Ask a PT

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Posted - 12/18/2007 :  15:55:38  Show Profile  Reply with Quote
Our user asked: "Hello, My wife has recently had bilateral total knee replacement and is currently undergoing physical therapy. My question is that before beginning her therapy the therapist wraps her knees with ice then begins the stretching. As well as during her other stretching exercises they put ice wraps on again. This seems like the opposite of what should be done. I would think the muscles should be warm before being stretched."

Ask a PT Response: "From my experience and working with other therapists, it is not common to ice an area prior to stretching. Your wife's therapist might be applying ice as a way to manage pain and control edema as these are reasons to apply ice. You may want to ask your wife's therapist to explain his or her rational behind the utilization of ice for her treatment. Usually to prepare a patient who has undergone a total knee replacement for stretching or ROM, I would utilize a hot pack, e-stim/IFC, or have the patient warm up on a stationary bike. Ice is utilized after the treatment session in order to help manage pain and edema. Please keep in mind that each therapist may have differing treament approaches but therapists should strive to treat patients utilizing evidence based practice. I hope this helps and thanks for using CyberPT."