hey everybody it's doctor Jo, and today I'm going to show you the best ways to
improve knee range of motion after something like a total knee replacement
ACL repair or just a general knee injury so let's get started.
so for these stretches and exercises, make sure that
if you've had a specific surgery that you're cleared to do these because
things like an ACL repair, you're on certain precautions in the beginning, so
just make sure that you're cleared to do these or that you know your
limitations and precautions before you start. so the first one is just gonna be
a simple heel slide. I'm on the floor. if you can't get on the floor, especially if
you've had a surgery, you can do this on your bed. you can do it on your couch. you
don't have to get all the way onto the floor. so with a heel slide, usually the
best way to do it is to lie all the way down just so you can get comfortable and
relaxed. I like to leave the other side propped up just because that takes a
little pressure off of your back and because it gives you a little bit of
pull for the other side. so it's just like it sounds, you're just sliding your
heel up towards you. so you're just gonna pull that heel and try and bring up that
bend as much as you can. now if you've just had a surgery, most likely you're
not going to be able to come all the way up this far. you might only be able to
get about to right here. so kind of try and hold it for about two to three seconds
and then slide back down. if you're having a hard time doing that, you can
take a belt or a strap or something to help kind of give you a pull. if you've
got a loop that works great, and just put it around your ankle and then lie back
down and then as you come up, you can use the strap to kind of help pull a little
bit more. so it's gonna feel really tight especially after the surgery especially
after a big injury. just again try and hold it for about two or three seconds
and then slide back down. so depending on what your injury or surgery is,
I would just start off with maybe two sets of ten doing the two to three
second holds and work your way up from there .but it just really depends on
what's going on with your knee. so the next one is then just while you're lying
down doing a knee prop to help getting the straightening out. so the first one
was for the bending or that knee flexion, this one is for the straightening out or
that knee extension. so again if you've just had your surgery or injury, it might
be really tight it might be uncomfortable, so I would just start off
with a little bit. this is just a small roll it's a pool noodle, but eventually
you can bring it up higher. and all you're going to do this then just lie
down and really try and relax your leg. so the goal is to let gravity push that
knee down. and if you have you know maybe not quite full extension or
straightening out yet, you're here, so if you can relax, eventually it'll just let
go a little bit. so this one you probably want to hold it for two or three minutes
and build your way up to about maybe 5 10 minutes depending on how much more
that you need. but the goal is to get your leg up off of the ground. so
propping it up a little bit and just let it relax. you can sit up doing it as well,
but again sometimes if you're lying all the way down, you can kind of relax your
whole body. and then if you want to do a little bit of a push you can. but don't
push on the knee joint,, push higher up kind of on your thigh area, and just give
it a little gentle push until you feel that stretch in there. and if you've had
that surgery you know that just even a little push is usually a lot of tension
in there, so don't push too hard. slow and steady stretching is really the
best way to go. another way to gain that motion that flexion that extension in
the knee is to use something like an EMS or tens unit to help get the muscle
going. a lot of times after a surgery, especially the total knee replacements,
especially the ACL repairs, your quad muscle isn't firing like it's supposed
to and the quad muscle has a lot to do with straightening out the knee, the
movement of the kneecap. so if this muscle really isn't firing, then it's not
doing what it's supposed to do and then it also messes up your motion as well.
so you really want that muscle firing. so the folks at massage therapy concepts
sent me their TENS EMS unit and this is a really nice unit because it is a
combination of both. and so you can do the TENS which is the transcutaneous
electrical nerve stimulation, which is for pain control where you don't really
want a contraction. and then the EMS which is the electrical muscle
stimulation where you are trying to get that contraction. you're trying to
activate that muscle. and so it's really nice to have the combination of both and
in this unit is a really nice way to do that. they've got 12 different settings.
each setting is you know different for the tea the the TENS or the EMS and this
unit unlike a lot of units has a really good instruction manual. and it tells you
what each one does. some units don't have much of a instructions it's kind of
just put it on and go, but so you can read in the instructions what each one
does. so for this one, I'm going to use the 10 and you can see that it's a
barbell, so it's kind of a good indication that that's for muscle
building or trying to gain that muscle simulation versus just a TENS which you know
some of the other ones which is the pain control. so it also comes with three
different pad sizes which is really nice because depending on the area, it's good to
use the different sizes so you can get a little more specific. when I'm doing the
EMS, I kind of like the the middle sized ones just because you can kind of get
that muscle group which is really nice. EMS you do want to be a little more
specific where you're placing the electrodes. when you're doing a TENS it
doesn't have to be exact, but what you want to really get on that muscle belly.
