Help with badly atrophied quads!!!

Lene28 · Apr 26, 2012

About a year and a half ago I ruptured both my patella tendons. 2 months after the original surgery my idiot therapist re-ruptured my left tendon. This really screwed up my therapy and made my new therapist take it really slow to ensure we didn't tear anything again.

Fast forward to today; my range of motion is 120 degrees which means I can pretty much do everything concerning day to day activities; however my quads are not growing!!! I still have these tiny chicken legs; I have good genetics for legs. I have always had large glutes, hams, quads but these things will not grow. Is there anything I can do to get my muscles "turned back on" and get them growing???

Quads are about 22 inches and were 27-28 inches at the time I got hurt.

Leggo my Ego · Apr 26, 2012

Did your therapist use an E-stim device? I think using that on your quads every day could help getting the neural pathways firing again... And working your way up carefully on high rep squats?

thebrick · Apr 26, 2012

How soon after surgery did you start PT? Its sounds like too soon with the re-injury. And how long has it been now?

Lene28 · Apr 26, 2012

I started PT about a month after the first surgery. I wasn't timing it was the therapist; he didn't warm me up and stuck me in a leg press and tried to push me to my max ROM right off the bat.

The first double surgery was November 2010 and the second one on the left knee was February 2011.

I have used a stim machine and my quads will flex and have been getting stronger but the size stays the same.

thebrick · Apr 26, 2012

I had the very same injury. Including the re-injury you had and ANOTHER surgery to correct because of a stupid PT. I think part of the problem is this injury is so rare and most PT's are not smart on the subject. He flat out told me he had never seen an injury like mine. I should have left then. After I found someone that knew what they were doing after my second surgery, I was not allowed to do ANYTHING for 6 weeks. I was locked in braces in full extension for that time while the tendon healed. They basically re-anchored the tendon to the patalla using screws and that needed to heal. Is that the technique they used on you? After the 6 weeks, I started my PT that focused on getting range of motion and stability back FIRST, not weight lifting!

After my PT, my doctor told me I could doing anything I wanted in the gym as long as my feet were on a flat surface (no heavy leg extensions at all) My size has come back but not to the same degree it was before, plus the teardrop near the knee is less prominent after my injury.

My advice is to be patient and keep training them. It was a very serious injury.

Lene28 · Apr 26, 2012

Both mine were the bottom part of the knee; so the tendon between the knee cap and the bone. I know they used heavy Kevlar sutures and wrapped that around the tendon in a box shape. For the second surgery they took part of my hamstring and wrapped it around the tendon and reinforced the suture. No screws or McLaughlin wire was used.

I just figured after a year they should be growing; I'm trying to be patient but it's hard to know if I'm not pushing myself hard enough and just being too cautious.

SIR-LOIN · Apr 26, 2012

thebrick said:
I had the very same injury. Including the re-injury you had and ANOTHER surgery to correct because of a stupid PT. I think part of the problem is this injury is so rare and most PT's are not smart on the subject. He flat out told me he had never seen an injury like mine. I should have left then. After I found someone that knew what they were doing after my second surgery, I was not allowed to do ANYTHING for 6 weeks. I was locked in braces in full extension for that time while the tendon healed. They basically re-anchored the tendon to the patalla using screws and that needed to heal. Is that the technique they used on you? After the 6 weeks, I started my PT that focused on getting range of motion and stability back FIRST, not weight lifting!

After my PT, my doctor told me I could doing anything I wanted in the gym as long as my feet were on a flat surface (no heavy leg extensions at all) My size has come back but not to the same degree it was before, plus the teardrop near the knee is less prominent after my injury.

My advice is to be patient and keep training them. It was a very serious injury.

