♪ Bob and Brad ♪
♪ The two most famous physical therapists ♪
♪ On the internet ♪
- Hi folks, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- Together we are the most famous physical therapists
on the internet.
- In our opinion, of course, Bob.
- Very delusional.
Today, we're gonna talk about,
is it time for you to get a knee replacement?
Lots of things to keep in mind.
And we're gonna present you
with some of the questions you should ask,
and maybe, this'll help you come to an answer.
- Sure.
- First off, just because you have knee arthritis,
it does not mean it's gonna get progressively worse.
They've done studies that have shown
that knees can stabilize and even get a little better.
So don't assume that, "Oh, I got arthritis.
I'm gonna have a knee replacement anyway.
I might as well do it right now."
Not necessarily.
So, first try physical therapy,
and there's anti-inflammatory drugs and shots,
and there's all these things that you can try.
- Right, there's these supplements.
They're a little...
Not confirmed yet, but whatever.
There's things that diet-wise that may influence it.
- Right.
- It's not gonna make you worse anyways.
- So if you've tried the conservative approach.
and you're still experiencing some of the following issues,
you may wanna consider knee surgery.
So the first one, you will require pain medication
just to get through the day.
- Yeah.
- That's getting tough because that's a downside in itself.
Especially with the pain medication.
It's a stronger pain medication.
- Right, there's side effects to those that can be worst.
- Right, you don't wanna stay on an opioid
for any length of time.
If it's really interfering with your life.
Like it's preventing you from sleeping,
that's when it's really starting to go bad.
- Right.
- If you can't walk upstairs.
You can't get out of the chair very easy or the bathtub.
- If you can't work because of it.
- Yeah.
- Well, that's obviously something
that we gotta take care of.
- Right. Number three, your knees are stiff and swollen.
Like you get in a car or sit in a movie theater,
and you try to get up, and you can't even get out
of the building. - Yeah, you're stuck.
- Right.
It's funny, having my mother-in-law and stuff like that,
you can see why they start limiting the things they do.
We just were recently gonna take it to a restaurant,
and I don't think she wanted to go
because she was worried getting in and out
of the restaurant.
- Right.
It's painful; limping, you don't wanna be seen looking like
you have a problem, which you do.
So yeah, it's definitely a consideration.
- This is a knee replacement issue.
But number four, if you had a knee injury,
like an athletic injury and your knee's deformed, (chuckles)
or if you're born with a deformity,
surgery may be a good option to have.
- Yeah, especially know if you have valgus,
or you're knock-kneed or bowlegged.
That actually can be sometimes corrected completely straight
or at least improved from the surgery.
- Right, exactly.
The other thing is if you had a previous ACL tear,
so if you tore one of the major ligaments on your knee,
it's gonna wear out quicker.
It tends to wear off quicker
'cause the support's no longer there.
- Right, so assuming you didn't have it repaired?
- Right.
When your knee hurts even at rest,
it's starting to become a sign
that you may need to have surgery.
- And if movement...
You try therapy, and it doesn't seem to improve,
or it makes it worse with the appropriate type of exercises,
yeah, that's a good sign that it's time.
- This next one I think is a lot more common
in our generation now, Brad,
is that we wanna stay active.
- Sure.
- Just because we had knee arthritis or knee pain,
I still wanna hike, and bowl, and ski, and run,
and all those sorts of things.
You're very active. You just did a triathlon.
- Right, yeah.
- For God's sake.
- Yeah, for God's sake.
(Bob laughs)
But I remember skiing out in Colorado.
We had a ski vacation, and I'm going up;
and this is at least 10 years ago;
going up one of these lifts that hold four or five people,
and here's a guy, he's in his 60s,
and I was talking to him, he says,
"Yeah, I just had my knee replaced a few months ago."
- No kidding?
- Yeah.
- And he was going there?
- Yep.
He wasn't doing jumps.
He was obviously a good skier prior, and he wasn't learning.
So yeah, he just wanted to keep skiing, so he did.
- Well, Brad and I were talking before this video actually,
and I just saw, these were ads actually in Forbes Magazine,
so I think they're legit,
but this guy, he wanted to get back to running
after his knee replacement,
and he wanted to run 100 mile race.
The doctor said yeah.
- Really?
- So I don't know if that's always the case.
I don't know the latest on surgeries right now.
We're trying to get a surgeon on our show.
- Well, yeah, that is quite of a...
Just going back to running is typically,
from my experience, not advised.
- Exactly.
- But maybe with new technologies
or maybe the surgeon was - Maybe so.
- an unusual surgeon.
I don't know what to say.
- So this next one, I always ask people this,
"Are you just sick of it?"
Because there's people that...
It could start affecting your mental health.
Like you could feel like sad and hopeless
because you're having knee pain.
- Right, you're just spiraling down,
and it's time to get after it.
- Yeah, and a sign of that quite often
is you've put on weight or you lost weight.
One of the two can indicate
that your mental health is declining.
Consider these additional points.
Most artificial joints last 10 to 20 years, so.
- I've worked with people in their 80s or 90s,
and they've had a knee for 30 years.
- Oh really?
- Yeah.
- I think that that's the average.
It can go less. It could go more.
And depending on how much stress you place on it.
If you don't have to place much stress on it.
If you're running 100 mile races, (laughs)
you may wanna-
- Then make sure then- - You're gonna be
at the low end.
- Or like that Wim Hof guy.
- The Wim Hof- - Deadlifting 700 pounds,
just like, "Yeah."
Remember that picture? Mike, you know that.
- Oh, Kelly Starrett? Not Wim Hof.
It was Kelly Starrett from the Supple Leopard.
He had deadlifted weight after his knee replacement.
- Yeah, and he's PT, so.
- Yeah.
- Yeah, it shows how much you're gonna listen to that.
(Brad laughs)
- Yeah, exactly.
- I thought it was Wim Hoff for some reason. (chuckles)
Anyways.
- Another thing which you really have to keep in mind,
if you're not a healthy person,
you may wanna have the surgery sooner than later
because I've seen a lot of people that waited too long,
and they didn't pass their physical then.
And they said, "No, you can't tolerate surgery."
And surgeries are tough.
You lose a strength, endurance,
and you're gonna have a hard time returning
to normal activities.
- Right.
- So keep it in mind.
It's easier to tolerate these surgeries
when you're a little bit younger than when you're older.
My mom had two knee replacements.
Not at the same time, but the first one was a lot easier.
She was only in her 80s at the time.
(Brad laughs)
Last one was in her later 80s.
- I had a patient, his second one for sure,
he was like 92.
- I had a hip patient in the 90s.
- So that's not common, but it certainly is there.
- All right, if you wanna check out
our entire program on knees,
go to bobandbrad.com, go to the program section
and look for the one on knees.
And we have a whole series of videos,
how to treat knee problems, specific knee problems.
And after you've watched a video,
you can actually print out
- A PDF.
And Mike is saying, you don't have to print it out,
but you can do a screen shot - You can put it on
your phone.
- or whatever.
And there you got it with you.
And look at it so that...
You know, little reminders.
And there's absolutely no cost.
Not even email's asked.
- That's right.
- Which is pretty rare.
- We asked very little of you.
- That's right. Good luck with your knee.
And we hope everything turns out wonderful.
(upbeat music)