VHA Home HealthCare partnered with Curovate to pilot our physical therapy app for their home care clients. On average VHA clients found Curovate to be intuitive and easy to use for their at-home rehabilitation. Read the full poster presentation below. The following poster was presented at the 10th annual AGE WELL conference in Montreal, Quebec.

I would like to sincerely thank the wonderful Innovation Team at VHA Home HealthCare, Jordan D'Souza, Philip Woode and Sandra Al Ali, who conducted this pilot project and authored the poster presentation you see below.

Learn more about VHA Home HealthCare and reach out to them by visiting this link. If you want to complete your own at-home rehabilitation and you would like the type of access and benefits you have read about here please download Curovate from one of our links below.

If you need further customized assistance during your surgery or injury recovery check out our Virtual Physical Therapy page to book your 1-on-1 video session with a physical therapist.

Curovate has always been focused on providing accessible physical therapy to people in their homes and this is why we are partnering with VHA Home HealthCare (VHA). VHA is a not-for-profit charitable organization that offers 24/7 healthcare and support services in the home and community to people of all ages across Ontario. VHA was formed in 1925 and today has over 3000 team members including personal support workers, nurses, dietitians, occupational therapists, social workers, speech language pathologist and physiotherapists who are leading the future of health and independence at home.

The clinical and research collaboration between Curovate and VHA will consist of working with VHA clients to provide at-home digital physical therapy. Curovate is a digital health company that provides mobile application (app) based at-home physical therapy for people who are awaiting or recovering from knee replacements, hip replacements, or anterior cruciate ligament (ACL) surgery. In addition, Curovate also provides rehabilitation for people who suffer from knee osteoarthritis, hip osteoarthritis and those who wish to strengthen their knees and hips to prevent injuries and surgeries. Select VHA clients will be provided with access to the Curovate app for a full year to help them with their recovery as part of our initial pilot project.

The purpose of our collaborative pilot project is to better understand the needs of people who are recovering at home after injury or surgery. VHA and Curovate will collect critical patient reported outcome measures, and conduct qualitative interviews to understand the perceived benefits and barriers to utilizing an at-home mobile app for daily rehabilitation. The findings of this pilot study will be openly accessible and disseminated so that other home care agencies and people who are recovering at home can learn from our experience. Once our pilot study is completed I will write a follow-up blog and post it on our Curovate blog so our readers can learn about how Curovate was utilized in collaboration with VHA Home HealthCare.

How will people benefit from this collaboration between VHA and Curovate?

Improved access to publicly funded physical therapy

There is a lack of access to publicly funded physical therapy in Ontario. This problem is not unique to Ontario or to Canada as people in many countries have limited or no access to critical physical therapy. In Ontario publicly funded physical therapy has been reduced since the early 1980’s and it continues to be reduced. Physical therapy is now provided by private for-profit community clinics. The major issue with this is that it leaves a large segment of our population without access to physical therapy and therefore results in poor health outcomes. The lack of access to physical therapy further disadvantages people of a lower socio-economic status, racialized people and Indigenous people all of whom already have poor access to physical therapy. If you want to learn more about exactly how little publicly funded physical therapy there is for people in Canada read our previous blog. We have also written a blog about the poor access to health care for Indigenous populations. Curovate’s current collaboration with VHA will help to improve the accessibility of physical therapy in Ontario.

People with mobility issues can access ongoing physical therapy in their home

One of the major issues with access to physical therapy is the need to travel to seek out in-person care. Many people after surgery or injury are not able to drive and find it very challenging to use public transit. Using Curovate, a person can access all of their daily physical therapy exercise videos, track their rehabilitation progress and have their physical therapy questions answered through our in-app chat. By providing a person with everything they need, our collaboration will make it possible for VHA clients to continue their rehabilitation at home.

Measure real time progress with the Curovate app

One of the reasons to seek out in-person physical therapy after a major surgery or injury is to make sure that you are making progress. Everyone wants to know that they are improving but the issue with traditional physical therapy is that you must see an in-person physical therapist to track your progress. This is both time consuming and unnecessary. Simple measures such as knee and hip range of motion can now be measured with the Curovate app. Typically, a physical therapist utilizes a protractor type tool called a goniometer to measure how much a person’s knee or hip bends and straightens. This measure, also called range of motion, is an excellent indicator of a person's progress or limitations. With Curovate, using nothing more than your mobile device, you can measure your knee or hip range of motion at home in 60 seconds. Watch the video in our previous blog to learn about how you can use Curovate to measure your knee range of motion. One common question we often get about Curovate’s knee range of motion measurement is how accurate is this app measurement? The short answer is very accurate! You can read all about our peer-reviewed pilot study that demonstrated a correlation of 0.99 or better across 4 different mobile devices and one licensed physical therapist measuring knee range of motion. In collaboration with VHA we are bringing reliable knee and hip range of motion measurements into people’s homes.