26 months ago I had a bilateral quad rupture also, from squatting only 405 lbs. Spent 8 weeks in full in old fashioned casts, then a locked brace when I began rehab. Each session they'd unhinge the braces and allow me to work on ROM exercises, but never weightbearing the first 2 weeks or so. They were super cautious, because, like Brick said, it was a rare injury. After about 3 weeks they let me walk around with the braces unlocked a little, but only completely freed them in rehab. Once the ROM reached 90 or so, they put me on the recumbent bike, then moved me into stability type excercises, and at the end of each session worked on ROM. It was very gradual, but only at the very end of the therapy did they have me on the leg press, and it was almost no weight.
I didnt squat again until a year had passed, and then only 135 on the smith. I haven't done over 225 yet and dont think I'll ever try it, even though 225 is like nothing. Before the injury, mine were about 29.5" at their biggest, I think when the casts came off they were no more than 25". Measured the other day at 28", but as Brick said the teardrop muscle has taken the biggest beating and I'm too damn scared to put any real weight on it to try to make it grow. At this point the priviledge of walking is a tad more important.
This past summer I got in my state show just for the hell of it, literally at the last minute, only 4 weeks hard prep, knowing my legs would look like shyt, especially hamms and glutes, but I'll try to attach some pics to show the now underdeveloped teardrop, but also that most of my overall size came back, just needed about 8 more weeks of prep to get the condition right.

thebrick · Apr 26, 2012

looking good SIR-LOIN. I was hoping you would chime in. Those that have bi-laterally ruptured the single largest tendons in the body belong to an exclusive club.

These days are much better than those old post injury days and it does put the fear of god in you…

jamescb77 · Apr 26, 2012

My good friend ruptured both of his patellar tendons at the same time. He has surgery were they drill holes through the petella and then anchored the tndon on there with wire for maximum strength. he was bed ridden for about 8 weeks and then wheel chair bound for a month or so later. He wore braces for nearly 8 month and was slowly allowed to unlock them. This was about 5 years ago. Once he was finally cleared for anythign goes he took it very slow as i suggest you do. He has regained all of his strength and size although wasn't very quad gifted to begin with. He can hit deep squats with 315 for 10 reps 3-4 sets no problem. He doesn't go over 315 anymore. It takes time but you will get there. Thats a major injury and you need to take it slow. Also after an injury your bodies dynamics are actually inhibited. You are gonna have to go slow and light and make sure that what you want to fire is firing and the body isn't adjusting just to move the weight. Also keep a focus on balance and stability exercises as those will greatly enhance the muscle synergy and ability to properly fire.

SIR-LOIN · Apr 26, 2012

I think the biggest thing that got half my size back was the recumbent bike, on light resistance, 30 minute sessions 4 - 6 days a week. The therapist I had was really good, had me doing some goofy looking stuff, like balancing on one leg standing on a half flat rubber ball, while bouncing a tennis ball off of a wall, trying to not step off. I looked like an idiot, but it was very helpful. Gotta stress being as cautious as possible the first 3 months post op. Even after that I had some instability, when I was walking, out of nowhere, it seemed like my knees shifted and I had to catch myself to not fall. I never did fall but it got my attention.
Brick, I know they anchored the tendon back to the patella, but do you know if they sutured the tendon ends back together as well? I never asked that question of the doc. I know its secure to the bone, but were the tendons reconnected to each other?

johnjuanb1 · Apr 26, 2012

Lene28 said:
About a year and a half ago I ruptured both my patella tendons. 2 months after the original surgery my idiot therapist re-ruptured my left tendon. This really screwed up my therapy and made my new therapist take it really slow to ensure we didn't tear anything again.

Fast forward to today; my range of motion is 120 degrees which means I can pretty much do everything concerning day to day activities; however my quads are not growing!!! I still have these tiny chicken legs; I have good genetics for legs. I have always had large glutes, hams, quads but these things will not grow. Is there anything I can do to get my muscles "turned back on" and get them growing???

Quads are about 22 inches and were 27-28 inches at the time I got hurt.

I had my quad tendon severed off the patella...very, very rare injury as the quad tendon usually tears elsewhere off the quad. They couldn't directly reattach it as it would shatter the patella. My left leg is held together with titanium sutures. I still am missing an ACL in the same leg, and have tons of meniscus damage in the right knee.

