Top 3 Tests to Tell if You Need Physical Therapy After Total Joint Surgery
So you had a total knee or total hip joint replacement, you are finished with home health care, and they tell you are discharged from therapy. Congratulations, it is time to see the surgeon for the next steps! The following information will prepare you for a post surgical visit to see if you are cleared to get back to normal life or if you would benefit from outpatient physical therapy.
How to Tell if You Need Outpatient Physical Therapy for Total Knee Replacement
Your team, which consists of you, your surgeon, and the home health care physical therapist, all look for different things when considering your healing process. Lets look at them below:
What your surgeon looks for, here are some indicators that your knee has healed after total knee surgery:
No pain or minimal pain in your knee
Full range of motion in your knee
Normal gait and walking pattern
No swelling or fluid buildup in the knee
No instability or giving way in the knee
What your home health care physical therapist looks for:
Home health care physical therapists see you in your home for a short time to make sure you can safely maneuver around your own home after total joint surgery. Here are the items they typically test for before discharging you from rehab:
Can you walk at least 50 feet, which is typically considered one room to the next.
Home health physical therapy is for patients who can walk 50 feet or less. After this you are considered ready to be discharged to normal daily life which includes driving, shopping, getting your mail, etc.
2. Can you get into and out of your home
Home physical therapists can give you ideas for assistive devices, rails, and grab bars to help you navigate into and out of the home. However, this does not involve getting behind the wheel and comfortably driving around the community.
3. Can you get up or down your steps?
Getting up or down your steps can be using a rail or two, and stepping both feet to a step. The quality of the step does not quite matter, just as long as you can accomplish the task safely.
4. Range of motion (ROM) test
The normal range of motion (ROM) after total knee surgery can vary based on the type of surgery, the patient's age, pre-operative joint function, and overall health. However, here are some general guidelines for knee joint ROM after surgery:
0 to 90 degrees of flexion: This is the normal range for most patients. It allows for activities such as walking, sitting, and standing.
0 to 120-135 degrees of flexion: This is an ideal goal for some patients, especially those who were highly active prior to surgery.
0 to 110 degrees of flexion: This is a typical range for older adults or those with certain medical conditions and is necessary ROM to have to get down a flight of stairs.
So when kicking the leg out, 0 degrees would be completely straight and 90 degrees would be the ability to tuck your foot under your chair while seated.
What You should be looking for:
Lets face it, what matters to your surgeon and a home physical therapist are probably completely different than what matters to you. You probably do not quite care that you have, “full range of motion and 5/5 muscle strength”. You care about function! Function is the ability to complete your daily tasks normally and easily. Here are the top 3 functional things you should be looking for.
Top 3 Functional Tests to Tell if You Need Physical Therapy After Total Joint Surgery
Can you get out out of a normal chair without using your hands? (Therapists commonly use the 5 x sit to stand test to determine strength and fall risk, read about it HERE.)
Can you walk up the stairs reciprocally, without pulling yourself up the stairs?
Can you get into and out of your car & safely walk across a parking lot?
Try the above listed functional tests. If you cannot complete these 3 items safely and normally, you would benefit from outpatient physical therapy. When talking to your surgeon, mention the fact you cannot complete the aforementioned functional tests. Even if your pain levels are low and ROM is normal, your function is not where it needs to be to prevent a fall and keep you independently active in the community. Outpatient physical therapy can get you back to normal function or even better than before!
Where Should You Go for Outpatient Physical Therapy?
Our mobile physical therapists at Custom Care Rehab provide outpatient physical therapy conveniently in the home. We provide mobile physical therapy for those patients who are still having functional deficits and bring the therapy directly to you. We bring all the equipment that you would find in a clinic, even a mobile bike! Better yet, we strength train in your environment, so your home program will be repeatable and familiar. If you are having difficulty driving or navigating outdoors, mobile physical therapy is a great option to continue your recovery. Read our frequently asked questions here: regarding service area and accepted insurance.
For those patients who prefer to get out of the house and be in a clinic just simply ask your surgeon who they recommend or do a quick google search on “physical therapy near me”. Many choices will pop up!
Conclusion
If you want to improve your function, strength, and endurance, mobile physical therapy is a great option to keep you progressing until your activity goals have been met! Call us at 330-618-5703 to learn more.
