Weekly Cup of Joe - Episode #12 - Total Hip & Knee Replacement - ROM/Mobility

Good morning, everybody! And welcome to your Weekly Cup of Joe. Today is a special edition. It's a Friday edition. As I mentioned the other day, I'm playing catch up because I was off and missed a week. So I'm trying to catch up two this week. So we did a Tuesday and Friday this week, hope you enjoyed the last episode. We're going to continue with our total knee or total hip replacement, questioning. And then we had a lot of people inquire about that recently. So we talked about walking and came to using a Walker, assist advice or a cane or whatever is necessary before surgery, but definitely after surgery. So today, what we're going to look at is just the range of motion, your mobility of that knee, your hip, especially the knee. Knee replacements are typically coming to see us the day after surgery.

Nowadays, they're not getting time to go home. They're not getting time to go to rehab or anything, they're not staying in the hospital, we're seeing 'them the day after. So it gets to be pretty rough to start with, but we want to let you know that range of motion is key. And the funny thing is we found that the more that you can focus on your range of motion before surgery, so the better your range of motion is before surgery, it tends to be better after surgery, which is kind of weird because you're getting a new knee or new hip in there and you wouldn't think it wouldn't make a difference but we've noticed that for whatever it's worth. But after surgery, especially knee surgery, what we're going to be talking about here, getting your legs straight or extension is the key thing.

We'll work on bending; The doctor is going to want us to get up to 120 degrees, but that's not the main emphasis to start with. We need to get that leg straight, get it to zero, but it's going to be very difficult with all the swelling that's in there. So, a lot of what we're going to be doing early on is getting the muscles moving, get that swelling out of there. We're going to be pumping the swelling out of it, and you're going to need to be icing it quite frequently throughout the day. So four to five times a day, you're going to need to be icing it, you're going to be elevating it. We'll talk about how to do that. I'll give you a description here and when you're icing it, you're icing it for 15 to 20 minutes maximum. Don't go any more than 20 minutes.

After 20 minutes, your body decides that it's too cold and then it starts to heat up and starts to bring more blood flow. So we're trying to take blood flow out of the area, so we want to keep it cold for 15 minutes, constrict the blood vessels, let that fluid go back up into the body and get reprocessed where it's supposed to be. So those are some big things to think about. Resting is going to be big. So the RICE principle R is rest, I is ice C is compression, so you may be using some compression garments either whether the therapist recommends or the doctor recommends and E is for elevation. So we're making sure when you’re icing your leg is elevated when you're doing so. So now the blood can flow down, back towards your heart. Gravity helps it out. Using your pain meds as the doctor prescribes to stay on top of your pain is very important. we want you to be able to sleep. If you can't sleep, you're not going to be able to heal. So helping stay on top of that pain by using your pain meds is very important.

Now, if they're not working, you need to talk to the doctor, the PA, and the nurse, to make sure that you get the ones that work. If you're having a bad reaction, let them know but don't try to be a martyr and say, I'm not going to use them because you need to stay on top of that pain. And if you can't control the pain, it's going to make therapy that much more difficult; the swelling is going to stay in there longer, and you have a lot harder time earlier on in rehab. So we've witnessed that quite a bit over the years as well. So I'm going to show you here. So when you're elevating your leg, you can lay on a couch and you lay on a bed or floor wherever you're going to be at, and you're going to put some pillows on you, so your leg is up higher than your heart. And another thing that you can do is just work on some ankle pumps that get the calf to move in and stimulated and helps pump the fluid back down this way. So the calf helps pump that fluid back up towards your heart. If this is your ice pack--- this folded blanket is going to mimic an ice pack---we want to make sure it's big enough that it goes over the entire knee, where you get two sides in the top, and then maybe you put even a small one underneath it as well, too. You can put it in a pillowcase, you can put a light layer of fabric around it, nothing too heavy. And you're just going to sit there or lie down in ice for 15 minutes, watching TV, you can do some ankle pumps while you do it sets of 40 or 50 ankle pumps, take a break and do another 40 or 50. So you can get quite a few of those done during that 15 minutes of time to help decrease that swelling.

So last episode we talked about what were the three main things that you wanted to do that day? So sometimes we have a big list of things that we want to do and accomplish and check off. And I said, just think of the three most important things that you want to accomplish during the day, write those down and accomplish those. The next level to that is looking at your goals. What goals do you want to accomplish for the week? What goals do you want to accomplish for the month? For the quarter? For the year? Doesn't matter, personal goals, professional goals, family goals, it doesn't really matter. The biggest thing is you got to get them out of your head and you got to write them down on paper. So once you get them out of the head and you're writing them down, that's a big step, and then an even bigger step is telling somebody. You tell somebody your goals; you are more likely to achieve them. Getting them out of your head, helps you get to those goals a lot easier and then from that aspect, once I've got them down on paper, and I tell somebody, now I'm going to be held more accountable and I'm going to be more likely to achieve those goals. So think about that as you are doing some goal setting, the daily things that you want to work on; the three daily things, and now maybe thinking of your weekly, monthly, quarterly, or even yearly goals. The next goal that you want to accomplish, write it down, find somebody to tell and be held accountable. .

Next week we're back on a regular schedule. It'll be Wednesday morning. 10:00 AM. Once again, next Tuesday though, we are having the Total Hip and Total Knee Workshop. Shay is going to be hosting that in-person and online, so please register. There'll be a link below if you haven't already, we've got a few slots left for in-person and can do the rest of the people can go on zoom. So you can go as many people as you want on zoom. So spread the word, let anybody know, invite a friend or two or whatever you want to, and hopefully, we'll see you next Tuesday for that. And then next Wednesday, we will see you for another Weekly Cup of Joe. Thanks, guys. Bye.