Anyway, I feel your pain as my legs are difficult to bring up to par with my upperbody. I try to do lots of high volume training. I do as many exercises and sets that I can until my legs have totally failed. This is the best way to get the size back. You have to literally destroy them. I can only press out 5ooLbs on leg press, as before I could do over 1,000Lbs. If you really kick your own ass with high reps and tons of variation and volume, they will grow.

thebrick · Apr 26, 2012

SIR-LOIN said:
I think the biggest thing that got half my size back was the recumbent bike, on light resistance, 30 minute sessions 4 - 6 days a week. The therapist I had was really good, had me doing some goofy looking stuff, like balancing on one leg standing on a half flat rubber ball, while bouncing a tennis ball off of a wall, trying to not step off. I looked like an idiot, but it was very helpful. Gotta stress being as cautious as possible the first 3 months post op. Even after that I had some instability, when I was walking, out of nowhere, it seemed like my knees shifted and I had to catch myself to not fall. I never did fall but it got my attention.
Brick, I know they anchored the tendon back to the patella, but do you know if they sutured the tendon ends back together as well? I never asked that question of the doc. I know its secure to the bone, but were the tendons reconnected to each other?

I did that very same exercise in PT. Pretty funny. I remember thinking at the time, this is weird but I'll do it. Really helped my stability after being laid up all that time too. And yes, be careful. I remember for quite some time after i was back up and around on my feet, my knee would suddenly buckle just a bit without warning. It has not done that in a very long time now.

My surgeon told me after my second surgery that with my first repair, the tendon was sewn back together at the tear (tendon to tendon). With the second surgery the surgeon took the healthy tendon still attached to the quad muscle and anchored it to the patella (tendon to bone)

And yes, it seems I have got much better results with my quad size doing higher controlled reps, really making the muscle burn vs. trying to push big weight… which only makes me nervous now anyway.

jamescb77 · Apr 26, 2012

thebrick said:
I did that very same exercise in PT. Pretty funny. I remember thinking at the time, this is weird but I'll do it. Really helped my stability after being laid up all that time too. And yes, be careful. I remember for quite some time after i was back up and around on my feet, my knee would suddenly buckle just a bit without warning. It has not done that in a very long time now.

My surgeon told me after my second surgery that with my first repair, the tendon was sewn back together at the tear (tendon to tendon). With the second surgery the surgeon took the healthy tendon still attached to the quad muscle and anchored it to the patella (tendon to bone)

And yes, it seems I have got much better results with my quad size doing higher controlled reps, really making the muscle burn vs. trying to push big weight… which only makes me nervous now anyway.

that is a very standard exercise for balance and stability. You can start on half a foam roll or a inflatable flat ball looking thing. If your really lagging you can start flat on the ground and point your non standing leg forward side and behind you. that movement is enough to create some instability depending on how bad your stability is since the injury. If you PT didn't have you do these thigns he is basically an idiot and is setting you up for failure IMHO.

taz · Apr 27, 2012

i had total atrophy of my right leg (im right handed) about 3 years ago. to this day 5 different ortho and specialist Dr's do not know what it was that caused my problem. I had severe pain and swelling that got so bad that every monday morning i would have nearly 100cc's of clear fluid drained from my knee just so i could go to work that week. it was horrible and the pain was so intense that painnkillers didnt even touch it.

anyway, fast forward, we had the surgery and they found nothing though they scraped and took pieces to test and the whole 9 yards. after surgery, which is normally a 1 day in and out procedure and rarely overnight for my type of injury, i spent 4 days in the hospital being tested. found nothing.
i was unable to walk without crutches for 3 months, then moved on to a cane. i had to wear my brace every day and had limited ROM. I did not do traditional PT because (maybe stupidly) I thought I knew better. In my case, i got lucky and I did it all right. But it took 1 year to get my leg strength to where I could do leg extensions with 20lbs with my right leg. It had atrophied down to 19 inches around from 29. i felt goofy and looked rediculous.
one exercise that helped me with stability and with firing off the muscle fibers was to take a stability ball and put it against the wall in a corner so that it cannot roll or move. then lay down i front of it with your legs slightly bent. now GENTLY apply leg press type motion pressure against the ball. because of the inconsistency of the ball this will also help develop your support tendons and ligaments. you can do it one-legged as well. gradually and slowly increasing how hard you press over time.

