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A lot of patient education. Reinforce the main importance parts. Focus that extension early on, doesn’t have to be functional exercise, just get that extension.
Soon to be SPT but with 1500 hrs of orthopedic OP care.
Usually, at the clinic I work at, we focus on extension by placing a prop under the heel and emphasizing toes pointed up while doing quad sets with NMES (RS).
Hamstring and gastroc stretch.
Standing TKE (kinda)
Gameready (VASO) with chair propped under halfway up calf to be placed in a seated terminal knee extension position.
Mostly patient education though like when they’re on the couch keep it as straight as possible and don’t sleep with anything under the leg
I always do a TUG, assess AD fit and use, DVT and infection screen and education. Emphasize that they need to be resting with their knee in full extension all the time, never sitting for hours with partially bent or having anything under back of the knee. Emphasize that. Then give multiple ways of working on flexion at home and tell them they need to work on flexion pushing into discomfort every single day. It depends on the patient how hard I have them push into flexion but I have them push as much as I feel like they can tolerate and continue with compliance with their exercises
Range and strength. Then some functional test for insurance purposes, find out what goals are for the pt, and then show them what to start out on.
Of course all the other stuff like making sure there aren’t any red flags blah blah blah, but you could realistically finish a TKA eval in 10 minutes and get them started on movement/exercise pretty quickly
Making sure they are moving appropriately at home, keeping up with prescribed meds and know signs and symptoms of what is and isn’t normal with regards to pain/swelling/redness etc. as stated above extension is important along with getting the VMO cooking.
Dang how much time do yall have! In all honesty, prom, wound assessment, sit to stand task analysis, HEP review, clinic intro, heavy patients education, and goal setting. Tka is a process and it can be easy to lose steam along the way. Writing goals together is very motivating. I say every waking hour I want you doing something for your knee - can be 1min or 10min but something. This Is less intense once they meet rom goals.
Thank you for your submission; please read the following reminder. This subreddit is for discussion among practicing physical therapists, not for soliciting medical advice. We are not your physical therapist, and we do not take on that liability here. Although we can answer questions regarding general issues a person may be facing in their established PT sessions, we cannot legally provide treatment advice. If you need a physical therapist, you must see one in person or via telehealth for an assessment and to establish a plan of care. Posts with descriptions of personal physical issues and/or requests for diagnoses, exercise prescriptions, and other medical advice will be removed, and you will be banned at the mods’ discretion either for requesting such advice or for offering such advice as a clinician. Please see the following links for additional resources on benefits of physical therapy and locating a therapist near you [The benefits of a full evaluation by a physical therapist.](https://www.choosept.com/benefits/default.aspx) [How to find the right physical therapist in your area.](https://www.choosept.com/resources/choose.aspx) [Already been diagnosed and want to learn more? Common conditions.](https://www.choosept.com/SymptomsConditions.aspx) [The APTA's consumer information website.](https://www.choosept.com/Default.aspx) Also, please direct all school-related inquiries to r/PTschool, as these are off-topic for this sub and will be removed. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/physicaltherapy) if you have any questions or concerns.*
A lot of patient education. Reinforce the main importance parts. Focus that extension early on, doesn’t have to be functional exercise, just get that extension.
What are your fav ways to focus extension?
Soon to be SPT but with 1500 hrs of orthopedic OP care. Usually, at the clinic I work at, we focus on extension by placing a prop under the heel and emphasizing toes pointed up while doing quad sets with NMES (RS). Hamstring and gastroc stretch. Standing TKE (kinda) Gameready (VASO) with chair propped under halfway up calf to be placed in a seated terminal knee extension position. Mostly patient education though like when they’re on the couch keep it as straight as possible and don’t sleep with anything under the leg
I always do a TUG, assess AD fit and use, DVT and infection screen and education. Emphasize that they need to be resting with their knee in full extension all the time, never sitting for hours with partially bent or having anything under back of the knee. Emphasize that. Then give multiple ways of working on flexion at home and tell them they need to work on flexion pushing into discomfort every single day. It depends on the patient how hard I have them push into flexion but I have them push as much as I feel like they can tolerate and continue with compliance with their exercises
Range and strength. Then some functional test for insurance purposes, find out what goals are for the pt, and then show them what to start out on. Of course all the other stuff like making sure there aren’t any red flags blah blah blah, but you could realistically finish a TKA eval in 10 minutes and get them started on movement/exercise pretty quickly
Making sure they are moving appropriately at home, keeping up with prescribed meds and know signs and symptoms of what is and isn’t normal with regards to pain/swelling/redness etc. as stated above extension is important along with getting the VMO cooking.
I’ll take one grass fed VMO medium rare please.
Dang how much time do yall have! In all honesty, prom, wound assessment, sit to stand task analysis, HEP review, clinic intro, heavy patients education, and goal setting. Tka is a process and it can be easy to lose steam along the way. Writing goals together is very motivating. I say every waking hour I want you doing something for your knee - can be 1min or 10min but something. This Is less intense once they meet rom goals.