♪ Bob and Brad the two most famous ♪
♪ Physical therapists on the internet. ♪
- Well, hi there folks.
I'm Bob Schrupp, physical therapist.
- And I'm Brad Heineck, physical therapist.
- Together we are the most famous physical therapist
on the internet.
- In our opinion of course Bob.
- And today we're gonna talk about top five mistakes
after total knee replacement.
- Total knee replacement, that's right Bob.
Bob, there's over 800,000 total knee replacements
in United States every year.
I think COVID year kind of threw that.
- You found it.
- Yeah, I did my homework. - Good.
- The COVID year did throw off that number--
- Yeah, I bet it did. - A little bit but this year
hopefully it's gonna get back to normal and...
Anyways, they're very common and the vast majority
I would say 90 plus percent have good to excellent results.
There's a few that don't and if you make some
of the mistakes we're gonna talk about it's gonna put you
a little closer to the having problems and these mistakes
can easily be corrected just go through them all
and you'll see.
Do this before you get that knee replacement,
it would be helpful.
Plus, Bob you wanna tell them about
our exciting program thing? - Sure.
Actually we have a program that lists all the exercises
you should do.
Prehab, posthab and--
- The extended-- - Yeah, long-term.
- What you should do, shouldn't do.
There's ten videos all together.
- I (indistinct) for a minute there.
And you just gotta go to bobbrad.com.
Go to the program section,
look for the one on knee replacement and it'll give you...
We don't have pictures but we have PDFs that
list the exercises.
- Right, and so you look at the video,
print out the PDF. - Right?
- There's 10 videos total.
It covers the whole program from before the surgery
till 12 weeks after their surgery.
Everything you need to know and it's completely free.
It can really be helpful to do work out before the surgery.
It'll make your surgery go a lot better.
- Absolutely. - Results.
- That's a must in my mind. - Yeah.
- Yeah, so shall we get on with the five big ones Bob?
The five big mistakes.
- So Brad and I will sit down with the patients that we had
which were thousands. (Brad laughs)
I mean and we would go through these five steps each time
when I first seen them.
- Yeah, and we would make sure that we continually reviewed
them and kept them on track. - Right?
- That's a big thing about going to see a therapist.
The first one is the prehab which we talked about.
This is...
Some people don't do the prehab exercises.
Some surgeons recommend that they have to do a prehab
which is great, some may not.
You can go to our PDR program section
and there's a 10 minute video on some simple exercises
to do before.
Posthab is after surgery. - Right.
- Almost everyone gets to see the therapist.
You're gonna get a nice posthab.
We have-- - And then wait
We'll give you exercises to do with that too.
- If you wanna get back to golfing.
I've had one person go back to skiing.
I don't know if the doctor recommended that
but he was doing it.
And also we wanna talk about the part of the plan
is get your house ready for when you come back from surgery.
You gotta get rid of the throw rugs,
arrange the furniture so you can walk around.
- There's a good chance you won't be able to go upstairs.
so you're gonna probably get a bed downstairs or maybe rent
a bed especially a hospital bed that can bend and flex and.
- It's gonna depend on your ability prior.
If you're a 45, 50-year-old which do get total knees now
you won't need as much of this but still better to be safe
than sorry. - Right.
And is there a bathroom downstairs?
- Yeah, that's a big one, obviously.
So make sure you have this plan with all
of those ingredients. Number two.
- And you might need some help too.
- Yeah, make sure someone's there to help you.
A spouseling, a family member, friend.
Okay, stake number two.
Stay consistent with the pain medication as prescribed
by your doctor.
There's some people out there that really would like
to not do pain meds but if you have the pain under control
it's gonna get your range of motion.
Everything's gonna be more pleasant,
it's going to be more fun.
- Well, the one thing you don't wanna let the pain get out
of control so if you say,
"I'ma tough this out."
By the time you realize that I can't tough this out
it's almost too late to take the medication.
- Right, 'cause there's scar tissue being laid down
every day and if you don't get the motion it will stiffen up
and it can become a real problem down the road.
So stay with your pain meds.
- You're not gonna become addicted to the medication
in one week so--
- Especially if you do it according to the schedule.
- By the doctor.
- And they'll tell you,
"Take your pain meds about one hour before therapy
so therapy goes better." - Right, exactly.
- That can be helpful.
Okay, Bob number three we're gonna focus on range
of motion, ride away.
- So we're talking about bending the knee as far as it'll go
and extending the knee as far as it'll go.
You're gonna get the strength back.
It's gonna come back eventually but the range of motion,
scar tissue as Brad mentioned before is beam laid down
and it could really hinder.
- Right, by the next after surgery,
by the next day scar tissue is forming.