another exercise i used to do was to sit on a chair so that my legs were at basically 90 degrees to the floor. then i would place a 8,10, or 12 lbs medicine ball in front of my right foot. using just the strength of the quad i would push my foot out as if i were kicking the ball. but the ball would be pressed against my foot already so it was just moving a weighted object. i would do this repeatedly with my wife placing the ball back each time. then up the weight of the ball as i got slightly stronger.

just know its a long road and even though 1 year seems like long enough in the grand scope of your life it is not very much and before you know it you will be at full strength again. as for me, i havent squatted over 135lbs, havent leg pressed more than 8 plates, and havent done extensions with more than 150lbs ever since my injury. my quads came back and i feel stronger than ever.

Dangkolo · Apr 27, 2012

In 2007 I had a cyst removed from my quad tendon that connects to the patellar. It had formed after I tore it 2 wks out to a contest. They said it woukd heal but formed the cyst then they had to do surgery to remove it. Its 2012 & I still deal with it. You really have to focus on the quad doing the work and try not to go too heavy, but in due time it can all work out. Just takes along time to come back from that kind of injury.

norm1220 · Apr 27, 2012

In 2001 I shattered my right leg in an ice climbing accident, I was off weight bearing for over a year and it was over two years before I could walk without a cane. Needless to say, my leg atrophied.

I began pedaling a bike before walking was possible, so that helped. I did a couple of months of PT and then they set me loose in the gym. It was frustrating, but I took it slow and steady. I knew training to failure like I had always done was no longer an option, re-injury was far to likely. So I started with baby weights and when I could do 4 sets of 15 I increased the weight (barely) and went for 4 sets of eight, increasing the reps by 2 when I could do 4 sets of the current rep range.

It was slow going, but eventually the baby weights became big kid weights and in another year and a half I was using what the average joe in the gym would (not the BB or powerlifters, obviously). Once I hit that point I began to up the intensity and although I still don't move the big iron around I can get one hell of a leg workout and my legs are actually bigger than they were before my injury.

Slow and steady is the trick, remember you are in this for the long haul.

Darb77 · Apr 27, 2012

I tore my pataller tendon in my left knee a couple years ago and my legs have gone to shit ever since! I didn't have surgery but alot of rehab and a couple PRP injections. It was always easy to put size on them but since they atrophied after not working them out for a little over a year I can't seem to get them to grow again. It is very frustrating to me! I was just thinking about this same thing today and its funny there is a thread about it.

I have been doing most of my leg stuff in the 6-12 rep range but I am thinking of just doing 15-20 reps on everything for a while to see if that works. They don't look bad at about 24 inches 5"8 170 I suppose.

Lene28 · Apr 27, 2012

It actually helps seeing other guys having serious injuries like mine! I guess after a year I thought I would be normal? I just started freaking out thinking I would be like this forever. I don't care if my quads are huge I just want them to go back some and for my legs to function correctly. I still can't go up and down stairs normally or get on a knee to get up off the ground. This injury has cometely changed my life as I'm sure it has yall's.

norm1220 · Apr 27, 2012

Here is the best thing I carried away from my life changing injury-
I now know that it's not about what you can't do, it's about what you can do.

Set your goals, achieve them, and set more. Nothing succeeds like success and every step you take now is proof that you can succeed. A lesser man would have been stopped but you have moved forward. Stick with it.

SIR-LOIN · Apr 27, 2012

norm1220 said:
Here is the best thing I carried away from my life changing injury-
I now know that it's not about what you can't do, it's about what you can do.

Set your goals, achieve them, and set more. Nothing succeeds like success and every step you take now is proof that you can succeed. A lesser man would have been stopped but you have moved forward. Stick with it.

:yeahthat::headbang: