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Old    Michael W. Gwin (mwgwin)      Join Date: Oct 2002       08-16-2010, 8:28 AM Reply   
So I tore my patellar tendon last Wednesday, going in for surgery tomorrow. Ive had both my ACLs reconstructed and it looks like the rehab for this one is laying around for 4 weeks and then starting to flex it and get it back in order. my quad will be mush by then Im sure but I wondered if anyone else had gone through this particular surgery and has any advice.

Much appreciated.

Gwin
Old    Michael W. Gwin (mwgwin)      Join Date: Oct 2002       08-16-2010, 8:34 AM Reply   
Some old schoolers may remember my old thread on ACL rehab so Im no newbie to doing accelerated rehab... just reading that patellar ruptures may more easily tear and you never seem to get a straight answer from a surgeon or physical therapist. They want everyone to rehab like a pussy.

http://www.wakeworld.com/forum/showthread.php?t=243823
Old    scoot_gt (scoot_gt)      Join Date: Sep 2006       08-16-2010, 10:48 AM Reply   
I did this in May of 2008. Was back on a snowboard in Jan of 2009 and back on the wakeboard in Apr of 2009.

You are correct, your quad will be mush and that remains my biggest problem still - quad strength. A little over 2 years now and I can do anything I could do before but my sprinting speed still isn't what is used to be. After 8 weeks or so, the doc should ok you to work out the quad. Take it slow on the quad, I developed some tendinitis from rehabbing too hard and it cost me an extra 6 weeks or so.

Be happy to answer any other questions - just ask...
Old    Alice W (aliwake)      Join Date: Dec 2006       08-16-2010, 3:29 PM Reply   
were your acl recos using a patellar tendon graft? just curious... would make sense if the tendon had been weakened by graft harvest?
Old    Rich Dykmans (richd)      Join Date: Oct 2003       08-16-2010, 7:06 PM Reply   
Chris totally ruptured his patellar tendon last year July. I think he would tell you he feels pretty good about it overall now but he took the doc's advise, didn't even strap on a board for 9 months and didn't start riding aggressively until late June. One mistake on a wakeboard before it's completely healed can put you back to square one.
Old    Michael W. Gwin (mwgwin)      Join Date: Oct 2002       08-19-2010, 7:24 AM Reply   
I did have patellar grafts in both knees. Doc said there wasnt enough data to say whether that graft this long after (7 years) would be in a weakened state... it shouldnt be... but it is very conceivable. This is why I recommend to anyone I hear tearing an ACL to go allograft (cadaver). I wish I did, not for this reason but because the rehab is incredibly easier and ask anyone with a patellar graft, its never the same.

Anyone have advice on rehab at all? im reading i can start to go to 45 degrees flexion 4 days post op... I really dont want to miss the snowboard season, and I had been fine with both my ACL reconstructions prior to be ready for winter... but never done a patellar surgery, so Im just trying to do my homework, check with my doc and make an intelligent decision. My last doc hadnt heard about the accelerated rehab I did (link above) and would have recommended normal long term PT, so I do believe no doctor is all knowing. He's not going to offer me anything on a silver platter, but if i bring him some info, I can get a read whether he things it will be good/bad...
Old    scoot_gt (scoot_gt)      Join Date: Sep 2006       08-19-2010, 2:33 PM Reply   
Based on my knowledge (which is admittedly not expert). You really can't bend the knee too much for 10 weeks or so. Most likely they drilled some holes thru your kneecap and literally tied the tendon to the bone. It takes 8-12 weeks for the 2 to "grow" back together. Any major knee bending during that time will just rip it back apart again - trust me, you will feel this. If you bend it too much, you can rip the sutures used to tie the 2 together and well.... then you are back to step 1.

The trick is to keep the quad strong during the time that you cannot bend your knee. Straight leg lifts, straight leg balancing, etc. Once your tendon heals, I promise you will have no knee pain and no issues with it... but your quad will be weak.

After your patella tendon heals, the trick is to not do anything too crazy until your quad is back strong or you risk tearing PCL, MCL, ACL mainly just because your knee is weak.

A little snowboarding in mid Feb is not out of the question. Late December could be sketchy - at this point, everything will depend on your quad strength and how much risk you want to put on tearing something else...

For now -
Keep your quad strong with no knee bending

Mid November -
Leg Extensions
One Legged Squats

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