The surgeons are gonna say,
"Get that knee moving.
"You're gonna have a therapist with you."
But nowadays, oftentimes it's a one night only.
You have the surgery and you're going home--
- And you're gone.
- You gotta get it in your mind you're gonna keep that knee
moving but follow the program or go to our program section.
- It's a race against scar tissue.
- That's right.
So when you're sitting in the chair they're gonna have you,
throw a towel on a shiny floor so you can move your foot
back and forth.
We use our knee glide which works really well on carpet.
You wanna keep that moving but remember you wanna focus on
getting it straight so you're gonna work this end range.
- Brad, why don't you show how you can bend it too
by using the other leg?
- Yeah, good idea especially if you've got something that's
a slippery floor or the knee glide you're gonna come back
to here and when you start you may only get to about here
and then you gotta take your other foot and push and make it
hurt a little bit and then you come back and push.
The one thing I discovered in working with (indistinct)
is the people is that they like to be under control.
They don't want me push it on it, they'll push out.
- And they'll get better range of motion 'cause they're more
relaxed as opposed to--
- They trust themselves more than they trust me.
- Well, that's understandable.
(Bob laughs) - Yeah.
- But no, it's just a natural human instinct that when
someone is giving you pain you tighten up more--
- Right, exactly. - As opposed to yourself.
So really work on that range of motion
probably three times a day typically.
- At least three times.
I mean that's minimum.
- Yeah, 15 to 20 minutes on your exercises.
Number four is, this is really important as well.
Keep it safe but you need to get your walking every day.
Obviously you're not gonna go outside right away
but that's the part of the plan in the beginning
of the number one, make sure there's an area if you can
to walk in your house.
- Yes, a little track.
- Sometimes people walk around the kitchen table,
sometimes people can walk down the end of a hall and back
or sometimes they have like a island they can walk around
in the kitchen and count laps.
And you know they'll...
You know your therapist will give you instructions on this
which leads us into the next one.
- Well, I also wanna mention Brad
don't progress to a cane too quickly.
My mother-in-law did this.
- So she had a walker--
- She's doing better and she goes,
"Oh, I feel better."
So she goes to a cane and a range of motion plummeted.
It got much worse and I go,
"You're not ready for the cane yet."
And the knee wasn't ready yet so she went back to the walker
and her range of motion got better again.
- Yeah, so make sure...
And that's where it's really nice to have a therapist.
They're experienced,
they will let you know when you're ready so you don't have
to guess on that and then especially going to a cane
to (indistinct) ... - Right.
- So, and number five.
Lastly but not leastly is be careful about who you talk
to about your surgery in regards to friends,
families, anybody else who has had a knee
or had a knee at the same time.
- They're all are gonna give you their story
and they are not gonna remember accurately.
- Either two things are gonna happen.
You might get the person that tells you about their total
knee experience which was hell on earth.
- Right, awful.
- And it was terrible, and it was painful, it took forever.
They're in therapy for five months.
- And we're never doing this again.
- Exactly, and then you're gonna get the other person,
"Oh, three weeks I had full range of motion
and I was walking without a cane."
- "And I was dancing."
- And it's true.
There are extremes that way but typically it's a four
to six week thing.
You're gonna progress to without,
to a cane probably in four to six weeks up and down steps
with a handrail and a cane in four weeks.
And that's ball parking it.
- And quite often if you have both these done at some point
you'll find one was a lot better than the other--
- Was easier or-- - I mean it progressed
a lot quicker.
- Exactly.
- So don't compare yourself to your selfie.
- Right, and one thing I'd like to say Bob
is as a therapist I would never...
I always try not to schedule two total knee patients
for therapy if one was doing really good and one was doing
really bad because psychologically it's so depressing
for the person not doing so well.
They can't get to 90 degrees yet after five or six weeks
and here's someone who's after two weeks going to 120
and just happy as can be.
Never compare yourselves,
stick with your therapy and you're gonna get through it
- Sounds good. - All right Bob.
- That's some good advice.
- Now, should we tell him the details on how to get
to our programs?
- I thought we did already.
Well, go ahead.
- Did we?
Tanner?
- Yeah, you're gonna go to bobandbrad.com.
That's a website by the way.
You're gonna see our mugs on the picture
and go to program section.
Did we do all these?
- I don't know but we might have done it in the last video.
(Men laughing)
- Yeah, and then you go to the total knee.
Yeah, because you said knee replacement.
This is the part where you can turn the video off.
We're just badly and there's nothing of importance going on.
- A little dementia going on.
(Brad laughs)
- You can relate to that if you're getting a total knee
possibly, I don't know.
- Thanks for watching.
- Be careful.
(upbeat music)