# Knee Injury -- severed quadricep tendon



## jay manning (Nov 16, 2008)

Hey folks, wondering if any of you have experienced this injury. Front tire went flat as I dropped off a 6 inch drop, front washed out and I got whipped around with my left knee slamming into a small douglas fir. Douglas fir won! I thought I broke my knee cap, but it turns out, the main brunt of the collision was just above my knee cap and instead of fracturing a bone, I severed the quadricep tendon where it attaches to the top of the knee cap. I've now had surgery to reattach the tendon to the knee cap. Its been 9 days since then and I'm getting around a little better. I will be in an inflexible brace for three weeks and then a slightly flexible brace for three more. I'm not sure when we start PT, but its at least three weeks of strict healing time. Anybody been through this one? Any advice? What a bummer, just as the riding season is beginning. Thanks for any advice you have for me.


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## pedromayall (Jun 12, 2013)

Well, I never had knee problems, but tore my left shoulder ligaments, had surgery and it took me six months to be back to normal riding. The advice I have for you is nothing that you did not hear before: be patient, follow all you doctors prescriptions, try to keep as fit as possible, take your PT seriously and don´t rush your return to the the trails. It worked for me. I would like to ask if you were wearing knee pads when you crashed?


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## jay manning (Nov 16, 2008)

I was not wearing knee pads at the time of the accident. Pads would have likely avoided the worst of the injury. Its a place I ride all the time and not terribly technical and I don't typically wear knee pads. I think I'm going to change that. Thanks for responding and good advice.


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## 127.0.0.1 (Nov 19, 2013)

yup

severed TWO quads the same way

after healing, the tendon and muscle will never be exactly the same...so
that means the kneecap may not ride in the same slot like it should under power

what you may find out is something like I have:

1) a permanent dent in my quads on that leg

2) my knee cap now rides in the wrong groove when

-pedaling easy, it's OK
-pedaling medium, for long duration can sometimes aggravate my knee
-going super hard max power, feels great. it kinda is why I tend to hammer when I can

so, it's gonna heal up but 

make sure you don't favor the good leg too much for too long, otherwise you
may end up with an imbalance or muscle size difference that will take a lot of work in the gym to fix. but should fix itself barring any other injuries

if they said put on ankle weight and lift that leg, DO that recovery and repair exercises
once able to....it'll hurt but suck it up obviously don't over do it though

long term all that might be predictable is that 'kneecap riding funny' and that might be the thing to adjust with phys therapy if you can never find a sweet spot for it

I was off riding for 8 months while letting my stuff heal. I did some light stationary work but nothing outdoors and nothing with any risk, lest rip it up again. your mileage will vary, injuries are never 100% he same between people

long term, you'll be fine as long as you stay on the bike


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## Cuyuna (May 14, 2017)

My business partner tore his quadriceps tendon. He had a 6 week recovery in an immobilizer, then PT . It was about 9 months before he could pedal a bike with even a low degree of effectiveness. He's done Ride the Rockies twice since then, but at best he figures he's about 85% of where he had been and realizes that that's as good as it's likely to get. If repaired properly, the kneecap should ride just fine.


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## jay manning (Nov 16, 2008)

Thank you so much for this info. Scary, but reality. Its just sinking in what a big injury this is. Glad you are back on the bike. I will be too, but have to be smart about being patient and letting things heal up.


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## jay manning (Nov 16, 2008)

Thank you for this response. I really appreciate it. I like the Ride the Rockies part; don't love the 85% part -- but its reality.


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## pedromayall (Jun 12, 2013)

jay manning said:


> I was not wearing knee pads at the time of the accident. Pads would have likely avoided the worst of the injury. Its a place I ride all the time and not terribly technical and I don't typically wear knee pads. I think I'm going to change that. Thanks for responding and good advice.


Look, no recriminations about not wearing knee pads. I was just curious. I try to use knee pads all the time and they have saved my knees from injuries many times. But when it´s too hot or when the trails to ride are really mellow I don´t wear it, just like you. Guess bad things will happen precisely at those ocasions.

Wish you a full and speedy recorvery.


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## 127.0.0.1 (Nov 19, 2013)

I'd use knee pads during the first two years post recovery, then toss them.

I've been cut up and carved a lot on rides and it is so random can't think of any one thing I would be able to do to avoid all possibilities, except cripple myself worrying and go out like the michelin man each ride, or just stay home and never ride. ymmv

it's helmet, gloves, and lycra for me. IF doing DH specific runs (which is rare for me) that is the only time I will armor-up head to toe


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## Cuyuna (May 14, 2017)

jay manning said:


> Thank you for this response. I really appreciate it. I like the Ride the Rockies part; don't love the 85% part -- but its reality.


Well, as a side note I should mention than he was 61 years old when that happened. Last time he Rode the Rockies was last year at age 65.

As an irrelevant additional side note, he's a GI surgeon. His son is an orthopedic surgeon/joint specialist and is the one that fixed his quadriceps tendon.


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## 786737 (Mar 13, 2015)

About 5-1/2 years ago I had this exact injury, but from a fall at home. I stepped off a stair into my garage, rolled my left ankle hard (severe sprain) and the 70-lb. plastic bin I was carrying fell down onto my quad tendon and ruptured it. Before surgery I was in a walking boot on my left foot and a knee brace on my right leg. Pretty pathetic. This happened when I was 50 but perhaps in the best shape of my life, training for a 50-mile 7,000' bike race on my rigid SS and backpacking >100 mile stretches of the PCT. So I feel you pain on the mental side of this.

I think I was wearing a knee brace for a few weeks after surgery but was doing unweighted leg lifts within a few days, then worked up to putting light objects over my leg doing the lifts. After 4 weeks I was out doing short hikes on mild terrain, and going to the gym. As more weeks passed I started riding the SS again on mild terrain and worked up gradually to harder climbing.

5 months after surgery I met my recovery goal: I backpacked about 75 miles on the PCT, in 4 days, on one of the hardest sections as far as climbing per mile.

I'm not back to the riding fitness I was at in 2012, but the injury is marginally to blame for that. Other things in life got in the way. I have minimal residual knee pain, usually only after harder rides with lots of standing & mashing. But last week I backpacked 180 miles in 10 days from the Mojave desert into the Sierras, with >35,000' of climbing. Only my feet hurt 

Edit: On further consideration, next time I carry boxes full of my wife's **** into the garage, I will consider wearing knee pads.


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## jay manning (Nov 16, 2008)

Thank you for your reply. Congrat's on the great recovery. Hope I can do as well.


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## oldcolonial (Aug 28, 2018)

I had a similar injury. Severed my quad tendon and then just for good measure did it again 12 weeks later. First time it happened while I was running some trails. I went to stop short and my leg simply collapsed. Second time I slipped on some icy stairs and landed on my feet. This was a problem since the repair was not quite strong enough yet to deal with the compression. Second time, the recovery involved 6 weeks in a cast, 4 weeks in a brace and a whole lot of PT. I was 48 when I injured it, am 55 now.
Some things to take away from the experience.

Do the PT. Make sure you do not ignore any of the "5 competencies"; power, flexibility, endurance, coordination, balance. I think I have had a pretty good outcome and what separates mine from those who have not seems to be access to and diligence in PT. 
Progress will not be linear, in fact you will have weeks where it seems like you are loosing ground not making up ground. 
Rehab should involve working more than just your quad. I found that the opposing and complimentary muscles needed lots of work. 
Some of it will be in your head. it will take a while for you to trust the leg fully again but you will. 
It may be a long road, but you will get to the end of it. Your leg(s) may never be the same but with hard work you can get things to pretty darn good.


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