♪ Bob and Brad ♪
♪ The two most famous ♪
♪ Physical therapists ♪
♪ On the internet ♪
- Hi folks, I'm Bob Schrupp, physical therapist.
- Brad Heineck
physical therapist. - And we are the most
famous physical therapists on the internet.
- In our opinion of course Bob.
- Today we're gonna show you the top three things
you should try before knee surgery or replacement.
Plus its a giveaway day Brad.
- Okay then.
- Lets start our giveaway,
if you are new to our channel,
please take a second to subscribe to us,
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Go to bobandbrad.com for the giveaway
which will just be starting,
go to the giveaway section,
this week we're giving away a knee glide.
- Oh really? - Which we will show you
later on Brad, we're gonna show them how to use this.
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Got Twitter, Instagram, or TikTok
if you wanna 60 second version of our program.
- Okay, 60 seconds.
- All right so,
lets first talk about,
lets say you're having trouble with your cartilage
or your meniscus.
- Sure.
- In your knee and you're talking about surgery.
The latest recommendations are,
and this is pretty solid sources
that I see this recommended again and again,
is they would not recommend having
any meniscus repair unless the knee is locking on you.
- Which means, if you've had this you know it,
Coz the knee will lock,
and it not only locks, but it's typically quite painful.
- Right.
- And then you have to work it around it then
- It comes unlocked. - The meniscus fold opens up
and then it's okay again.
- Yeah, the idea is that if you have surgery
on a meniscus repair and its not locking.
What they're finding is that like six months later,
you're in the same position that you would have been
if you wouldn't had the surgery.
- Sure
- So the surgery really is not,
you know, you're putting yourself at risk,
even though it's minimal risk,
for really all for not.
There's really not much to be gained.
- Right.
- So we're gonna have you try these things first.
Now, if you're gonna have full blown knee replacement,
in that case, I want you to try these things first
to see if you can put it off a little bit.
Knee replacements tend to last about 20 years.
- Right.
And so if you are younger,
you know, by younger,
when we say younger now,
it's anybody lower than 60 (laughing).
You know, you wanna make sure you get a good 20 years out,
but I don't want you limping around,
and not being able to sleep with knee pain.
- But actually, if you're gonna have knee replacement,
the better your range of motion is
- Right
- Before for going into surgery,
the better the rehab comes out.
- Better the strength too,
- Right.
- So all these things will help you no matter
if you are gonna have the surgery or not.
- Right.
- So the first thing I try to tell people,
try to calm the knee pain down.
Knee pain and arthritis whatever you have,
tends to flare up and it tends to calm down.
And if you're in a flare up,
you're gonna be thinking,
Wow, this is so bad, I need to have surgery.
But give it a,
try these few things first to get it to calm down.
The first thing we recommend is use a walking aid.
And this is the one that people chafe against a lot.
They'll say - Chafe
- Yep, they say, I'm not gonna be using a walking aid,
I'm only - Yeah
- So what's funny to me though,
is that a lot of people, got me Mike.
A lot of people will walk around like this,
and they think you know,
that a walking aid it's gonna draw attention to them.
- So he's talking about a cane technically.
- But believe me,
you're drawing attention to yourself already,
because you're really limping.
So yeah, what we have here,
I thought we just mentioned this Brad,
they said these are really nice.
The Prime Stick Dynamo,
really nice walking stick.
It looks a little sportier too,
does it look like a cane.
- Yeah, so you're gonna be on the in.
Aint it nice and adjustable here.
- Yeah, and they're lightweight.
They got a good tips on them.
We'll put a link below because a nice company.
They sent us some.
And what I like about it too,
it's a lot easier to keep your posture Brad.
- Right, it's up higher,
kinda promotes that. - You're not leaning forward
You know, my wife went through a bout of knee pain,
really bad.
And to the point she first said,
there's no way I'm using a cane.
By the end, she was using crutches.
We had her on double crutches,
- But she'd rather have crutches than the cane.
- Right crutches.
- Right.
Better appearance for some people.
- For some that are young.
And she used the crutches for a while.
We did some other things.
And she's back to running.
- Yeah, just start running the other day.
- Yeah, So, you know if you can calm that knee pain down,
if she was'nt married to a therapist,
she might have had surgery by now.
So you know, I'm serious.
- No, I agree Bob.
- Why do you have that look on your face.
- I thought I could come up with something on that one,
but I couldn't.
- So you also may try some medications,
some anti-inflammatory medications.
Recommended by your doctor or pharmacist,
like ibuprofen
- Some across the counter
- The other also wanna do,
is you wanna decrease your load bearing activities.
What I mean by that is,
decrease the amount of kneeling you are doing,
you know especially,
I had just had a nurse that was doing this.
He goes, I like, I sit like this a lot.
- Yeah.
- I'm like and you're wondering why you have knee pain.
- What did you mean he sits like that a lot.
- I mean, he gets to that position a lot.
- Oh, like for gardening whatever
- Yeah.
- So and that's why I'm saying,
My sister just went through a bout of knee pain,
and she couldn't figure out why it started.
I go what you do last weekend.
I gardened all weekend.
And she just made no correlation between that,
she stopped gardening for a couple of weeks,
or just a weekend even
and her knee pain calmed right down again.
- Sure.
- So you wanna avoid stairs if you can.
You wanna avoid hills if you can.
I know you can't completely baby,
but you can
- One thing that sets off,
I've done with a lot of patients,
is I just tell them take one step at a time.
Use the good leg going up.
And then when you go down lead with the sore knee.
- Yeah.
- Takes a lot of stress off the knees.
- Yep, on even ground too is really hard on.
