♪ Bob and Brad ♪
♪ The two most famous physical therapists ♪
♪ On the internet ♪
(both clapping)
- Pump it up, Brad.
- Pump up the volume. - Strong Like Bull.
Hey 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.
- Should you have knee surgery?
Arthroscopic, replacement, meniscectomy,
we're gonna discuss it today in today's video.
- Sure, so keep your ears open.
But before we go too far-- - Eyes open, too.
- Oh yeah. - 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 every day.
Also, we're real excited, we're giving away something
really cool again right now. - Right.
- And we're gonna do it on our social media channels.
You can also join us on bobandbrad.com
and go to the Giveaways section.
- Sure. - Or Facebook, BobandBrad.
We're giving away the RENPHO Foot Massager.
This thing is awesome, isn't it, Brad?
- Yeah, it's for your feet obviously.
You stick both feet in there with your shoes off.
- Yeah that's right, (laughs) and your socks on.
You don't want to have stinky--
- Yeah, it does compressions for fluid reduction
as well as massage all at the same time.
- Yeah it's really comfortable, it really works well.
Today, we're gonna talk about the whole ranges of surgery.
There's the ones that are just the arthroscopic,
where they go in and sometimes they just
clean things out a little bit or repair the cartilage.
- Debride it.
- Or debride it, do the lavage where they do
a little bit of water and cleaning and all that but uh.
- They've got a number of procedures they can work with.
- All the way up to hip, knee replacement.
- Sure.
- We're gonna discuss the two.
So the first one we're gonna talk about is
the arthroscopic surgery, should you have it.
You're having knee pain, you're having problems
and you're like, "they found out I have a torn
meniscus or something."
- Sure.
- Or torn cartilage, should they go and
do this?
Well according the guidelines by the Royal
Australian College of General Practitioners,
they developed these guidelines both in
2009, now they revised them in 2019.
- Oh, so just this year?
- Yeah.
- Okay.
- They have a strong recommendation against
arthroscopic, minescectomies, cartilage repair,
unless the knee is locking on you.
- So, it literally it locks up.
- Right.
- You can't move it, it's painful typically
during that episode and typically it unlocks,
you get it to move around and then you're okay again.
If you have that, you probably have like a floater.
- Yeah.
- A mechanical.
- The meniscus or cartilage may have folded over
on itself.
- Sure.
- So there's something that they do need to go in
and take care of.
What they're often finding is that if you have it,
you don't have a locked knee, is that quite often
the knee is not gonna be any better then if
you went to have the surgery in a few months
or a few weeks down the line.
- Sure.
- So.
- Yep.
- It's just they had a strong recommendation,
it wasn't just a recommendation, it was a
strong recommendation against it.
- Okay.
- All right how about knee replacement?
Now that's a whole different story.
You're getting to the point where things are bad,
these are some of the questions
you should ask yourself.
I have them written right down here Brad.
- There you go, I'll document it.
- Number one, this is the first question you
should ask yourself.
Have you tried less invasive measures?
- All right.
- I mean have you tried Bob and Brad's therapy?
- Right we give a, we have a number of videos
on range of motion.
Keep that knee moving the best you can.
There's options that you can.
- Have you used a cane?
- Right.
- What we find is arthritis and knee joint deterioration
it tends to flare up and it tends to calm down.
- Sure.
- So, you know, make it through the tough periods
and maybe your life isn't gonna be so bad.
- Right.
- You know, it'll get to you.
- Or you know, get the range of motion better
you may have a real pleasant experience and a long,
you know get a lot more life outta that knee.
- They do recommend by the way that guidelines,
they said you can definitely try injections
as far as steroid type injections.
- Steroid but not the Rooster Comb.
- Not the Rooster Comb.
They did not, they recommended against that, so.
- And that was the Australian study?
- Yeah.
- Okay.
- So again, you can look that up.
The Royal Australian College of General Practitioners
it's for non-surgical management of hip and knee
osteoarthritis, so.
- Okay.
- If you have either.
Second question.
Are you needing help right now doing your daily life
because your knee is so bad?
- Right.
So getting up and down stairs becomes a real problem.
You're going one step at a time,
favoring the sore knee.
- Or you can't do certain things because of it.
You're relying on other people.
- Right.
- You're becoming a burden.
- Exactly.
Trying to, you no longer can squat down.
- Yeah you can't clean the floor, you can't.
- Right.
- So you can't wash my or polish my shoes, Brad.
- Go on Bob.
(Brad laughs)
- I don't know where I was going with that.
Do you have really bad pain daily, does your pain
continue even when you're at rest?
- Mm-hmm (affirmative)
- That's starting to be a sign then that
things are getting bad.
- Right.
- Another one is if it's hurting at night.
