- Bob and Brad
the two most famous physical therapists on the internet.
- Hi folks.
I'm Bob Schrupp, physical therapist
- Brad Heineck, physical therapist.
- Yeah. Together, 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 & Brad Crew.
Both are physical therapist assistants
and both have been providing treatments
to our patients for years. They do
- Fantastic work
- Fantastic work.
- We're very happy with all their work with their patients.
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of their material that they're bringing up.
So they're showing you our treatment
through them with their experience.
And it's been a,
- Exactly
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Enjoy the video.
- Good luck.
- Hi folks.
I'm Alex, physical therapist assistant
- I'm Mike, physical therapist assistant.
- And this is the total knee replacement
fitness program exercises immediately after surgery
- Immediately right away.
Probably the day you have surgery, later that afternoon.
- Yep. This is right after you wake up.
These are some things you might wanna think about.
Three goals of this phase, right after surgery.
Number one, preventing complications with your breathing.
Your heart and your lungs have been through a lot.
They need some recovery period.
This is gonna be a big goal to get them
up and working again.
- Yep. Goal number two is to increase circulation
of your legs and your feet to prevent any blood clots
from forming and to help the swelling in your legs
helping decrease the pain you're experiencing.
- Yep. So those three goals, 1, 2, 3, and then note
we wanna note, this is important, very important.
Get ahead of your pain with your medication.
Your doctor, your surgeon,
he'll have, you know, kind of
like a protocol to follow, you know,
what he wants you to do for pain.
Don't think "I'm too strong for that," especially right
off the bat, you can get behind in your pain management.
- Yep.
- And you can struggle from there.
- They'll probably puts you on a, a schedule of when to
take your pills, however many hours.
And then over time, you know, within the first month
you'll slowly start to wean
off of them and just take them as needed more. So
- Yep. But once you fall behind,
it's hard to catch back up. So
- Yep.
- All right. Into the exercises.
There's six exercises in this phase
We can do number one together.
Cause we both, we have a lot of stress in our lives.
All right.
Number one is deep breathing
and I don't wanna get too technical with this.
I mean, keep it simple.
Basically. You wanna breathe
in through your nose, inhale and, and out through your mouth
and you wanna exhale longer than the inhale.
- You can go different time in durations for this.
You can inhale for three seconds, five seconds
whatever your lung capacity can handle.
Just inhale slowly through the nose
and then blow out through your mouth.
- Smell the roses, blow out the candles.
And this is for pain and relaxation.
- Yep.
- And repetitions, it's hard to say.
You might have to do this once every hour.
You might have to do it once every 30 minutes.
It just depends on how much pain you're in.
- Yep.
- So. All right. Number two.
- Glute sets.
So for this, I'm gonna lay down.
- I'm gonna get outta the way.
- So the green tape represents me having surgery
on my right knee.
So I'm gonna lay down.
Are you gonna gimme a pillow?
- Oh, you need one?
- Yeah. Isn't this like a hotel?
- There you go, sir.
- Okay. First things first, gonna lay flat
on your back and all you're gonna do is squeeze
your butt cheeks together.
You've probably done this
in the pre-surgery exercises as well.
So I'm gonna squeeze.
- Yeah.
- I'm gonna hold it for at least five seconds.
3, 4, 5.
- And do about 10 of 'em probably.
- I'm gonna relax.
- Yeah. This is good for circulation, you know
and you're not necessarily strengthen
strengthening the affected body part.
So you're just circulating blood
getting some strengthening started.
- Yep. And then the stronger all your other leg
muscles are, the more pressure it'll take
off your knee while it's recovering.
- Yep. All right.
Let's move on to the next one.
This is more of a positioning thing
than an exercise, but hey, very important.
- So we have a foam wedge here.
We can link one down below if you wanna buy one
or if you just have a bunch
of pillows at home, you can use pillows.
It doesn't matter.
- Yep. So this is for swelling.
So Mike is elevating his legs above the level of his heart.
You can see his legs are above his heart.
