- Do you have knee arthritis, Brad?
And are you thinking you need surgery?
- Boy, I've had that question asked to me
many times by patients.
- Maybe not. - Right.
- Stick around
♪ Bob and Brad ♪
♪ The two most famous physical therapists on the internet ♪
All right, before you consider having surgery on your knee,
you should definitely try these four or five things.
I mean, I want you to give a good effort towards it.
- Exactly.
These are things you can do at home.
- That's basically what we're gonna call a shotgun approach.
- That sounds pretty serious, Bob.
- Maybe we should change the word.
But we're gonna talk about first activity modification.
So for a trial period I wanted to get the knee to calm down.
- Mm-hmm.
- Knee arthritis tends to flare up and it calms down.
So, for a little while I'm gonna recommend you use a cane.
- So, this would be my flared up knee.
I'll just pull that up.
So if it's flared up,
and you keep walking on and hurt it,
then it just continues to flare and irritate it.
- Right. - We wanna give it a break.
Take the weight off it by using a cane.
This is a family heirloom anyways.
You probably will have a modern cane
that you can adjust to get to the right height.
But you're gonna use the cane in the left hand
if it's the right knee and we're going to walk like that.
And I've never had anybody with knee pain or hip pain,
and I gave 'em a cane, and I say "Can you walk with them?"
And they'll say, "Well, yeah, that helps."
Sometimes it's not enough to warrant them
giving up their dignity for the cane.
- It always helps. - Yeah.
- It always helps.
I mean, I would highly recommend this one.
I mean, for me, Brad,
quite often it's just this one thing
that makes a difference.
- Yeah, it's just quit irritating it,
let it settle down.
- Avoid stairs, avoid hills as much as you can.
- Yep.
- Use the cane just at home if you
are really self-conscious about it.
- Yeah, that can be an issue.
- Number two, you're definitely gonna need
some physical therapists.
- You gotta drop to that level.
You gotta go to the therapist.
- No, you wanna try some things that we're gonna recommend.
So, the first one is, Brad,
you want to strengthen the quadriceps
which is the muscle on the front of the knee.
- Yep.
- That is the muscle that tends to get weakened
after you've had arthritis.
- When you have pain the body just kind of,
it tells that to turn off.
- Very simple.
Yeah, you take a pillow, fold it in half,
put your knee on top of it,
and you're gonna push down and straighten the leg out.
And like, you're trying to push the knee down into the bed.
- [Brad] Squish the pillow.
- Yeah, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10.
- So, he can count to 10.
- Three sets of 10.
(Brad laughing)
I'm showing off.
- You know, you can do this one in a couch.
That's pretty nice.
'Cause if you can lean back a little into the arm rest
it's a little more comfortable and watch TV a little.
- Very good.
All right, Brad, how about extensions?
- Ah, yeah, so extension.
Getting the knee straight often times
can help more with walking than flexing it.
I wanted to see, check your knee
that it does go fully straight.
You can compare it to the other one.
Let's say this one goes straight like that,
and or is it this way?
This one goes straight,
and this one only goes that far and they're not even.
So I'm going to-
- Very often it's very subtle.
- [Brad] Yeah. - Yeah.
- So you're just going,
you can do it on the edge of a chair like this,
and push down above the kneecap gently.
And push maybe five to 10 repetitions.
If you have a stool, an ottoman at home, that can be used.
- Yeah, Brad, you wanna also show
that you may wanna turn the leg out,
or turn the leg in.
- Yeah, and that's where it works in handy
when you do have it up on here.
Are we looking from the other side, Ted?
This is kind of fun.
Yeah, rotate to the outside and then try to push down.
See how that feels versus neutral or straight up,
and then in.
Now I found with my patients,
oftentimes it was going to the outside
that would allow it to get better range of motion
and feel better.
But that's, you know, that's why we try everything.
- We are also gonna stretch it the other way.
Into bending.
So, you just, you scoot your butt forward in a chair.
- This is one time we allow slouching.
- That's right.
And then you just go ahead
and reach back down and pull back.
- [Brad] Yep.
- The same thing,
pressure on pressure off, maybe 10 repetitions.
- Yeah.
It may vary if you put your hands up closer to your knee,
or farther down by your ankle, see what works best.
It works best if it feels better,
and gets range of motion better.
- The other thing,
throughout the day I like to see
that you have some repeated movement without weight bearing.
So, all you have to do is do some of these.
- Right, five to 10 of 'em,
particularly before you stand up
if you've been sitting for a while
- If you want,
you can make it very simple using the knee glide.
- [Brad] Oh, yes, let's just use that.
This little device that-
- And you can use that for a half hour at a time.
- Yep, and now Joni, our office manager has got-
- Is doing this, right.
- She's 64 now.
Waiting for the magic age to get hit that, you know?
- Sure.
- Boy, she says this is working very well for her.
- Awesome.
- So it works well to get on an angle.
That'll help the quads a little bit more versus this.
What's next, Bob?
Another one you could do in bed
is actually sit up like this,
and put a rolled towel underneath your heel,
and trying to straighten your leg that way.
- [Brad] Yeah.
- And- - This bump right here
makes a big difference.
- Right, and you can do it,
put a cold pack on there while you're doing this.
- [Brad] Yep.
- Now, if you want to get fancy,
you could even put this on the knee glide.
- [Brad] There we go.
- And now it's gonna straighten a little bit
while it's all trying to straighten.
- [Brad] And then you can go up
and down with that a little bit.
Sometimes these little loose motions can be helpful.
- Exactly.
- Tip the toe out to the side, try it.
Tip the toe straight ahead.
To bad your your body's in the back
and we have our camera.
Can you see anything from that way?
That's alright.
- This actually works out really well.
- Yeah, it just, it's a beautiful thing.
- All right.
Number three.
Ask the doctor about using an anti-inflammatory.
You might just simply take ibuprofen,
or they they have prescribed, like, naproxen,
is stuff that's a little bit stronger.
Number four, ask your doctor or pharmacist about injections.
Is it time to try a corticosteroid injection,
or they also have injections that are lubricants.
- [Brad] Right.
- So, you're gonna have to ask them.
- We do have a really nice video.
If you Google "Bob and Brad."
- Well, we have Chris the pharmacist.
- Yeah, and he explains it in detail.
It's a very good video.
- I would without a doubt, try these four things.
I said four or five.
It's four.
(Brad laughing)
- Who's counting.
- Before you have surgery.
I mean, it's gonna help you when you do have surgery.
- Right. - If you do.
- Yep. - And it may
delay it for years.
- Right, absolutely.
- If not forever.
So, remember Brad and I can fix just about anything.
- Except for?
- A broken knee.
A broken heart. (Brad laughing)
A broken heart.
- Broken knees are hard to fix for us.
That's usually surgery.
Well, or you know, a cast, but anyways-
- But we're working on it.
- Now we're babbling.
We're trying to cut down our babbling.
- That's right, we're working on-
- They've tuned out already.
(upbeat music)