Conclusion

On a personal note, as the founder of Curovate and a licensed physical therapist, publicly funded and accessible physical therapy is very important to me and the main reason I founded Curovate. This collaboration with VHA in support of their purpose of Care at home. Delivered with heart. Led by science., is the perfect partnership for Curovate. I have ambitiously stated that the vision of Curovate is to make physical therapy affordable and accessible to everyone who needs it globally and this partnership with VHA helps us stay consistent with that vision. Once our pilot project is completed I will provide the outcomes and lessons learned in a future blog.

You can learn more about VHA Home HealthCare and get in touch by visiting this link. If you want to complete your own at-home rehabilitation and you would like the type of access and benefits you have read about here please download Curovate from one of our links below.

If you need further customized assistance during your surgery or injury recovery check out our Virtual Physical Therapy page to book your 1-on-1 video session with a physical therapist.

AGE WELL is Canada’s “technology and aging network." AGE WELL is a federally funded network that is focused on utilizing technology to allow older adults to live meaningful lives at home. AGE WELL achieves this mission by collaborating with researchers, student trainees, technology partners and by supporting startups that help with aging and technology. The 2023-2024 AGE WELL Annual Report highlights the work done by the network to help over 5000 older adults and their caregivers, 2994 publications they have helped to release and the more than 70 startups they have supported. Curovate, a digital health company that has developed a physical therapy app, is one of those 70 startups. AGE WELL provided the initial funding that made Curovate’s work and existence possible through the Strategic Investment Program (Sip) Accelerator Funding in 2018. Over the past 7 years Curovate has continued to work with older adults who require pre and post-operative physical therapy for knee replacements and hip replacements. For their Annual Report, AGE WELL spoke with and conducted a photoshoot with one of our clients Peter Crosby.

I know and work with Peter personally as his physical therapist prior to and after both of his knee replacements. Peter recognizes the importance of “prehab” or pre-rehabilitation which simply means completing physical therapy exercises prior to a major surgery. You can read all about the importance of prehab for knee replacements in our blog here. The goal of prehab is to get your knee joint ready for surgery, improve your knee bending and straightening and increase your strength and balance before surgery. If people are able to complete rehabilitation before their knee replacement they will have an easier recovery and better outcomes after surgery. One aspect of prehab that is not mentioned in the scientific literature is the fact that structured physical therapy exercises are much easier if you have already done them prior to surgery. After a knee replacement you will experience pain, swelling and disturbed sleep for some time. With all of this going on, learning new exercises is very challenging. If you have already done all of the exercises as part of your prehab then doing them after surgery is much easier. Read our previous blog to learn about what to expect after a knee replacement.

What the research does prove is that people who complete a structured prehab program have better knee range of motion, improved strength and better overall outcomes compared to people who do not complete rehabilitation prior to surgery. If you read about Peter’s experience of using Curovate prior to and after his knee replacement you will hear all about the benefits of prehab. You can read Peter’s full story in AGE WELL’s Annual Report here.

Conclusion

Curovate has been working with AGE WELL since 2018 and we appreciate the support that we have received from the network. In this blog I discuss how AGE WELL helped to fund the early work that Curovate was doing and how they continue to support us through mentorship, strategic partnerships with home care agencies and featuring Curovate in their publications. In AGE WELL’s 2023-2024 Annual Report you can read all about Peter Crosby who has benefited by using Curovate prior to and after his knee replacement to return to a healthy and active life.

Curovate continus to help people with their pre and post-operative rehabilitation for knee replacements and hip replacements. If you are preparing for your surgery and you need at-home rehabilitation download Curovate from one of our links below.

If you need further customized assistance during your surgery or injury recovery check out our Virtual Physical Therapy page to book your 1-on-1 video session with a physical therapist.

Are you experiencing chronic knee pain and wondering if video physical therapy is as good as in-person physical therapy? This video will go over what telehrehabilitation is, and explain a new research study that examines how effective video physical therapy is compared to in-person physical therapy for improving knee pain and function.

