Total Knee Replacement Goals

Total Knee Replacement Goals

 

 

 

Following a Total Knee Replacement surgery, one of your long term goals is to regain full range of motion of your operative knee.  However, one of your immediate goals is to regain full knee extension range of motion.  Initially, knee extension is even more of a priority than knee flexion range of motion.  This is why you are repeatedly told not to place a pillow under your knee when you are lying down.  Most of my patients say they are very comfortable when lying in bed with a pillow under their knees.  But this is a "no-no."  The best you can do is place a pillow under your calf and ankle so that there is a space under the knee.  This will create gravity-assisted knee extension.  The absolute only time you can place a towel roll or pillow under your knee is if you are performing TKEs or Terminal Knee Extension exercises. 

 Here, you place a towel under your knee joint so that you can contract the quadriceps muscles which will fully extend your knee.  The last few degrees of knee extension (aka TKE) is the toughest to regain. 

Click Total Knee Replacement for the full Physical Therapy Video Protocol and follow along workout.

  

Knee Arthroscopy

Knee Arthroscopy

 

 

If you or a friend/family member have recently undergone a Knee Arthroscopy Surgery due to damaged cartilage, meniscus or unexplained knee pain, specific Physical Therapy Home Exercises will be beneficial in your complete recovery.  You may be advised to attend a Physical Therapy clinic initially and will probably go 2-3 times a week (if your insurance, schedule, and wallet allows). 

 

The S.O.D. Knee Arthroscopy DVD consists of the same Physical Therapy exercises that will be prescribed to you when attending the clinic, and will therefore help you to maximize your knee strength and mobility even when your time at the clinic has ended. 

 

To see what a knee arthroscopy surgery entails, click here: Knee Scope Video

The Value of Tactile Cues on Your Client

When training a client, you may want them to contract a particular muscle/area of their body during an exercise.  In the fitness and rehabilitation industry, we realize very quickly that every person we work with has a different level of body awareness.  Some clients demonstrate great control, while others make you wonder how they survived walking from their car into your clinic.  Tactile cues, or in this case, "tapping" a muscle is very beneficial in getting your client to do the exercise the way you want them to.  Just remember how quickly you corrected your own posture upon feeling someone tap your lower back, telling you to "straighten up."  If a client is having difficulty "firing" the exact muscle that you are asking him to, tap the area of concern to provide manual/tactile cues, along with providing verbal cues.  The more information your client receives into their CNS (central nervous system), the better they will perform a given task.  This works especially well with stubborn muscles following injury, such as the Vastus Medialis (VMO).  This is the "tear-drop" shaped muscle on the inner aspect of your knee.  Following any knee injury or surgery, inflammation is expected.  Very little swelling causes the VMO to 'shut down.'  With the VMO "off," the lateral thigh muscle (Vastus Lateralis) pulls the patella laterally during a quad contraction.  During a quad contraction, the patella should track superiorly.  This does not happen when the VMO is not firing properly and therefore you can expect more problematic knee issues in the future.  When having your client perform a basic quad set, if the VMO does not appear to contract, have them tap it with each contraction. 

You can also use this technique to assist with lower trapezius recruitment during shoulder/scapula exercises in order to maintain stability of the scapula.  If you are observing an incorrect exercise movement, tap the muscles that should be activated during that exercise and see how quickly your client corrects his/her form.  This should help your clients progress quickly through the intial stages of rehab or post rehab fitness.