring stretches, heel slides, sitting abduction/adduction with therabands, balance boards, shuffling with therabands, and then friction massage on the scar.  It looks pretty good not that I’m self-conscious about it!  I still use the e-stim at 44 and the the Game Ready to minimize the swelling.  All in all, things feel great and I’m eager to test it out further!

January 5, 2017:  I went to the gym do do some stretches and walk on the treadmill for about 1 mile and a half at 3 degrees incline at 3.5mph.  It seemed pretty easy but a tad tiring since I haven’t run in months.  I walked it in my brace and then followed it up with chest work on the Hammer Strength.
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January 6, 2017:  So after seeing my PT for a day of cardio and weight training, she went to discuss my progress with the surgeon and I got my good news…NO MORE BRACE!  I’m now allowed to go past 90 degrees but no lunges, squats, or eccentric contractions as of yet.  But that’s huge for now.  We worked on scar tissue massage and some theraband work.
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January 9, 2016:  Worked out at the gym and walked the treadmill for 1 mile and then the bike for 2 miles.  Treadmill felt okay but the bike tested my leg out and I had a little pain at flexion on the top of the cycle.  I moved the seat back on the recumbent bike to minimize that pain.
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January 10, 2017:  Went to the gym again this morning to walk on the treadmill for a mile and my leg seemed to have given out from fatigue twice towards the end of the mile.  I switched to the bike again and only did a mile and a half there with a little more pain than I would have liked.  I finished the rest of the time at the gym working on shoulders and chest.

January 12, 2017:  I went to physical therapy to find a very disappointed PT.  My leg was pretty swollen from me overdoing it at the gym.  We couldn’t do anything that was planned and instead worked on some isometric exercises and reducing the swelling with KT Tape and edema sleeve.
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January 18, 2017:  I started the morning with physical therapy and went all out with some sweaty exercises.  I had no swelling throughout or even after the balance and strength exercises.  I iced up with the Squid anyway as I had my ortho meeting in the afternoon.  Happy to say that I had a pretty good appointment.  I was given the green light I’ve been waiting for!!  I can return to work on January 30th with no restrictions!  When asked about running, he suggested I wait a few weeks before pushing it and I get it.  While I’m ecstatic about getting back to my normal life, I never want to go through this again.  I won’t push it and will start out slowly.

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2 Comments on “Quad tendon tear from the start

  1. Hang in there Frank, I’m hoping for a strong recovery for you from here on out so you can get back to your active lifestyle! We always come back stronger from these unwanted setbacks! Big hugs!

    Liked by 1 person

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