so if you can contract the muscle a little bit you want to do that to try
and find it. if you're in a PT clinic, sometimes they'll use a little electrode
pin to kind of find where the muscle is activating, but you really want to kind
of follow along where that muscle belly is. where you're trying to activate it.
but if you've had that injury if you've had some surgery, when you squeeze that
muscle might not activate. it might look like this if you're squeezing. you know
eventually you want to be able to see it squeezing, but sometimes that just
doesn't happen. so I'm just going to kind of put these on. and when you're placing
the electrodes, you don't want it to be on. if you have to end up moving it just
a little bit you want to go ahead and pause it or make sure that it's turned
off when you're doing just so you don't get any a little bit of a shock
somewhere else while you're doing it. so I have it here and then so you can see
let's say I want to go down to that one. so I just press it and so it's really
easy that it's nice and touched. you have your a channel in your B channel, so I'm
just going to use the a channel for the EMS. and you can see that up there so you
can change it here. you can change it on the side here as well. this is for the
time. you can change the time there and you can see the minutes up here and then
you can just press the ones that you want to go to. and here's the pause
button pause play button. if you want to move these a little bit and you you can
see that they're all blinking when you pause it. and then you press play again.
so when you're going, if you don't end up getting a muscle contraction like that,
then you might want to change the setting and see what's going on because
sometimes different settings are going to work better for different people. so
for a really good contraction I'm gonna use setting seven and show you how that
looks. so once I start taking it up and you can see it's going up here now you
can see that contraction starting. so I'm not doing anything right now. I'm letting
the unit do the work. but what you want to do is when you get that contraction
started and you feel the unit doing it, you want to squeeze as well. so now I'm
squeezing with it as well and then when it lets go, I'm letting go. and so that's
just helping those muscles activate. so with this, if you haven't done it before
you probably just want to start off with three to five minutes because you're
doing a quad set, you're squishing it down trying to straighten out that knee
as much as you can, but you don't really want to over fatigue that muscle. so I'm
going to show you a couple other exercises sitting, but I'm going to use
the tens unit while I'm doing that. so if you're interested in purchasing the
massage therapy concepts TENS EMS unit, make sure and click on the link
there. so for the last exercise and stretches, I'm going to use the tens
portion of the unit. so with the tens this is really for pain control. this is
just to help edge out the pain a little bit to ease up ease it off some. and so
with the tens, you can do one or two channels or two or four electrodes. I
like the four which is all the way around. just make sure each channel is
crossing. so this is one here and here, and then the other one is crossing. so
then those channels cross each other and then you're getting that general pain
control in the middle. when you're doing the two channels here, when you turn on
the intensity you then do a or B and then switch it in the middle there, and
then do it so this is for comfort. you want it just to be taking that edge off
just a little bit, and if you're getting a little bit of a contraction, you want
to take it down just a little bit. so with this one, you're going to do a heel
slide with a little bit of a tap. so what I'm going to do is just now I'm sliding
that heel back, and if it's tight right there,
then I'm going to tap that heel a couple times. and that just kind of helps loosen
it up a little bit. and then try and slide it just a little bit more. tap tap
tap. and then slide just a little bit more. so each time give it a little tap.
and you just go till you get a lot of pressure. not extreme pain, but you know
tolerable pressure, and then hold it for about 10 to 15 seconds, and then slide
back and start over. so the heel tapping does a really good job of helping you
just slide a little bit more. so slide again a little bit, a couple taps, and
then slide back some more. so again you can do you know maybe ten reps two sets
of ten a couple times throughout the day. and then the last one is going to be
then for the extension or straightening again. so of course that was for the
flexion or the bending. so then you're gonna kind of prop up again but when
you're seated propping up you're going to get a little bit more motion in there.
so you can have it a little bit higher. if you've got you know a coffee table in front of
you or an ottoman, but you want to be able to prop that leg up. so if you're
still having a little bit of a bend there, you really just want to try and relax
that leg, keep it propped up. if you want a little bit more pressure, again you can
push on it some with your hand or if you have an ankle weight or something you
can set it on your thigh, but you don't want to put it directly on the knee
joint. you want to put it up higher. if you don't actually have a weight you can
take a grocery bag and put maybe a couple cans of soup or vegetables in there
and then just put it through your leg. and again, put it on your thigh. don't put
it actually on that knee joint. and so just resting it there and relaxing. you
can watch TV, you can work on your computer a little bit, and just let it
get that stretch. let gravity do its work. just to help get that extension or that
strengthening out motion. so if you're interested in purchasing the massage
therapy concepts TENS EMS unit, make sure and click on the link up there. and
don't forget to subscribe by clicking down there. And remember, be safe, have fun, and
I hope you feel better soon.
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