♪ Bob and Brad ♪
♪ The two most famous ♪
♪ Physical therapists ♪
♪ On the internet ♪
- Howdy folks, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- We are the most famous
physical therapists on the internet.
- In our own opinion of course, Bob.
- Today we're gonna show you the one critical exercise
that you should be performing after knee replacement.
- That's right, Bob.
- And we've seen a lot of 'em.
Thousands.
- Thousands, yes.
- Between the two of us,
we're probably ten thousands, of a hundred thousands.
- We're not that old are we?
- We're old.
(chuckles)
By the way, if you're new to our channel
please take a second to subscribe to us.
We provide videos on how to stay healthy, fit, pain-free
and we upload everyday.
Also you wanna go to our website bobandbrad.com
'cause we're always giving something away,
show you in just a minute what it is.
But you can also find it on Facebook,
it's pinned to the top of the page, our giveaway.
- On the top, yes that's right.
- The top, yep.
And if you go to Twitter or Instagram
we have a 60-second version of our program.
- That's right.
- So the thing that we're giving away this week
is the Bob and Brad hanging handles.
- That's right.
- These handles allow you to attach to our wall anchor
which you get along with the kit.
And along with that you get a set, one for each arm
(snickers)
and this allows you to work on hanging
which is great for shoulder pain.
And which there's been a whole book
written on it by Dr. Kirsch.
- That's right.
- And it's also great for back pain.
And decompression of the spine.
- I'm feeling good, Bob.
- And posture.
- But we better get on with the knee.
- Let's go to work.
Okay so right after knee replacement,
Brad and I are concerned about five main things.
- As well as any other therapist.
- Right.
One, we're concerned about watching for blood clots.
- Right.
- Blood clots can be very dangerous.
Two, we're watching for infection.
Three, we're watching for edema or swelling.
- Right.
- We're trying to control that.
Number four, range of motion and stretching.
We're concerned, that we gotta get it moving.
- Right, that's what therapists are known for.
- And number five, strengthening.
- Another key aspect.
- Now what's nice about this one exercise,
it's gonna take care of four of those,
it's not gonna take care of infections.
- Right. - But it's gonna help you
with the four.
The big thing about, I want you to think about
after you have a knee replacement.
Scar tissue is being laid down
and I had one surgeon said, Brad that this,
it's a race against scar tissue.
- Sure.
- 'Cause as the scar tissue gets down,
the knee's not gonna move as well
so you wanna get it moving as soon as possible
and as far as possible
so that you can regain that motion and function.
- Right, and it's less painful that way,
it just makes everything faster, so this,
we want something to help promote that and make that easier.
- So what we have found,
this is another one of our creations.
We have found that the best way to do this
is with one of our knee glides.
Now, the reason the knee glide works really well
is because you can start with it in bed.
- Right.
- And this is something that there's really no other
substitute for it.
- Right, you know they have that.
- Oh, passive motion machine.
- Right, but they are very expensive.
A lot of surgeons don't use 'em anymore.
- A lot of them aren't. - At least the ones
that we've been working with.
Because it's passive.
- Right.
- This allows range of motion
and it starts some of the strengthening
at a very early phase, are we?
- So Brad, why don't you go ahead and demonstrate?
- Yeah, that's right.
So we're gonna pretend this is you know,
day one right after surgery, maybe the next day.
- So what we did, this is the knee glide.
It's a simple device that slides like this,
but it also, you can use a towel when you're in bed
'cause it's a little bit harder on your heel.
- Right because you're not gonna have a pair of shoes on.
- Right.
- That makes it comfortable.
And as it very, the resistance is very low
on this so you can get this knee movement.
Yeah, give me a pillow, Bob.
- [Bob] There you are.
- Now in a hospital bed you may be elevated slightly,
but you don't wanna go too high up.
But we're just gonna slide now.
Early on you may have the therapist or a nurse
or you could help with the other leg possibly.
- [Bob] You could even take a sheet.
- Sure.
- And pull.
I'll grab one, Brad while you're talking.
- You can even use your gait belt
that they're gonna walk with you,
in the hospital. - Right.
- Whatever, you know the therapists
are gonna help you out, the nurses.
But this option you know, really can get that knee bending
and I'm doing some active motion here.
It's not like a machine is doing it,
but we have some active, and you feel more under control.
- [Bob] Right.
- You know when that machine is moving your knee, it's--
- [Bob] Well I can move it beyond
what you wanna move it as far.
- And it can be uncomfortable and painful!
