(upbeat music) ♪ Bob and Brad ♪
♪ The two most famous ♪
♪ Physical therapists ♪
♪ On the internet ♪
- Hi folks, I'm Bob Schrupp, physical therapists.
- Brad Heineck, physical therapist.
- Okay, we are the most famous physical therapists
on the internet. - In our opinion,
of course, Bob.
- This video today was put together by Mike and Alex
of the Bob and Brad crew.
Both are physical therapists assistants
and both have been providing treatments
to our patients for years.
They do-
- Fantastic work.
- We're very happy with all the work with their patients.
We have reviewed
and approved all of their material
that they're bringing up.
So they're showing you our treatment
through them with their experience.
And it's been-
- Exactly.
- Wonderful.
- Make sure you subscribe to the Bob and Brad Crew Channel.
It will save you reviews of products
that keep you healthy fit and pain-free.
They handle all of our new products now.
Enjoy the video.
- Good luck.
- Hello everyone, I'm Alex physical therapist assistant.
I'm Mike, physical therapist assistant.
And this is the total hip replacement fitness program.
Exercises zero to four weeks after surgery.
So about a month out after surgery.
Four goals again, in this time of your life.
Number one pain control.
Continue with your medication, you know,
if you think you need it.
Take your pain meds about one hour prior to exercise
to maximize your results during exercise.
The next goal, number two is work
on your swelling management.
You wanna prevent any blood clots from forming
and continue to monitor your incision.
You can Rest, Ice, Compress, Elevate still,
the RICE principle.
Just do those things and get your swelling under control.
- "Let pain be your guide," they say.
Number three, continue following your restrictions.
You know, whether you had a posterior approach
or an anterior approach, your surgeon will tell you that
but we wanna avoid, you know, a dislocation.
I think it's worth saying it does not happen often
but-
- It can happen.
- You said you've heard of it, so.
- Goal number four is keep progressing your range
of motion with this video.
Also working on your strengthening of your hip
and your leg and work on your walking or gait quality.
- Yup, your range of motion within your restrictions.
And we're gonna get into that.
So we don't have to say, you know, one set of 10
throughout all of these,
start with one set of 10.
Increase your reps and your sets as able
with all these exercises.
And you said, last video, you don't have to do them all.
You know, there's 13 exercises here.
Don't do them all at one time, you know.
Break them up and you might be able to pick
and choose which ones you need
to do at this time. - Yeah, if you're early on
week zero to one, go through exercises one through six more.
Seven through 13 are more for the later weeks.
- Yup, Yup, exactly, so.
We're gonna get it.
I'm gonna get in a chair out of Mike's way here.
He's gonna start by-
- I'm taking a nap again.
- Laying down.
- Number one is ankle pumps.
- I'm younger than him too, by the way so.
I'll let him lay down. - (laughs) Barely.
You age more though, you have kids.
- Easy.
(laughs)
- Yeah, that is true.
I can't deny that.
- Okay, pumping my ankles up and down.
Alex's probably doing more
calf toe raises. - Calf toe raises same thing.
- Do them any way.
Sometimes I like doing these in general when I wake up
in the morning.
But that's just me.
- And again, Mike, you could elevate your legs
on some pillows and do ankle pumps.
Would probably get a little swelling out
of there a little faster, but just an option.
- As long as you're not, you're past your precaution range.
It's fine to do that.
- Yeah, number two, glute sets.
Squeezing your butt cheeks together.
- These ones hold for five seconds, try to, at least.
You can go up to 10 seconds if you can handle it but.
- I just squeezed it and I thought it was gonna fly
off the chair there for a second.
- Oh boy, why?
- Glutes of steel.
- Thought you were talking about passing gas there.
- Well,(laughs) that too.
(laughs)
All right, number three.
Quad sets.
Michael demonstrate as he's laying down here.
- So this one again you're gonna push the back
of your knee into the mat.
Activate your quads.
So this one again, hold for five seconds if you can.
Four 1,000, five 1,000.
Relax, try to do 10 sets of it.
Not too complicated.
It's in a previous video as well.
- Yup, number four, laying on your back,
bringing your heel in and out.
Hip abduction, adduction.
- Yup, so going out and then in.
Try to keep your toes pointed towards the ceiling.