You know you went on it all day and it's not
allowing you to sleep.
- And that's a chronic thing.
- Yeah.
- It's just not for a night or two here and there
throughout the year, it becomes a chronic
nightly situation and with knee pain,
people know they have arthritis often times.
They don't wanna do surgery which is completely
understandable but however, there it gets to be
that point where.
- It's time.
- How many patients have you had, after their
knee surgery say, "I wish I would've done it
years ago."
- Yeah.
And you know that's a good point to make as far
as how long does a knee replacement tend to last Brad?
- Well I think now they're saying 15-20 years
is not uncommon.
- Right.
So you gotta keep that in mind.
Yes, you know if you're younger, you may
end up having another one.
But to me you have to weigh that against,
do you really wanna suffer the next year or two
or three?
- Sure.
- When you could be enjoying some of the best years
of your life?
You know what I mean?
- Right.
Yeah, if you're 55 and your knee is so bad
that you're having a hard time doing things.
- Right.
- If you get a knee replacement it brings it
back up to 80 or 90 % of your normal activity.
- Right.
- The rest of your body is there, your mind is there.
- Right.
- You've got those 15 prime years of life.
If you wait 15 years and you're 75,
you get a new knee, well you're knee's good
but other things might be falling apart.
- Yeah.
That's a good point too is that whether or not
you'll even be able to have the surgery.
If you medically can tolerate it.
- Right.
- I mean, you need to ask yourself that now
because if you ask that, and you can't,
well then, this is done.
You don't need to watch this video.
- Sure.
- But if you can tolerate it now, are you going
to be able to tolerate it 10 years from now?
You may not.
- Right.
Especially you know, yeah there are some
conditions that if you have some
pre-existing conditions.
- Yeah.
It happened to my grandpa.
He waited too long and I mean he lived into his 90's.
- Yeah.
- He should have had hip surgery replacement
and it ended up disabling him because he just
kept putting it off.
- Right.
- And then he couldn't have it.
- Sure.
- It was too late.
- A lot of things to think about.
- Yeah it is.
Are you tired of being reliant on medications?
Because medications can have side effects too.
You were mentioning Brad.
- Yeah, ibuprofen, you know your stomach.
Is your stomach gonna take it?
- Right.
- Your liver?
- Liver.
- Right.
- So you could be doing damage by being on
high levels of ibuprofen.
- Chronic, like you're doing it.
- Yeah.
- Months and months at a time.
- Um, I had mentioned earlier,
is it keeping you awake at night.
You know the question I really ask a lot of people
the final question is,
are you just sick of the knee pain?
- Yeah.
- You know.
- Yeah.
- I mean.
A lot of people go, "yes I'm just sick of it."
Well it's time then.
(Brad laughs)
The other one I'll bring out too is
a lot of people go, well they're just hobbling
around like this.
I'm like, and they're going, "I just don't
wanna have the surgery."
I was like you know, you really, it's
very evident to people that you've got a problem.
(both laugh)
there was one girl at one of the nursing homes
we were at.
She's hobbled for years and she finally
had the surgery done.
It's like, it's just weird to see her
walking normal.
- Sure.
- Because I was calm.
- She was an employee?
- Yeah, she's an employee.
- Yeah, okay, sure.
You know and the other things is, if your knee
is getting so bad that you compensate your
walking or your gait, you could throw your
hip or back or other knee off because of the bad knee.
- Absolutely.
- The bad knee is causing other problems in your body.
So we don't want to get to that point either.
- My tendency on knee replacements is
to honestly, sometimes, is to have them more
sooner than other people think.
- Mm-hmm (affirmative)
- That's my opinion.
I just think that some people, yeah, like you said.
Too many people wait too long.
- Right.
And I don't know exactly what the stats are
but I'm quite certain you can say 90% do very well.
- Very well, yes.
- And you hear some of the horror stories of
people who had problems.
I've worked with them but I would say.
- It's so rare.
- Yeah.
- And some of them, the reason they have
problems is because they waited too long.
(Brad laughs)
I mean seriously, I had some people that I think
you know, they had so much contractures
already in there.
- Right.
But you know for your knee, just take this with
a grain of salt, listen to us, talk
to your surgeon about it.
- Talk to your surgeon.
This is a decision you make with you,
your family, the surgeon.
- Right.
- You know.
- They're the big players.
We're just throwing some good things to think
about for questions.
- Yeah.
That's right, food for thought.
- There ya go.
- All right.
Thanks everybody for watching.
- What about the broken heart Bob?
- Oh.
Do you wanna say it?
- Yeah.
- We can fix just about anything.
- Except for
- A broken heart.
- There you go.
We got time, nine minutes.
- All right.
(Brad laughs)
We're working on it, we're working on it.
(musical note)