patella tendon rupture

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patella tendon rupture

by dave venables
(davevenables@live.co.uk)

Hello Josh and Team,

May 1st 2010, I had a patella tendon completely rupture in my right knee, which required 4 screws in my kneecap to secure the tendon to heal. Since, I have undergone physio at the local hospital, and now been referred to a local gym. The advisor at the gym gave me a workout to strengthen the quads, calfs and hamstrings. I can now push 200kgs@6x10 reps.

I can lift 80kgs on the leg curl machine, (I lift the weight then I try to hold the weight for about 5 seconds before lowering the 80kgs slowly to use the muscles in a different way...if that makes sense.)I can achieve only 6 reps doing this, yet I can do the same number of reps one the injured leg @ 40kgs.

The problem I have is I find it difficult to walk down the slightest incline comfortably, even the camber in the road causes problems. I cannot descend stairs without a death grip on the hand rail, or I use the method of a young child utilising the injured leg leadng on each stair. I cannot climb a vertical plane, I recently lost my job as a lorry driver as I cannot get in or get out of the wagon cab safely. I would like to gain employment asap, and be able to descend stairs comfortably and without pain. I cannot lower myself off a 4 inch roadside kerb.

I can, however, climb stairs at two at a time, and I find walking uphill more comfortable than walking over flat level ground.

I have requested a consultation with the surgeon who did my operation, but the appointment is going to be a few months away.

I hope you can give some advise which may help.
I'd like to get back to some normality asap.
I live in Warrington, Cheshire, UK and your advice will be greatly appreciated.

Kindest regards,
Dave Venables.

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patella tendon rupture

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Some Help for Your Knee...
by: Josh -- Author WLC System

Hey Dave...

Before I start, I need to let you know that I am not an expert on the type of knee problem you are having. You really need to listen to the surgeon on this one and see what he has to say. Don't take my advice as expert advice because that I am not for this problem.

With that said...

If it was me, I would build a 2" high box and do step ups onto that. Step back far on the way down and see if that hurts.

I really wouldn't mess with leg curls. I would do pull throughs or stiff legged deadlifts or even glute ham raises instead.

By pushing, I think you mean the leg press. So... you don't have any pain on the negative of the leg press (lowering the weight)?

How about squats? Do they hurt or have you tried them? How about lunges? Do those hurt?

The plan...

1) Do mobility exercises

2) Push, drag, and pull a sled

3) Use a foam roller often on the legs (quads, hamstrings, IT band, calves, tibia, etc)

4) Do free weight strengthening exercises as mentioned above

Never do an exercise if it hurts.

And please let me know how everything works for you. Would love to hear from you and keep me updated. Let me know what your surgeon says too. Best wishes to you Dave. Please keep in touch too.

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Mobility Exercises
by: Josh -- Author WLC System

Hey Dave,

I little more info on mobility exercises:

Start out with easy ones and make sure they don't hurt. If so, stop doing that particular one and look for others that don't hurt. If they do hurt, let me know which ones hurt.

Mobility exercises are going to really help you out. Lack of mobility might not be your problem, but you should be doing them anyway to keep your knees healthy for the future.

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patella tendon rupture
by: dave venables

Hello Josh and team,
Thank you for your reply.
To clarify, I did mean the leg press when I said push. There is no pain on either stroke of the leg press, other than that of the usual resistance.
I have tried lunges, to no real effect, however squats give me excruciating pain at the front of the knee, similar to it trying to tear apart, or someone forcing the blade of a knife into my knee, (because of this I am reluctant to carry out this excercise). Incidentally, this is exactly the same pain I get when descending stairs.
I can carry out steps ups no problem, and can go up stairs two a time with no problem and no pain at all.
Next week I am forecasting 3 visits to a local swimming pool where I plan to do some knee excersices similar to what you suggest, that being walking forwards and backwards, but utilising water as a resistive medium. ( Similar in effect to sled pushes and pulling.)
Also I plan to climb out of the pool using the vertical ladder. (This activity is also a problem area for me.) Hopefully the water will support some of my weight, so may allow full range of movement, without full weight bearing.
I wish to thank you again at this stage, and I shall let you know how I get on.
Kindest regards,
Dave Venables.

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Water Resistance
by: Josh -- Author WLC System

Hey Dave,

Sounds like you have a great plan... the water resistance is a great idea.

Definitely don't do squats if they hurt. Stay away from them for now.

You seem to have all the trouble in the negative and vertical plane. Horizontal plane is good on positive and negative. Vertical plane is good on positive.

Your surgeon/doctor really needs to help you out on this.

I do believe the foam roller will really help you out. Please give that a shot too. A foam roller is only $20 or so. If you feel lots of pain when using the foam roller, then you'll know that there is something there contributing to your pain. Continue using the foam roller to get rid of scar tissue and this might just help your problem.

Seriously... the foam roller might just be the key here.

Here's a video that will help you:

If you have scar tissue, this is going to hurt really bad. If you continue foam rolling where there is no pain, the scar tissue will be gone and your knee will most likely feel much better.

This can take several months of foam rolling to get rid of all the scar tissue. Start working on that now... I think this will really, really help you along with your rehab in the water.

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patella tendon rupture
by: dave venables

Hello again Josh and team,
A quick update on my physical state.
Thank you for all the help and pointers. In my case this has been most benefitial.
None of the physios or gym advisors who have dealt with me since my knee injury occurred have suggested pulling/pushing a weight to strengthen my knee. The last time I contacted you I said I'd use a swimming pool and the water as the resistive medium. I can honestly say this most definatley worked for me. I utilised this "exercise" with gym work, leg curls, leg press, and the recumbent bike. Within two months of doing these routines (3 times a week) I find myself max'ing out the gym equipment and doing many reps in the mean time, such as 12x10 reps@200kg on the leg press. 200kg is the highest weight for this machine. I also max out on the leg curl; this may not sound too much in comparison with the leg press but I do 5x5reps@80kg, but when I lift the weight and straighten my legs, or as straight as they will go, I hold that position for a count of 10 then lower slowly. The recumbent bike is excellent for cardio and this max's out with a resistance of 25. I hold 25 for over 2 minutes@70-75 rpm.
One area I had difficulty with was decending stairs. I don't know what happened inside my knee, but something made a terrible tearing/ripping noise. I hasten to add, this has caused no problems for me, no swelling, no pain, no loss of strength or movement. I assume it was scar tissue tearing, however this has allowed me to walk down stairs. With the gym work and water resistance, I am now able to carry out my general day to day tasks, and comfortably.
I'd like to thank you again for your advice.
Kindest regards,
Dave Venables.

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