Telerehabilitation refers to the delivery of rehabilitation services, like diagnoses, check-ups, and treatments through the use of digital technology.^[1] Telerehabilitation is beneficial because it allows you to communicate with a healthcare provider and receive rehabilitative services without the time and financial burden of having to travel to a physical clinic.^[1] While there are many different types of telerehabilitation, in this blog, when we refer to telerehabilitation, we are referring to video physical therapy where you and your healthcare provider can both see and hear one another in real time via a video call.^[2]

While telerehabilitation holds promise and potential for increasing accessibility and transforming the healthcare system, you may be wondering, how effective it is compared to in-person physical therapy. A recent randomized controlled trial study titled: Telerehabilitation consultations with a physiotherapist for chronic knee pain versus in-person consultations in Australia: the PEAK non-inferiority randomised controlled trial,^[3] published in the Lance on March 30th, 2024 explored this very question. What’s interesting is that only 45% of the people being treated in the study thought that video physical therapy could be effective.^[3] Additionally, less than half of all allied healthcare workers (physical therapists, occupational therapists etc) think that video therapy is as effective as in-person therapy.^[3] Despite the skepticism, the findings of the study demonstrated that video physical therapy produced similar results to in-person care for people with chronic knee pain in terms of improving pain and physical function after 3 months.^[3] The results of this study challenges the commonly held belief by both physical therapists and patients that video physical therapy is not as effective as in-person physical therapy.

If you are experiencing chronic knee pain and wondering what physical therapy services are available to help you, know that video physical therapy or telerehbilitation is a safe, effective and convenient option. Another aspect discussed in this study was travel time and cost. On average a person who lived in a city traveled 28 minutes to see a physical therapist whereas people living outside of a major city traveled between 56 to 84 minutes per appointment.^[3] The researchers calculated the average cost of travel, both in terms of distance and a person’s time, to total $218 per person.^[3] As such, opting for video physical therapy is just as effective as in person therapy and can also save time and money since it does not require you to travel for your appointment.

If you are interested in exploring telerehabilitation, Curovate is a digital physical therapy platform that offers real-time 1-on-1 video physical therapy sessions with a physical therapist, as well as asynchronous, video-guided daily exercises to help with your recovery. Simply download the Curovate Physical Therapy App by clicking on the links below or visit our Virtual Physical Therapy page to book your real-time synchronous session with a physical therapist today!

Blogs related to video physical therapy and the Curovate app

• How to use Curovate, the physical therapy app, every day to recover after injury, surgery or for strengthening
• How to sign up in the new Curovate physical therapy app for knee surgery
• How to measure knee range of motion in the Curovate app

References

1. Levy CE, Silverman E, Jia H, Geiss M, Omura D. Effects of physical therapy delivery via home video telerehabilitation on functional and health-related quality of life outcomes. Journal of Rehabilitation Research and Development. 2015;52(3):361-370. doi:10.1682/jrrd.2014.10.0239

2. Prvu Bettger J, Resnik LJ. Telerehabilitation in the age of covid-19: An opportunity for learning health system research. Physical Therapy. 2020;100(11):1913-1916. doi:10.1093/ptj/pzaa151

3.Hinman RS, Campbell PK, Kimp AJ, et al. Telerehabilitation consultations with a physiotherapist for chronic knee pain versus in-person consultations in Australia: The peak non-inferiority Randomised Controlled Trial. The Lancet. 2024;403(10433):1267-1278. doi:10.1016/s0140-6736(23)02630-2

Note - we have received permission from Jo to share her recovery story to help motivate and inspire others.

Life Before the ACL Injury: An Endurance Athlete's Story

Meet Jo from Adelaide, Australia, an accomplished endurance athlete who completed her first marathon in an impressive 3 hours and 44 minutes. As a dedicated runner, cyclist, and swimmer, Jo believed completing that marathon would be her toughest physical challenge. Little did she know, her ACL recovery journey would test her resilience in ways she never imagined.

The Unexpected Turn: A Common ACL Injury Scenario

Ironically, Jo's ACL injury didn't occur during her intense endurance training. Instead, it happened during a casual game of touch football - highlighting how ACL injuries can occur in unexpected moments. While sidestepping around another player, Jo experienced the classic ACL tear sensation: her lower leg going in one direction while her upper leg moved in another. This non-contact injury mechanism is particularly common in ACL tears, regardless of the activity level or sport involved.

