The Medical Model of Knee Replacment Rehab Can Waste Your Time, Increase Your Pain, and Steal Your Money

The knee replacement rehab industry hasn’t changed in 20 years : “By God, really!”, you state. Yes, really, because there is no need to. We are getting paid for visits not results. I  don’t want to drag you into the granular details of a third party payor system but rest assured it isn’t always best for you.

Here’s the truth along with some knee replacement recovery tips. Therapists who own clinics are just like any other people who own business except that they are subject to market forces ensuring that all business entities will make the same money from a treatment whether they give good quality or not. Let me say that again, lower quality facilities make the same money per treatment as good quality ones.

Your PT entrepreneur or your big corporations can make more money in only two ways… 

Lowering overhead

One of the biggest trends in therapy today is that PT’s are doing less and less actual treatment and just supervising lower wage employees like Physical Therapy  Assistants,  exercise science majors and athletic trainers to reduce labor costs.

Getting more productivity from labor

What this means that they must treat more patients per day. The way this is done is by employees treating more than one person at a time.They are stealing your time so that their employees can treat multiple people per hour.

In other words  four patients might be scheduled at 11 am for a treatment.  While 3 patients are doing  non- supervised “filler” exercises,  one is getting more personal attention and then they rotate floating between different patients. This results in a time cost for you. They are stealing your time so that their employees can treat multiple people per hour. Instead of being able to get in and out in 20-30 minutes, many times people can be in therapy for 1 -1/2 hours. This leads to what I call “Monster Session Syndrome”

“Monster Session Syndrome”

After 1 1/2 hours of exercise you will no doubt…

  • feel exhausted
  • think that you got your “moneys worth”
  • be very “glad” that the days therapy is over
  • put a star on your frig thinking that you have been a “good little patient”

The problem is …

you are now using the least effective knee replacement recovery technique. “Monster session syndrome” can easily lead to increasing inflammation because you are encouraged to do too much in one setting and it equally results in people doing little or nothing until the next monster session because they are sore the next day. But don’t just take my word for it. Check out what Dr Van Horne has to say.

Your therapist cannot get the range of motion for you. Very aggressive therapy that leaves you hurting more than an hour or so after therapy or which leaves you more painful the next day actually will slow down your progress. Very aggressive therapy can tear not stretch muscles, ligaments, tendons and other soft tissues, causing pain, swelling and fear. This will slow down your therapy by making you afraid and unable to relax your muscles with your therapist. Obviously, your must work hard getting your own motion and not depend on the therapist to “force” your knee and “overpower” your muscles. You will go backwards not forwards.

Dr James R Van Horne, MD Paragon Orthopedic Center Grants Pass, Oregon

The most effective knee replacement recovery technique to regain your knee range of motion is four to six incremental stretching sessions spread throughout the day. Remember the phrase, “A little a lot”,-stretching your knee a little (gentle) a lot (many times a day) is simply the best method to remodel the soft tissue around your knee and to make sure that the swelling after a knee replacement is contained.

You can now see that you will waste hours in therapy being less productive, waste weeks progressing more slowly than you are capable, incur higher costs associated with  knee replacement rehab, and overall struggle with more pain and discomfort by following the traditional medical model.

Why the Medical Model Needs to Change

Remember, since the 1970’s up until just a few years ago most people getting a replacement were over 65 and retired. The rehab model though flawed worked adequately for retirees because they were not in a hurry to get back to work. Well yes maybe their golf game suffered a bit but not enough to demand changes in the system. Now many people were not facing going back to work early (when they don’t feel ready) because they do not want to burn up all their PTO time for the year recovering from a knee replacement. Can you blame them?

But you say; “It’s the only way available to me”

Here is the best therapy program for knee replacement; a better and faster way.