- Yeah. Legs here, heart here.
So whatever way you have to do that
you can do it in a recliner
if your recliner goes back far enough
but this is, you know
right away when you're probably still in the hospital.
- Yeah.
- I dunno if you're gonna have a recliner in your room
but if you do just make sure the position
your heart is lower than your legs.
- Yep. Because the fluid,
the swelling will go down your body
if it's elevated because the gravity towards your heart,
your heart will pump it out and then you will
- Eventually excrete it through your urine.
- You will pee it out.
- And after a knee replacement, we don't like to have you
in a bent knee position
- too long
early on it's okay, just to get by,
but try to put, you know, as many pillows
as you can to keep it as straight as possible
as much as your pain lets you so
- And onto number four, exercise is ankle pumps.
Yes. You can do it in this position.
You can do it on the other position I was in before.
It doesn't really matter.
All you're gonna do.
You're probably in the way of my ankles.
- Pump those ankles.
Am I outta the way? All right.
- So just pump the ankles up and down.
You can do as many repetitions as you want.
You can do this seated on the edge of the bed.
Doesn't really matter which way.
You can do 10 to 20 reps of these.
Do 'em as often as you please.
- Again, great for circulation.
- These are a good one when you like
wake up in the morning or you just wake up
from a nap and you're like really stiff and you're sore.
You just wanna start moving, just
You don't even have to do 'em together.
You can like alternate 'em
- Yep.
- Just try to control it a little bit.
- It'll feel good.
It'll feel good to do 'em.
- Yep.
- And then, you know every hour you're probably
gonna wanna do those.
- Yep.
- Then next one, number five. We're gonna ice.
- No, this is not an exercise.
- This is not an exercise, but
- It's important.
All right.
So I have two ice packs here.
You don't wanna put the ice packs directly on the skin.
So I'm gonna,
- You want something in between.
If you have thick pants or like jeans on,
that's probably fine.
If you have shorts on, like I do, put something there
- And you would like in a perfect world
you want something that's kind of pliable,
that's gonna mold around your new knee.
- Yep.
And even, and wrap the whole knee.
If you have two ice packs.
- Yeah.
- Put one underneath, one above.
- Sure.
- Um, you might get a cooler pack from your surgeon.
Some of them do that.
Those are super nice as well.
- Yep.
- You can make a homemade cold pack.
They're probably gonna send you home
with some sort of cold pack.
Yep. So use those wisely.
- The rule of thumb is 15 to 20 minutes
of icing and then rest for two hours between icing sessions.
- Yeah. Don't just leave it on
for like an hour till it gets warm,
do like 15-20 minutes. When you take it off
what happens is all the blood flow comes back
to that area and then you start getting all the nutrients
and it starts recovering faster.
- Yeah.
- So you don't wanna keep it on all the time.
You wanna like at least have it off for an hour
or so before you put it on again.
- Yep. It needs a break.
- Yep.
- And number six, this one, it might seem simple
but when you have a knee replacement, you know, early on
it's not real simple.
- Yeah.
- Just sitting at the edge of the bed.
That's a start. If you're up for it, standing.
Thanks for not hitting me in the head.
- I try not to.
- Standing.
- Or you know, Mike would probably have a walker here
in most situations. Walking, if he's, if he's up for it
- Just get position changes throughout the day.
It's gonna help a lot.
Don't lay in bed all day.
That's about the worst thing you can do.
That's what they used to do in the olden days.
And it took a lot longer to recoup for surgeries.
- Yep, yep.
- So get up and move.
As often as you can, don't overdo it.
There's kind of a gray area of how much you need.
This is how much you don't need.
If you're dizzy, super nauseous, maybe lay back down.
- Yep.
- But just kind of take it slow
- If you're not up for walking right away,
Don't feel like you're behind.
You'll catch up.
- Yeah.
- All right. Six exercises right after surgery.
Good luck.
- Check out all the other videos related
to this program on Bob & Brad slash programs.
- Thank you.