♪ Bob and Brad ♪
♪ The two most famous physical therapists on the internet ♪
- Hi folks.
I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- We are the most famous physical therapists
on the internet.
- Oh, and our opinion, of course, but.
- Right.
Today, Brad we're gonna talk about best sleeping position
after a total knee or total hip surgery.
This is your baby.
You gotta take it away, Brad.
Talk.
- Did we do the intro yet?
- Oh yeah, we just did the intro.
- And our opinion, of course, Bob.
- Yes, we did all that.
I was really
thinking about this. - Yes, you really are
out of it today there, so. - Okay, yeah.
So sleeping position.
We really want to talk, you know,
a lot of people, you gotta get your sleep,
but you gotta protect the injured
or the the involved knee or hip,
whichever you had the surgery on.
So you gotta attend to that.
But if you don't get your sleep,
we were just discussing
this before. - Yeah, we were having
this discussion in depth.
I mean, it's imperative that you get sleep.
- Right.
- 'Cause that's how healing happens
and that's how you're gonna be able to participate
in rehab during the day.
- Right.
- But if you're tired and crabby,
it's just not gonna work. - We've both had patients
that are coming, "Oh we didn't get any sleep last night."
- Right, and it just doesn't go well.
- Yeah, you're not very productive.
So these are some tips that you're gonna wanna use
after your surgery and have good success.
- Yeah, now, if your doctor's saying
that they want you in a certain position,
you gotta follow their guidelines.
- Right.
- But we're gonna tell you, you know,
basically what we'll tell patients
if there aren't any specific guidelines.
- Right.
- This is what we tell our people.
- Okay.
- By the way, our people.
- Oh, there they are.
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- Yeah.
Sooner or later.
All right.
TKA, that's what we call it.
Total knee arthroplasty. - Knee arthroplasty.
- You got a new knee and you need to sleep.
Well, they're gonna help you in the hospital.
You're gonna be kind of drugged up a little bit.
When you get home,
you may forget some of the things they tell you.
So look at this video and we'll cue you in.
- Okay.
- First thing you have a pillow under your head.
- All right.
- That's important.
- Sounds good.
- The next thing, hopefully you may need one of these.
- A leg lifter
- To get in and out of bed
without injuring or hurting the knee.
And they work nice.
You get under there, under your foot
and you're not gonna wear your shoes to bed like this.
But you know, you might lay down on the couch for the day
or the bed in the middle of the day with your, you know,
your slippers on, depending on your, what you like.
And you're gonna get up there and here.
And now, one thing's for sure,
if you're watching this before your surgery,
you're not gonna sleep on your stomach at all.
If you're a stomach sleeper,
you're not gonna do it after surgery.
- Right. - Okay.
- That one's ruled out.
- Right.
- For sure.
- Okay.
The next thing is the pillow under,
A lot of people wanna put the pillow underneath their knee
because it's gonna feel good that way.
- [Bob] Right?
So this is a no no.
- Right.
- Because they don't want the knee bent all night long.
- Right.
It's all right. - But it'll feel good,
but you can't do that. - It'll be okay.
So we would suggest
putting it underneath the calf like this,
the length of the calf - Sure.
behind the foot too. - Yeah.
- And that way you're getting the knee, it's going,
you know, it's trying to go into straightening extension,
but it's not putting it into the harmful flexion.
- Right.
And if you do put it way down here,
it's gonna give you some good extension
to straighten it out, but it's probably gonna
be very uncomfortable. - Yeah.
You probably won't be able to sleep that way.
- Five or 10 minutes of that
and you'll be very uncomfortable.
The other thing I did wanna mention, Bob,
particularly if you're a diabetic or have fragile skin,
the heel, it's nice here to have the little.
- That's a good point.
- The air gap so that you don't get a pressure.
- So there's no pressure on the heel at all here.
- Right. - Which again,
it's surprising I've seen relatively healthy people
that were in bed.
I remember one that she was a physical therapy instructor
and she got a compression fracture
and she was in her 50s
and she would push on the bed with her heels
to get herself in position
and her skin broke down.
I mean, just from doing it constantly, you know.
So it's not hard to do.
- Yeah, even if you're younger
and reasonably healthy. - Yeah.
We consider 50 younger by the way.
- That's right.
Bob, let's get the wedge out.
- Okay.
There it is.
- Now with total knees,
you can use the wedge and I've used it on patients,
but there's some things you have to be aware of
because it bends the knee.
- Right.
- It's usually much more comfortable for people.
They love it, but you have to take a pillow or two.
Oh, there's one.
- What are we doing, Brad?
- [Brad] You gotta put it under the calf.
- [Bob] Oh sure.
- So gimme another one too. - So, another one, huh?
- Yep.
And then you go like that.
- So now you're getting some straightening at the knee.
- Right. - Yeah.
- And I've done this with people
who have swelling problems from the knee down
after their surgery and they're all edematous and swelling.
This elevates the leg to above heart level
which is a general ward.
- Yeah, remember fluid has to go down into the body,
into the abdomen - Right.
to be processed. - Sure.
- So it doesn't go out your toes.
So you gotta have something like this.
Now you could lay like this
for a short period of time, Brad.
I mean, if you were taking, you know
a 10 minute nap or something like that,
you could for a little rest period,
you could lay without the pillows.
- Sure, right. - Right.
- Even with the pillows,
I don't think I'd recommend that you're gonna sleep
eight hours like this.
