Critical Thinking

Just Zip It

This is a repost of “Just Zip It” originally posted to the  website, Keith’s Korner.  I highly recommend you check the site out (and follow) his writings and reflect on the messages he conveys.  They are quite important for the rehabilitation community.   

By: Keith P.

“He told me before i had my surgery that he was going to make me work hard to get 130° of flexion.”

My patient, 3 days after surgery, is excited about the prospect of returning to outpatient physical therapy. The outpatient therapist, who she has worked with previously, has already set the bar very high for her.

I am quite certain that he is a competent clinician. He has a tremendous reputation and I have no doubt that some of his patients do indeed achieve 130° of flexion after a total knee replacement.

Out of curiosity, i asked my patient what she intended to do with her 130° of knee flexion after she was done with her rehab. She told me that she was eager to return to exercise which included stationary cycling, walking on a treadmill and returning to her personal trainer for light strength training.

So what’s my beef? I have a problem with a 67-year-old woman with 120° of knee flexion (who successfully returns to cycling, treadmills and personal training while living her life without limitation) being led to believe that she didn’t work hard enough to achieve 130° of flexion after a total knee replacement and (as result) she is a failure.

His ego may not take a hit, but hers might.

Unless he is willing to take the blame if she doesn’t achieve her ‘new’ goal, he should keep his mouth shut.

Read more of Keith’s writings

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1 reply »

  1. Thanks for this article. I work as a massage therapist and a few years ago a client of mine fell on an escalator and broke her right humerus. Now- several years later, she bemoans the fact how her arm doesn’t have the exact same ROM. I try and tell her that the break in her arm, which wasn’t set right by her doctor and therefore didn’t heal well, may not regain the same ROM due to the biomechanics of the arm post break. But I definitely encourage her in PT and her movement exercises. I don’t want her to feel like she should be discouraged just because she won’t attain perfect ROM.

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