Episode 1669 - Kneeling after total knee replacement #PTonICE Daily Show

Dr. Dustin Jones // #GeriOnICE // www.ptonice.com 


In today's episode of the PT on ICE Daily Show, join Modern Management of the Older Adult division leader Dustin Jones Dives into why working on kneeling is not a matter of IF we should do it but WHEN. Dustin covers a sequence of kneeling progressions, designed to gradually expose patents to kneeling in a manner where they have control over how much they flex their knee & how much pressure they allow onto the knee cap.
Take a listen to learn how to better serve this population of patients & athletes, or check out the full show notes on our blog at www.ptonice.com/blog.
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EPISODE TRANSCRIPTION
DUSTIN JONES
What's up crew, good morning and welcome to the PT on Ice daily show brought to you by the Institute of Clinical Excellence. My name is Dustin Jones, one of the lead faculty within the older adult division and today we are going to be talking about kneeling after a total knee replacement. kneeling after a total knee replacement. We're gonna dive into this somewhat hot topic if you will or debatable issue that we come across so often with our folks but more importantly give you progressions so you can actually get people's knees to touch the ground again. Alright this is a big issue that in my clinical experience I would often see the detriment of people not working on kneeling you know years decades after they had said surgery and it was really eye-opening for me and I'm sure many of you all as well to see what that does to people when they go for so long thinking that they are not allowed to kneel to let their knee apply pressure to the ground or that they're they're just afraid to right just think of all the functional implications that that has when you are scared to death to let that knee kiss the ground to be able to pick something up off the ground to be able to play with your grandkids to be able to kneel and garden right this is a This has huge implications for our patient's quality of lives and what's unfortunate is that it's often neglected, right? You think about your standard post-op protocol, what are you working on, right? You're trying to get full range of motion, trying to get that full extension, then really working on getting that flexion to be symmetrical with the other side. We're working on our strength deficits, we're working on our balance. and working on getting back to their independence in terms of gait as quickly as possible. But how many of y'all are getting applying pressure to the knee and progressing it to the manner where they're doing half kneeling, full kneeling, floor transfers, burpees, for example. How often is that getting neglected in the rehab setting? And it is far too common, far too common.

NO EVIDENCE THAT KNEELING IS HARMFUL AFTER JOINT REPLACEMENT
Now the unfortunate reality is we do not have any evidence to state that kneeling is actually harmful for individuals after they've had a knee replacement. There's even a really good article in the Journal of Knee Surgery, all right, so this is an orthopedic surgeon journal, in 2020, that basically said, I'm gonna read this verbatim, which I love this, there is no biomechanical or clinical evidence contraindicating kneeling after a total knee replacement. I'm gonna repeat that again for the folks in the back, there is no biomechanical or clinical evidence contraindicating kneeling after a total knee replacement. The folks that wrote this article and this quote are orthopedic surgeons from Johns Hopkins University that work in the orthop