Bad knees. - Yeah, exactly.
- So all these things, do it for a while.
I'm not saying do it forever.
I'm just saying do it till it calms down,
and then we'll see how it goes.
- Sure.
- So a couple stretches that seemed to really help.
you get that stool over there Brad, don't you
- I do, Bob.
- If your knee is locking the bend,
or it's not going as straight as the other one,
and it's very easy to test this.
All you do is put both legs up like this.
And let them straighten out ,
and I gotta get to the edge of the chair Brad.
- Yeah.
- I'll probably show off on the side here like this.
Now, if you put up one,
and you can see it's bent a little bit,
you put up the other one that goes right down.
It'll probably be better that way.
- Well, yeah,
so they can see what's going on there
- This one's bent a little bit.
This one's locking extension.
If you can regain that extension quite often.
It lowers the amount of pain you're having in that knee.
Believe it or not,
and we've seen this happen time and time again.
So what you're gonna do,
is you're gonna put your foot up on a stool.
Sometimes people even just do it on the floor.
- You can.
- And you can do, you go pressure on,
you can put one hand above and below
or you can put right above.
Not on the knee.
- Right in the kneecap, especially.
- Yeah. So you're doing pressure on, pressure off.
The reason we say those words,
that's how long we want you to push.
- Right.
- Pressure on, pressure off,
pressure on, pressure off.
Now you can do that throughout the day.
- You can do it five to 10 times.
- Sure. Every hour.
- Yep.
- As much as possible.
Little variations on this.
Some people have a little more success.
If they turn their foot out.
like this and then do pressure on.
- Sure
- That's how my wife's, that what she responded to.
- Toe out.
- Toe out Yeah,
she's used to even doing on the couch.
She lay on the couch,
watch TV and she put the foot up on the foot
- Yeah, You never helped.
- No, I did some things.
- Oh, you did.
You watched TV and sports.
- I watched TV, I told her I was on TV.
Now she, you turn your foot in and try it that way too
- Sure
- So you can also work on knee flexion.
And I'm gonna simply just show you this way, Brad.
You can just grab on,
grab near the lower, close to the ankle,
and pressure on, pressure off.
Pressure on, pressure off.
- Sometimes I've had people have better success,
up closer to the knee.
It just changes the force of where
the joint is articulating.
- Which makes me think,
do you want to grab that towel Brad real quick.
I'ma show McKenzie maneuver.
- Oh, yes. Oh, yeah, this one?
- Yeah, they recommend this too.
Sometimes to help the knee bending.
You actually put a towel underneath the knee like this.
And it gaps the knee a little bit.
- So the towels rolled up.
- yeah, it's rolled up underneath the knee.
And you do the same thing, pressure on, pressure off.
- It's right up in the crux of the knee. Yeah.
So the last thing,
the last recommendation we're gonna make,
is try some unweighted movement.
So what do we mean by that?
We mean like a bicycle,
where you're really not putting weight on the knee,
but you're getting movement.
- Sure.
- The other thing is this week's giveaway,
the knee glide.
So we, this is used quite often
for people after they had surgery.
- Or even before.
And the idea is that you can get movement in your knee,
without weight on the knee.
- Right.
- So I can just go ahead and it works just really easily.
It's very portable.
This thing weighs less than five pounds.
Right Brad.
- It's 3.1.
- 3.1 pounds.
And what's nice about it,
the stand makes it a better angle,
but you can also do it flat.
And you can also do it with the stand,
on on this side close to me.
So then you're working the hamstring a little bit more.
- Right.
It's amazing what the incline makes a difference,
one way or the other,
particularly after surgery.
- Right.
- Then it's really noticeable.
I do have the mention Bob,
I just had a friend of mine,
had a heart attack.
Went in, luckily they saved him,
they put a stent in, he made full recovery.
But he laid on the bed for about a day and a half,
during you know, right after surgery.
And they didn't want him to move.
They had the, coz they went in for the stent entry
through the femoral crease.
- Right.
- So he couldn't move that leg
and he has a tendency to have arthritic knees,
and that non movement, got his knees so stiff.
I brought him one of these,
coz he was trying to get it to move.
I says, I just got a thing for.
- What a nice friend.
- Yeah, so I brought this,
and he texts me back it works.
And you know, it was only about a week or so,
and his knee got back and he gave it back to me.
But yeah,
- I think this is a surprise to many people out there.
You think that,
Well, it's gonna feel better because I'm not moving it.
- Right
- But actually knee pain.
I remember the study from when I was in school, Brad.
- Yes.
- 150 years ago,
that they did a study on little rabbits,
and the rabbits had arthritis.
- Yep.
- And half the rabbits.
They had them on a motion.
- Yeah
- Moving them and the other half they let it rest ,
and the ones that rested got worse.
The knee pain.
- How do they did they,
did they asked them if they had Arthritis
- Yeah the bunny said Oh,
- Got arthritis.
- Yeah.
- Those studies are amazing.
- Yeah, I don't know how they found all the rabbits of ours.
Like we're looking for rabbits with arthritis care if you
to join our study
- Yeah
- So anyway,
we got off a tangent and all.
A bike will also work for that.
But it's just a great way to start getting,
some smoothness to that knee.
- Alright.
- Give it a try.
Give it like 15, 20 minutes a day,
you can even work up to on that.
- Right.
- In this case is like he's laying in bed
just for a day and a half,
but it was like the knee got rusty,
and it just locked up,
and then we just had to break.
- This works well in bed.
- Yeah.
There's no reason why you cannot use that in bed,
or right after surgery in the hospital bed.
All right.
Thanks everybody for watching.
Appreciate it.