- Sure.
- This is more for those needing to get some rest
during the day, you know, half hour, maybe an hour,
where you know you're gonna take it out
'cause if you lay like this all night long,
you're probably gonna, you know,
may come off - Off we go.
and you shift around a little bit, so.
- Sure.
- Okay.
Now with the total knee,
eventually within probably a couple weeks
you may want to go to side sleeping,
particularly if you've been a side sleeper all your life.
- Yeah, and your motion is starting to come along.
You're not as concerned
about getting the knee straight or bent.
You can start laying on your side.
And of course you wanna protect it.
- Right.
- By putting the pillow between the knees.
- Sure.
And you can lay on either side, you know,
as long as it doesn't hurt your knee, it's comfortable,
but put the pillow between your knees.
And then of course-
- Usually you have double pillows
if you're gonna be on your side.
- Yeah. - Oh, sorry,
I got you a little shock there, Brad.
- So yeah, you always, you got a bigger gap here,
and we've talked about this with other sleeping videos.
On the side, it's two pillows or double it up.
On your back, it's a thinner pillow.
You know, and you can do this.
This is comfortable.
You know, you're kind of rehabbing,
your babying yourself a little bit.
I'm gonna double that up,
put this pillow under my arm
and just get all snuggled in here.
- Well, sometimes we even take another pillow
and put it like this. - Oh yeah.
There you go.
- And then the arm really stays up there, so
Just, you know, contact, MyPillow
and order a dozen of them and you'll be set.
- Yeah.
Okay, should we go onto the hip?
- Yeah, let's go
onto the hip, Brad. - Okay.
- So after a hip replacement,
these are the things you wanna keep in mind.
- So some of these things are gonna be similar,
some not.
And one thing that will probably be similar
is you may need the leg lifter again
to get in and out of bed for that first week or two.
And then your leg will strengthen up
and you won't need that.
- Right.
- The next thing is again on the hip,
you are not gonna, if you're a stomach sleeper,
you're not gonna sleep on your stomach after surgery.
That's for sure. - Right.
- Okay, got that out of the way.
So pillows again, while you're on your back,
now if you had a posterior approach,
so they came in from the side
or the lateral posterior approach,
there's gonna be three precaution.
- Back or side.
- Yeah. - Yeah.
- There's gonna be three precautions.
You can't bend your hip past 90 degrees.
You cannot internally rotate it.
And then you cannot, what was the other?
Oh, head ducked. - What?
Head ducked, yeah.
- You can't cross your legs.
So when you're laying down,
you're not gonna cross your legs like this.
- Right.
- Okay.
And this one people rarely do,
but you can't let your toe point inward.
- Right.
- Most people never do that anyways.
And then, but you can put pillows under your legs.
- Yep.
Two. - There you go.
- Give me a couple, Bob.
Oh yeah, that feels good.
But the wedge.
- I was gonna say,
they can use the wedge.
- Yep, that's not like the knee.
- Right.
- You can use the wedge.
- And it actually puts the hips
kind of in a comfortable position.
- Yeah.
- Kind of a loose packed position.
- Right.
- And it often feels really good to be in this position.
- Yep.
- By the way, anytime we mention products,
we normally have a link towards it
to it down below in our description.
So it's in our favorite products.
- Right.
- Amazon. (Brad mumbles)
- I did wanna mention with this wedge
why it feels so good,
I think particularly with a hip
is the support right here-
- Gives all the way along the hip.
- On your hamstring right up.
And it does something that relaxes those muscles inherently.
We really like it.
So again, you're probably not gonna sleep
all night with this.
This is one of those things that
because it may get wiggled out of the way or whatever,
but it's a good thing if you're gonna take a nap
or just rest throughout the day
'cause you've been out doing your therapy
and you need, you know, rest or ice time
to put on your hip.
- Precisely.
- Precisely, Bob.
- Okay, how about eventually you can lay on your side there.
- Sure.
With your hip.
- You're gonna probably lay on the non-operated side, right?
- Right.
Yeah, if this was the hip that was operated on,
I gotta watch out
for my mic. - Oh your mic.
Same thing. - Yeah, if you got
a mic in bed,
you better take it out of your pocket.
Again, you really need to put the pillow between the knees.
And with the head, double your pillow up.
- Or use two.
And then you can-
- The same thing with the arms you can do.
- And my glasses are getting in the way, Bob.
- Yeah, they are (mumbles).
- I gotta tell you if you're gonna wear glasses to bed,
take them off.
And if you got these click ones like this,
they're pretty handy.
You can just put them over here.
There.
Oh!
- All right.
I don't know sometimes, you know,
we have people kind of even lean back
a little bit more like this. - Oh sure.
- And so it puts the pressure more
on the meaty part of the butt.
- Yeah.
- And the pillow back there kind of helps support them up.
- It's amazing what you can do it pillows
to get yourself comfortable in bed.
- Yeah.
Anything else we need to mention, Brad?
- Well, let's see here.
But I love it.
I think we're pretty much clear
with the exception of that one big problem
that we're having.
- Oh, that's right.
Brad and I can fix just about anything-
- Except for.
- A broken heart.
It should be somewhere out in this area here, so.
- Yeah, and that's well, the hip and the knee
are getting a little closer. - Put it back together.
Put it back together, so. - Yeah.
- Take care. - Thanks for watching.