Bilateral Patellar Tendon Rupture~Recovery Pt. 2

bilateral patellar tendon surgery

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In first post of this series, I wrote about what to expect in the first 2 weeks or so after bilateral patellar tendon surgery.

This is a rare injury and there isn’t much about it on the internet except medical journal articles about how rare it is.

I’m writing about the recovery in parts so the posts don’t get too long. To give you an idea without the suspense, Mark was walking with crutches (unlocked to 30 degrees) by week 10. Three months out, he is driving and walking up and down stairs (stiffly and relying a lot on railings). Neither of us could picture it even 6 weeks post-op.

Weeks 2-6

If you recall from the first post, Mark had a visit with the surgeon one week after surgery to remove the surgical bandages over his incisions. The following week, the staples were removed.

During the second visit, the surgeon taught me how to do Mark’s therapy for the next 4 weeks. First was moving his kneecap around to inhibit or break up scar tissue (mobs). #yuk.

My other job was bending his legs one at a time. “Bending” is an overstatement. The first few times, each leg probably didn’t bend more than 5-10 degrees. If you can imagine a tight rubber band connecting his quad to his knee cap but less flexible.  Before each of these sessions, I would move his knee cap around. Like I said…yuk.

The key with the bending is that Mark wasn’t supposed to flex his quads at all. I learned later that flexing the quad naturally pulls the knee cap up which I guess could have interfered with the repair and complete healing.

So, this all sounds doable except when you consider that while I was working my magic on one leg, his other was locked in extension and had to be supported straight out in front of him.

Once again, that chair and ottoman was a lifesaver.

I basically moved from one side of the ottoman to the other. The leg I wasn’t working on would rest on the inside edge of the ottoman (which was pushed up against the front edge of the chair but pushed out to the side opposite the leg I was working on. It was tight because I would be wedged right agains it so the other leg was a close to in line with Mark’s hips as possible (not flared out).

And the slooooooow process began. The first time we tried, I was scared to death to drop his foot or move it to quickly. I sat on a low stool in front of him, cradling his heel and calf in my hands. This was hard on my back but the consistency paid off.

The left knee was (and still is) 15-20 degrees behind the right and a lot more stiff but we saw slow, steady progress in each leg by sticking to 10-12 reps, holding for 10 seconds. We did this 3x per day religiously and I think it made a big difference when he was ready to work with a therapist at a facility.

A couple of tips for bending therapy:

  1. We used a sliding board across the front edge of the chair to create a flat, level surface and some support under the knee/thigh we were working on. Otherwise, I felt like the give of the chair cushion allowed Mark’s leg to go lower instead of the tendon or muscles stretching.
  2. As Mark’s flexibility increased, he had to sit on stiff cushions to get high enough to allow the leg to bend without touching the floor.
  3. Mark had to scoot as far to the side of the chair of the leg we were bending to give me enough room to sit next to the ottoman where his braced leg was resting. The goal was to do the exercises while his leg was straight out in front of him.
  4. It is no easy task to relax the quads during either motion (down or up). The idea is passive movement on Mark’s part.

Care and Comfort

Pain was not an issue in this period. Sleep was difficult since he was still locked in braces at this point.

Mark was more amenable to visits from friends and family and awake most of the day in the chair. The weather was still pretty nice and he would read the paper on the porch for an hour. Still housebound except for doc visits.

 

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