(Reggae music)
- My name is Brad Heineck
and we're talking about total knee replacements.
What I want to talk about is strengthening of your knee.
Two specific exercises that are critical to help you
with your walk and your balance in the long run
as well as getting started.
And the first one we're talking about is quad sets.
So the quadriceps are these big muscles right here
very responsible for keeping you upright and moving.
And we wanna get those muscles working.
They've turned off after the surgery.
It's the body's natural response to surgery.
We want to get them strengthened
and once you can get your knee
to the point where it's this straight
it's time to start doing quad sets.
Which is relatively early after surgery.
One way you can do this is in the chair.
You're gonna get your bottom forward in the chair.
Make sure you have arm rests
you can rest against, get the knee as straight as you can
and then simply try and straighten your knee.
And to do that, the quadriceps must contract.
Okay, you can see my knee is straight.
Your knee may not straighten as much,
you may only get this much
but at least you're getting some movement
and those quadriceps are kicking in.
You can put your hands there and feel them, okay.
That's biofeedback in the basic sense.
And that can help strengthen those quads.
Okay, the next one in the chair to also get the knee motion
and the quads working
you're going to scoot yourself back in the chair.
A firm upright chair works best.
Sit with armrest, good posture.
And you're simply gonna try and lift the leg up in the air
without any assistance.
Okay?
In other words, in therapy your therapist may help do that
or you could use your other foot to help lift it
but we want to work on quad strength.
So we're gonna work on up and then down
and then up and then down, okay?
Thank you, Bob.
Another thing you can do to help support the knee
Right here.
Take a towel, just roll it up, put it right here.
And that gives more support
and it makes it easier to do your quad sets from the chair.
Okay. I do wanna say both of these exercises
can be done very effectively laying down.
Now I know you're not gonna get on the carpet at home
but I'm gonna do it here
and imagine we're on your bed at home.
All right.
So you're laying supine on your back
then we're going to do straight leg raisers, okay?
You're going to take your good leg, bring it up like this.
All right.
Get a pillow there and get comfy.
Okay. Have your spouse get you something to drink
after your exercises make them work for you.
- I want to help you out, Brad.
- Okay. It's always better to have two people.
When you're going through rehab
you have a spouse or a family member.
There we go, all right.
This knee is up.
This leg stays as straight as you can.
And it's called a straight leg raiser.
This works the quadriceps, it works the hip flexors.
All very important muscles as per walking.
Okay. You're gonna bring it up
as far as you feel comfortable.
Hold it for a second and go back down, okay?
The idea is not to go fast.
It's gonna be hard to do that anyways
and bring it down with control
and don't do that because that will be painful.
Okay, so that's straight leg raisers
The next one is quad sets laying down.
What I like to do is if you have, this is a roll I have
or you can use a towel roll
and you're gonna put it underneath your knee, okay?
What that does, this is where someone helping is good too,
you're going to try and squish that roll.
If you've got a foam ball, a little Nerf ball
that works good.
You put it under there, give you something to squish against
and that's all quadriceps.
Plus you're straightening your knee as well, okay?
You're going to do 10 to 15 of those
as well as 10 to 15 of a straight leg raisers.
And after that you may wanna ice your knee or rest
whatever it may be, take a nap.
Thank you.
Okay. Continuing on with total knee replacements.
I want to talk about using cold packs on your knee.
It's very common, almost everyone uses cold packs
after their total knee replacement.
One thing I always do with my patients is at home,
when they do use their cold packs
they oftentimes use a recliner.
And I don't have a problem with people using a recliner.
You can get your feet back up.
We can elevate the feet
which is good for decreasing the swelling.
And you can also work on straightening the knee
if you do it properly.
You can also do it in a chair like this, okay?
And put another chair in front of you
and we're going to bring the knee up as such, okay?
The height of this chair is gonna make a difference.
This might be a little high for a lot of people
early on in the phase
but you'll just have to get a lower chair
or an office chair, you can just lower it manually, okay?
You're gonna bring the knee up.
Now you want a little stretch on the knee.
When you put the cold pack on
you don't have to stretch it real hard.
You've already done that.
We just want to cool it down,
but a little stretch is better than keeping it real flexed
or bent, okay?
Bring it up, so we've got some elevation here.
So it's gonna help lessen the swelling
along with the cold pack.
And you put a cold pack right over the knee like that.
And the typical response is, "that feels real good."
Especially after you've worked it and stretched it
for the previous 10 or 20 minutes.
You put the cold pack there.
Now with some people at home, they'll have their cold pack
and there's cold packs you can actually make.
And following this section of the video
we go through a section of how you can make a real simple
and cost effective cold pack that works for your knee.
You want to make two of them possibly
take one, put it underneath your knee
and the other over the top
and you totally surround the knee with a cold pack
and you get the complete package right there.
Cooling that knee down, decreasing the swelling.
And again, you get the elevation there.
So the fluid gets back into the system.
You can add ankle pumps
is what they're gonna talk about in the hospital.
when you leave.
Ankle pumps are nothing more than working your ankle
back and forth like this.
And it works the muscles here,
helps reduce the swelling as well getting the fluid moving
and it keeps your ankle stronger for when you're walking.
So you're going to do 20 ankle pumps.
Give it a rest, sit back and relax.
And you can do three sets of 20
while you're there cooling your knee down for 20 minutes.
- Brad, before you stop there, I just wanna make sure
you want to mention that sometimes with the ice pack
you want make sure that there's a piece of material
between the ice pack and your knee.
- Good point, Bob just brought up.
When you use the cold pack at home
you never wanna put the cold pack directly on your skin.
Always make sure you have towel.
If you have some sweats on that's good.
If you have real thin material,
if you're in pajamas or whatever you're in are real thin.
You might wanna put an extra towel there.
So we have a little insulation between the cold pack.
It's possible if you've got a good cold pack
you could frostbite your skin
which is not desirable at all.
So make sure we have some insulation there with quad.
Thank you.
Now another thing to address with cold packs is
what can you use at home as cold packs.
With my patients, oftentimes they don't want to
or they don't have the funds
to go down to a pharmaceutical store and buy a cold pack,
a nice new one, especially for the back
where you need a larger one.
It's gel filled.
They're very nice, but they're very expensive.
Okay. Chances are you're going to need the cold pack
for a week or two.
Then what do you do with it?
Well, if you wanna spend the money you can
but there are other options that work equally as well
as a bought in cold pack.
One of them that I use and I have for over 10 years now is
I have a recipe for a cold pack.
And here it is, we have Ziploc bag, okay?
And we simply take one cup of rubbing alcohol
pour it in the bag, take four cups of water
pour it in the bag and mix it up, okay?
Excuse me, Lindsey.
But I'm gonna use your back, okay?
When you do that you want to get all the air out
and zip the first one up
and then you're gonna put a second bag over the top of that
just so you have some more mechanical strength.
So it doesn't break open because they will break open.
The worst that happens is you get a little water
mixed with alcohol and it evaporates and it's okay.
but they work very well.
Make sure you put it in the freezer flat like this.
And when you pull it out, it'll come out in slush form.
So it actually will conform to your body
just like bought in and gel pack will.
They work excellent. I've been using them for years
as I said.
And my patients are very happy with them
I hand out the recipe regularly.