The Silver Lining: Maximizing Pre-Surgery Preparation

Due to Australia's public healthcare system, Jo faced a five-month wait for her surgery. While this might seem disadvantageous, it became an opportunity to optimize her pre-surgical condition. Using the Curovate app's pre-operative rehabilitation program, Jo achieved remarkable pre-surgery milestones:

• Performed weighted squats with proper form
• Mastered single-leg sit-to-stand exercises
• Maintained running capacity up to 7 kilometers
• Retained excellent knee range of motion

Digital Physical Therapy: A Global Solution

Jo's experience highlights a crucial advantage of digital physical therapy - its accessibility isn't limited by geography. Whether you're in Australia, Canada, the USA, or the UK, the Curovate app provides consistent, professional guidance through:

• Daily video-guided exercises tailored to your recovery phase
• Precise knee range of motion measurements using your smartphone
• Progressive milestone tracking
• Pre and post-operative exercise programs

Post-Surgery Recovery: Measuring Progress

After her hamstring graft surgery in July 2019, Jo approached her recovery with the same dedication she brought to marathon training. By following the Curovate app's daily exercise recommendations and tracking features, she achieved several key milestones ahead of schedule:

• Day 13: Completed full rotations on a stationary bike
• Week 2: Achieved 110 degrees of knee flexion
• Week 5: Performed single-leg sit-to-stand exercises
• Week 5: Matched her non-surgical knee's range of motion

Keys to Success: Consistency and Guidance

Jo's remarkable progress stems from her commitment to the rehabilitation process and proper guidance through digital physical therapy. Her dedication to the RICE protocol (Rest, Ice, Compression, Elevation) soon after her ACL injury 4-5 times daily, combined with consistent exercise progression through the app pre and post-operatively, created optimal conditions for recovery.

The Power of Digital Physical Therapy

Jo's experience demonstrates how digital physical therapy can provide professional guidance regardless of location. The Curovate app offered:

• Structured daily exercise programs
• Precise progress tracking
• Range of motion measurements
• Clear recovery milestones
• Exercise technique guidance

Conclusion

Jo's story exemplifies how digital physical therapy can support ACL recovery across international borders. Her advice to others? "Keep the end goal in mind! You can't build a skyscraper without a strong foundation. The basic exercises may be monotonous but they work!"

If you need further customized assistance during your surgery or injury recovery check out our Virtual Physical Therapy page to book your 1-on-1 video session with a physical therapist.

Whether you're preparing for ACL surgery or starting your post-operative rehabilitation, having professional guidance at your fingertips can make the difference between good and optimal recovery outcomes.

Start your guided rehabilitation with Curovate today:

Note - we have received permission from Mohammed to post his recovery story to help motivate and inspire others.

Understanding Multiple Ligament Knee Injuries

The human knee contains four major ligaments, each playing a crucial role in stability and function. When Mohammed's car accident occurred on June 5th, 2020, it resulted in tears to three of these vital structures: the Anterior Cruciate Ligament (ACL), Posterior Cruciate Ligament (PCL), and Medial Collateral Ligament (MCL). Only his Lateral Collateral Ligament (LCL) remained intact.

For context, this type of injury represents one of the most complex knee trauma patterns that medical professionals encounter. While single ligament injuries are common in sports, multiple ligament injuries often result from high-energy trauma, such as car accidents. The combination of torn ACL, PCL, and MCL creates a particularly challenging recovery scenario due to the knee's compromised stability in multiple directions.

The Mechanics of Car Accident Knee Injuries

Unlike sports-related injuries, knee trauma in car accidents presents unique characteristics. During a collision, the lower leg can be forced backward while the upper leg remains fixed by the seat belt, creating a complex injury pattern. This mechanism typically affects multiple ligaments simultaneously, as seen in Mohammed's case.

Understanding these injury mechanics is crucial for rehabilitation planning:

• The ACL prevents excessive forward movement of the tibia
• The PCL prevents excessive backward movement
• The MCL provides stability to the inner knee
• When multiple ligaments are compromised, the knee loses stability in multiple directions

Initial Recovery Challenges

Multiple ligament reconstruction presents unique challenges compared to single ligament repairs. During the initial phase of Mohammed's recovery, his rehabilitation team focused on carefully managing the widespread inflammation throughout his knee joint. This delicate period required a precise balance between protecting the surgical repairs and introducing gentle movement. The complexity of having three ligaments reconstructed meant that each movement needed to be carefully controlled. Mohammed learned to navigate the challenging balance between rest and activity, understanding that too much or too little of either could impact his recovery.