Depending on your approach you're not supposed to rotate
in or out too far.
- That's a very good point, Michael.
- So keep your toe up.
Also when you come back, don't cross over.
I mean, that's awkward anyway,
but just go in a comfortable range.
If it starts to hurt, stop there.
And always keep that foot neutral.
- Very good points.
You can use a towel roll under your heel
if you're having trouble sliding
or the Bob and Brad knee glide works well under there too.
So a couple of different options.
Now Mike's going to do some heel slides.
He's gonna pop his shoe off here.
- Okay, so you can put this leg up if you want it
for some support.
And you're just gonna slide your heel towards your bottom.
Don't go past 90, if you have those precautions.
If you can't go that high, don't worry.
If you can just go here, that's fine.
Whatever's comfortable for your hip right now.
If you have knee pain,
just do what's comfortable for that as well.
- The first couple of weeks,
you might just be able to go halfway you know.
Weeks two to four, you're probably,
your heel's probably gonna get closer to your butt.
But you know, don't worry about it too much.
Number six, I'm gonna give you your pillow again.
- Shorter quad.
Okay, so again, it's like straight.
We're going to kick up, channel hold for five seconds
if you can, then relax back down.
- Go down slowly 'cause it's still strengthening.
- Are you trying to tell me something?
- Straight line.
Yeah, go slower.
Always people usually put the coffee can under the knee.
I always picture that with the older people.
You know that Folgers coffee can.
You know what I'm saying don't you?
- I drink good coffee so, no, I don't know.
- Hey, let's not make people mad.
(laughs)
All right.
Number seven.
This one we were going kind of back and forth about.
Be very careful especially
if you have posterior hip precautions with this one.
- Yes, this is more of an anterior approach.
It's called a hip flection stretch.
- Where'd I put that towel?
- So if you- I don't know what you did with it.
- Here it is. - If you can reach
with your hand, that's fine.
This is more for the anterior approach
'cause you're allowed to have your hip go past 90 degrees
of flection,
I should specify what. - Yup, degrees of bending.
- So basically all I'm doing is stretching up like this.
Obviously, if you have the posterior approach,
this is a no-no.
- No-no, no-no.
You can't break that 90 degree angle, there.
This is my 90.
I can't tell from my- - Yeah, that's about nine 90.
- This is about 90, so yeah.
If you're just stretching here, I mean you'd be okay.
- Yup, that's good.
- But I'm not really feeling a stretch
But if you have a anterior approach,
you can try stretching out like this.
- All right.
- This is more of a holding one 10, 15, 30 seconds.
Whatever you're comfortable with.
This is to gain a little range of motion,
but restrictions still remain number one.
Brad would be proud how we said that.
He's always very anxious about
not breaking restrictions. (laughs)
All right.
Let's get up.
Let's sit up.
(groans)
Is that okay?
Sitting up?
- No.
- All right, seated long arc quads.
So Mike showed you the short arc quad with the coffee can
or the pillow folded up underneath your knee.
This is long arc quads.
So I'm sitting in a chair leaning back,
not to break restrictions if I am posterior approach.
And I'm just kicking out straight,
holding it for a few seconds
back down, slow, and then take a break.
And let's do 10 reps of those.
- It's gonna be easier if you're in a chair
and your feet can actually touch the ground.
- Yup.
- Gives a little break.
I'm kind of hanging right here, but.
- And if that gets easy, hold it a little longer.
Hold it for five seconds.
- You can also alternate with your other leg
for fun if you want.
It's not gonna hurt anything.
- That's your idea of a good time?
- Yeah.
- All right, number nine.
And then we're gonna go into some standing hip flexion.
So this is my surgical side.
So I'm just gonna, can you pretend I have a walker here?
- Sure.
- Alright.
I'm just gonna lift it up.
No more than 90 degrees.
This would be beyond 90.
This is probably about 90.
- Well this 90 angle we're talking about is right here.
I don't know if the camera could see that
'cause your angle's funny. - Yup, right here.
The hip.
- So do not go-
Oh right there. (laughs)
- Yeah, he's thinking the knee.
- I'm showing his knee, too.
His knee's at 90 as well.
His 90 degree bend is right here.
So if he was up, go beyond 90.
Yeah, that's beyond 90.
- Yup, no- no, so.
