- [Speaker 1] (Singing) Bob and Brad
The two most famous
Physical therapists
On the internet
- Well, hello there folks.
I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- And together, we're the most famous
physical therapists on the internet.
- In our opinion, of course, Bob.
- Today we're going to show you
the six best exercises to do
before a knee replacement.
- Yes.
- And the fact is, you can actually do these after, also.
- Actually, the before therapy-
- Is very critical.
- Very critical and make a much better after surgery.
- So Brad's going to be a model here.
- Oh.
- Why don't we do the first one, Brad?
Lay flat on the bed.
- Oh, yes.
- Lie flat on the bed.
- Yes, yes, yes.
I'm going to, take a nap.
- And you could start, now if you don't have a knee glide
you can use a garbage bag.
- You're in the way, Bob.
- I know, but I'm trying to get you to work.
- Well, I know I'm going to show him what we're...
This is the goal to get some range of motion.
- Right, right. Where's the strap?
- The strap is right here.
- Oh you got it over there, okay.
- Mm-hmmm. I'm prepared.
Yeah. I'm not totally asleep
but the goal is to do this, to range your knee
but your heel is going to stick to the bed sheets.
- Right.
- So if you take a plastic garbage bag,
a bread bag, I've had people at home use a cookie sheet.
- That seems to work the best.
- Yeah. So you use whatever it takes.
Because that'll make a big difference
if you don't have any,
or the least friction is desirable.
We do have something we're going to show you in a minute.
That works really well.
- I Wonder it it'd work if you'd put your foot inside this.
- Oh, well, yeah, just in case things
don't go out well with the surgery.
Then you can thrown the whole leg away, huh?
I'll get her by.
My wife makes me do this on a daily basis, you know?
Yeah.
- There we go.
And then, you know, if you have a belt
or a strap like this, this can be awfully helpful.
You can put this around your leg.
It's nice to put it around twice.
- You can put it around the toe too, Brad.
- You can but the garbage bag gets in the way.
We'll try that.
Either way be creative and you'll see what the deal is here.
There!
And then you can-
- That works pretty good.
- Because when your knee's painful and after surgery-
- Right
- This is a pretty big deal.
- And plus you get a little bit of stretch.
- Yep.
- When you do it this way.
- Exactly. Yeah.
Because your muscles will not be working very well
because of the surgery.
So you're gonna need some assistance with the strap.
- I will show you a much better method.
- Oops.
- Oops I almost tripped over it.
- Oh.
- All right, Brad?
- All right, there we go.
Let's get this positioned properly.
Okay. There is a towel over there, Bob.
- This works really nice in bed.
- Yep. Now this is much less resistance, much nicer.
You don't need to get one, but if you want to
you can use it before surgery, after surgery.
If you just have arthritis in your knees,
they're very good for that to avoid surgery.
So I'm going to-
- [Bob Schrupp] Sometimes you want to put a towel
underneath the heel.
- A little more comfortable.
- [Bob Schrupp] Right.
- Just to get a little cush there.
Oh yeah.
Yes, yes.
And so we're going to go as far
as you can stretch that knee and then go back down.
If it's before surgery, you're probably going to go
all the way up to here and if you can, that's great.
You're going to do this for a couple minutes, at least.
Just to keep that cartilage and everything in there mobile.
- Yep. Get both [Inaudible 00:03:41]
you're going to find out works really well.
- Yep. All right.
- This really works well after surgery.
- It does because then that leg
is going to feel quite heavy, little painful.
- All right with knee pain,
the one muscle that tends to get the most weak of all
is the quadricep.
So that's the one we want to make sure
you work on strengthening.
So Brad, if you want to grab a pillow.
- I have one.
- Yep. And fold it in half. Really simple to do.
Now what he's going to do is push the knee down.
He's going to squeeze the pillow
and he's going to count to ten.
- One, two, three, four, five, six, seven, eight, nine, ten.
I'll go a little slower. One, two, three, four.
And so you go up to ten and then you relax.
- Right.
- And you do that at least five times
you want to get up to ten.
- Right.
- Ten repetitions of ten. Count.
The pillow really gives you something to squish into it,
Just makes it easier to get those quads working.
All right.
- And eventually you can do like three sets of ten.
- Right. Yep. Exactly. Good point.
- All right. Next one.