- [Bob] Or even for the scar for the--
- As a matter of fact, - for the (muffled) site.
- Paul our patent lawyer who helped us patent this,
he had his knees done.
He said he hated that thing, it was so painful.
- [Bob] Oh sure.
- He said this is gonna be a perfect,
you know from his personal experience.
But anyways, and it works really nice that way.
And if you do want some motion laterally.
- [Bob] Well, first Brad-- - Oh, go ahead.
- [Bob] do you wanna show extension?
- Oh, sure.
- So when you get to the end right here,
your knee's probably not gonna go this straight.
- Right.
- It's probably gonna be like right here.
So with the towel kind of rolled up like this,
you can actually work on extension.
Let gravity do it or even take your hand and push
just slightly to--
- And with that, you know you'd elevate the bed up
so you're up here comfortably. - Right, exactly.
- And then you're gonna, you can do all these independently
and the more independent you are with your exercises,
the better the results are gonna be.
- [Bob] Now it may be too much to push on it at the start.
You may wanna just let gravity do it's thing.
But the gravity will be working on it
when you have the towel rolled up
like that so. - Exactly.
- So yeah, you were gonna show the hip abduction too, Brad?
- Yeah, you know it just gives another aspect,
so you can work some muscles that should be worked
while you're in bed.
- [Bob] Sure, keepin' the toe straight up.
Don't be turnin' it one way or the other.
- Right, this way or that way.
Just another really cute way to work it.
Okay Bob.
- Really cute?
- Cute, well you know.
- While we just say it now, as we progress
you're gonna start using the glide on the floor.
Now what's nice about the knee glide on the floor
is people used to just put a washcloth down.
- Right.
- It's not as comfortable on the leg,
right when you get to this point.
You see how the dorsal flex, or plantar flex the ankle is?
- Right.
- That's a term for saying it's push down.
- Right.
- You put the little handle up like this
and now it's comfortable to work on,
and plus gravity's helping it work flexion.
- You gotta put it a little downhill.
So it works really well for the range of motion,
for the knee.
Now what I do with patients, is I'll have it flat
a lot of the time, but they can, I'll say,
when you get to here and it starts to bend your knee,
and you wanna get a little extra stretch,
either I will help push or the patient themselves can do it.
Take your good leg, go over the top
and you're gonna push back, stretch, stretch, stretch
- and back. - And if it gets too far,
if you go over this far and your can't go around the ankle
anymore, then you go to the front of the knee glide.
- Push back. - Precisely, Bob.
And when people get really good and they're past,
you know up to a 110 or so degrees and you want to work
more strengthening of the hamstring,
you simply turn it around and you work uphill this way.
And this actually is amazing how much hamstring you get.
If I do this with a healthy leg like mine
and I do this for a few minutes,
I can clearly feel my hamstring
start to (mumbled). - The hamstring is working.
So what I recommend, Brad with both of these,
you know hamstring, quad or whatever,
I always say, do 10 of 'em.
Do 10 just going back and forth
and then on the 10th one--
- There you go.
- I'd go ahead and give it a little stretch.
- Ahhhh, yeah so every time you're not pushin' on it.
Motion, motion, motion, stretch.
- And if you wanna add some weights.
- Ah, yes.
- As you progress along.
You can go ahead and add some weigh on to your ankle
and it'll make it a little more difficult
and you'll start gettin' some more strength
for the leg here.
- You know this is the kind, I think,
at least in the states, United States,
they want people out of the hospital as soon as possible.
This gives you an opportunity to continue your exercises
at home really effectively.
- I always think it's a great visual reminder too.
If you walk by and you see the knee glide sittin' there,
it's callin' out to you, Brad, - Right.
- it's time to use me.
(chuckling)
It's time to put the time in.
- Say no more.
- We recommend usin' it three to five times a day.
And up to, I usually say three to five minutes.
Usually when they start, probably about three minutes,
but later on they can go up to five.
- Right, so all right.
- And then I'll also at that point,
you know you can work on extension
by just putting your foot up on another stool or chair.
- Well actually some of our therapists--
- I know some of our therapists do this.
- Will go out like this, it allows your foot
to slide and you can get that straightness
of a full extension aspect.
You know, it's an important part of walking
to get a full extension.
So it covers all the bases, Bob.
- All right, remember Brad and I can fix just about anything
- Except for,
- a broken heart.
- I don't think this is gonna help that.
- No, but we're workin' on it.
- Yeah.
We'll figure out somethin' for that.
- Thanks for watching.
(note tones)