- So just go in a comfortable range.
- And you probably won't even get close to 90
when you're doing the, I mean, in this stage, so.
I'm gonna sit back down so they can-
No, I'm not.
- No, you're not.
You're gonna show the next exercise.
- All right, you do squats.
(laughs)
- Well, give me the chair.
- Okay.
- Okay, so you can hold onto your walker or a chair.
These are just mini squats.
Again, do not break your hip precautions
of bending too far over.
But if you just do a little squat like this, this is fine.
Just to have something to hold on to support.
I mean, if you're a month out
and you're not using assisted device anymore
and you feel comfortable, go ahead.
Otherwise, most people we have them do these
in parallel bars in the therapy room.
But walker or a chair works.
- Did you say a chair behind you
if you're very nervous about it?
- Yeah, if you're an unsteady person,
have a chair behind you.
You can even have someone holding onto a gait belt
if you want.
- And get that butt, the cue we give everybody,
almost everybody, get that butt back like you're sitting
in the chair behind you.
That's proper form.
- Yeah, I'm just thinking about my butt dropping.
I'm not- a lot of people will bend their knees like this
- Yeah, that it doesn't do much for you.
- And their heels come up and they do that.
Just keep your heels flat.
Try to push your butt back.
That's all you're gonna do.
- And then Mike's gonna show you a calf and toe raises.
Every, you know, this isn't your hip, but this is balance.
And your calf, your calves get weak.
Your anterior tib muscle gets weak, so.
- So, hold on again.
Just go up on your toes.
Back on your heels.
I would suggest doing both feet together.
It gets a lot more challenging if you do one leg,
but after hip replacement, just do both.
If you can't go, you know,
as high up on your feet, that's fine.
Or if this bothers you, you know, you don't have to do it.
It's just an optional one.
- And when you do the toe raise,
do a toe raise, Mike.
Don't fall backwards again, I repeat, safety is number-
(laughs) Safety is
number one. - I almost fell.
- Should have been an actor.
(laughs)
All right.
I'm gonna demonstrate a few here.
- Okay.
- All right, then I'm going to do,
this is actually number 11.
This is just a hamstring stretch on a stool.
We see people, after hip replacement all the time.
A lot of them get tightness in their hamstrings.
So just wanna stretch it on a stool.
If you wanna give a little over pressure to stretch it out.
- Notice him, Alex sitting straight up.
He's not breaking hip precautions.
If he were to bend forward,
now he's actually breaking his hip precautions
if you have the posterior approach.
So just be aware of that.
Do not bend forward.
Keep it there.
Yeah, all right, you can hold that.
I would say 30 seconds and do that a couple times.
You know, three times a day.
It's just a stretch.
Nothing too difficult.
And then again, the knee glide
- Probably keep it flat.
- Flat, yeah.
- We don't really want it at a incline yet just
'cause most of you are gonna have the posterior approach
and you'd be over 90 degrees of flexion.
So you can also use the towel if you would like,
if you don't have one of these.
But these work well.
- As you get like three, four weeks
and you're doing the glide, you could do it 10, 15 minutes
if it's feeling good so.
- You can even try their fit, glide.
Get both legs working.
That's fine.
We don't have it out here right now, but.
- Yeah and then the last one, continue your walking.
You know, increase your walking distance.
Your, I mean you're walking quality should be getting better
as the weeks go on.
- Yep, make sure work on focusing on landing
on your heels when you're walking and rolling to your toes.
Just for a normal walking pattern.
I'm exaggerating right now.
Obviously I don't walk like this, but work on that.
If you're, a lot of people when their hip is still weak
and they wanna ditch the cane or ditch the walker too early,
they're gonna start walking like this.
- Yep, that's a very good point as well.
- If you're walking like this,
you ditched it too early and get the cane
or the walker back.
You want to be strong in your hips.
You don't wanna fatigue it early and be walking like this.
- You're not doing yourselves any favors
if you try getting rid of assisted device too early.
That's for sure.
- Yeah, so don't be ashamed that you're still using it.
You'll get rid of it eventually.
Just definitely use it for a while.
- All right, subscribe to us and.
- Check out more videos related
to the total hip replacement fitness program
at bobandbrad.com/programs.
- Thank you.
- Thanks.