If you want to get a little more advance,
you get a coffee can and you wrap a towel around it.
This one actually is a sheet and towel all wrapped
up together.
- Yep.
- And you can just start working on some,
a different way of working on quadriceps.
- So that-
- And eventually you can even put some weight
out on the ankle.
- Okay. So we're just going to do this.
- Right.
- Shirt art quads I always call them.
- Yep.
- So then we get... Isolate that quad
with this open chain we call it.
- [Bob Schrupp] Yep.
- You know, if you're going to use a coffee can, get one
of those metal ones.
They still sell them.
- [Bob Schrupp] Right.
- Yeah. My mom prefers the metal ones.
- All right.
Then it's very simple.
Bend the left leg, Brad.
- Yep.
- And you're going to do straight leg raise.
- Ah, yes. Now this is one of those things where-
- That's going to get the hip, too.
- Yeah, yep. And to start out with, you may do this
with your... if you do have a long belt
or a strap and just to start out with because-
- A little assistance.
- Yep. And that can make a big difference.
Bringing this leg up helps a lot.
- Stabilize the back, too.
- Yep. Yeah. You'll find it much, much better.
And then after you don't need that, then we'll go here.
You just go up as high as you feel comfortable, you know,
you're not going to get it up to here
and if you are you're probably pretty athletic.
- All right.
This is one, a lot of people don't like Brad.
- What?
- Because it can become painful after a while.
- Oh, yeah.
- We actually put this under the heel.
- Yep.
- There's not much gap here
but there's enough that we put strips on here,
especially because a lot of people
don't have full extension when their knee-
- Yeah, it may only go to here.
- Right.
- And then the key is to relax
and let gravity try and straighten it up.
- And keeping your toes straight up.
Don't let it curl. I mean, not curl, roll off to the side.
- Yep. Actually I don't know if we can get that other view.
There you go. Beautiful. It's our new camera. New toy.
Anyways. Yeah. Get that toe up.
Try and keep it that way.
- Now, I think with the knee glide
this works even a little bit better too.
- Right, it does. Yep.
- I'll take that too, Brad.
- Oh, oh. Oh, I see. Sure.
- See?
- Beautiful.
- Yep. Yes.
- Yep. Then you get that-
- [Bob Schrupp] Slide.
- Yep.
- [Bob Schrupp] That's going to make it
straighten even more.
- That's the difference from nice to beautiful.
- [Bob Schrupp] Yeah.
- And you know you could put the cold pack on your knee,
do you-
- [Bob Schrupp] Sure.
- Do you have one around here?
- [Bob Schrupp] No, I don't.
- Oh, I thought you brought one in.
- [Bob Schrupp] No.
- Yeah. And that, that makes it feel better.
Plus you get a little weight on there.
If you want to get a little more aggressive with it.
- It's definitely a good time after the surgery
to put the ice pack on there and stretch at the same time.
- Right.
- All right. The final one, Brad is in the seated position.
- Ooh. You want me to get over there?
- Yeah. You can do... Again you can take your garbage can
or you can actually... a garbage can, your garbage bag,
or you can actually just do bend and straighten like this.
- Yep. Sometimes I'll have, you know, my patients kind of
grab here for a little support
and they feel a little better with that.
That's up to you.
And-
- What I like about this one,
you can do it throughout the day.
I mean, if you're at your desk
but that's where the knee glide comes in too, because...
And Brad do you want to show
some of the other advantages of the knee glide?
- So we're going to get it as far as we can.
And we've found with a number of patients,
when you put it up on the stilt, you get this downhill
and it seems to make the ankle work better.
- [Bob Schrupp] Yeah, a lot easier on the ankle.
- And even that little bit of a downhill angle
can make a big difference.
And then you take your other foot to give a little
over pressure, which is...
after surgeries, you really need to do that.
- [Bob Schrupp] And even before,
I could trust will it be helpful.
- When you get stronger and you don't need that downhill,
then you want to get the hamstring stronger, this up,
then you turn it the other way.
This is a lot harder than it looks, by the way.
- Yeah.
- That's amazing. All right.
- [Bob Schrupp] All right. That's it Brad.
- Oh, really?
- The top six exercises you're going to do
before a knee replacement.
and after a knee replacement.
- This is feeling pretty good.
- All right.
- Great
- Good luck with that knee.
- Thanks.