The Critical Nature of Early Knee Flexion

Regaining knee flexion emerged as one of the most challenging aspects of Mohammed's recovery journey. Multiple ligament reconstruction creates unique complications that aren't typically seen in single ligament repairs. The extensive surgical repair work meant that multiple tissues were healing simultaneously, creating increased post-operative inflammation throughout the joint. This inflammation, combined with the complex rehabilitation protocols needed for multiple ligament recovery, made the process of regaining motion particularly challenging. Despite these obstacles, early mobility work proved essential for laying the foundation for long-term recovery success.

Technology's Role in Complex Recovery

Modern rehabilitation benefits significantly from technological support. The Curovate app played a crucial role in Mohammed's recovery by providing:

• Weekly rehabilitation goals specific to multiple ligament recovery
• Daily exercise guidance with video demonstrations
• Progress tracking for range of motion
• Milestone monitoring
• Exercise progression based on healing timelines

Progress Through Dedication

At nine months post-surgery, Mohammed's recovery stands as a testament to the importance of consistent effort and proper guidance. While multiple ligament reconstruction typically requires 12-18 months for full recovery, his progress has been remarkable. His success stems from unwavering dedication to rehabilitation protocols and careful attention to exercise progression. Throughout his recovery, Mohammed maintained detailed tracking of his improvements, demonstrating the value of consistent monitoring. This commitment to understanding his condition and rehabilitation process, combined with proper utilization of technological support tools, has played a crucial role in his impressive progress.

Key factors in his successful rehabilitation include:

• Strict adherence to rehabilitation protocols
• Regular exercise progression
• Consistent tracking of improvements
• Understanding the injury and surgery recovery process
• Use of technological support tools

Educational Insights for Multiple Ligament Recovery

Mohammed's experience provides valuable insights for others facing similar injuries:

• Recovery timelines may extend beyond typical single-ligament rehabilitation
• Progress requires patience and consistent effort
• Technology can provide crucial support and guidance
• Regular monitoring and adjustment of goals proves essential
• Professional guidance combined with home exercise programs optimizes outcomes

Conclusion

Multiple ligament knee injuries present unique challenges requiring dedicated, long-term commitment to rehabilitation. Mohammed's recovery journey demonstrates that with proper guidance, consistent effort, and technological support, significant progress is achievable. His experience particularly highlights the importance of early mobility work, consistent exercise progression, and regular monitoring of improvements.

For those facing similar complex knee injuries, the combination of professional guidance and technological support through tools like the Curovate app can provide the structure and motivation needed for successful rehabilitation.

If you need further customized assistance during your recovery check out our Virtual Physical Therapy page to book your 1-on-1 video session with a physical therapist.

Start your guided rehabilitation with Curovate today:

Other Blogs Related to ACL Recovery

Note - we have received permission from Elina on Instagram to post her recovery story to help motivate and inspire others.

When Life Takes an Unexpected Turn: The Injury

Meet Elina, a women's fitness and weight loss coach, certified trainer, and nutrition expert. In 2018, just three days before her 30th birthday, what should have been an exciting ski trip to Whistler, British Columbia, turned into a life-changing moment when she tore her ACL.

Instead of celebrating her milestone birthday as planned, Elina found herself following the crucial RICE protocol (Rest, Ice, Compression, and Elevation), preparing for the road ahead. As a fitness professional, she understood the importance of proper initial care - reducing swelling and maintaining range of motion before surgery would be crucial for optimal recovery.

The First Steps: Early Recovery Phase

Nine weeks post-injury, Elina traveled to Ukraine for her reconstructive surgery. The first 24 hours proved challenging, with pain management being a primary concern. The initial three weeks tested her patience as she adapted to using crutches for mobility.

"The transition from crutches to a cane was mentally challenging," Elina recalls. Like many athletes, she wanted to skip straight to normal walking, but understanding the importance of proper progression helped her stay focused on long-term success.

Technology Meets Determination: The Rehabilitation Process

From day one post-surgery, Elina committed to her rehabilitation. Using the Curovate app to track her progress, she focused on improving her knee's range of motion, which initially wouldn't bend past 90 degrees. Despite this challenge, she maintained her determination, following her exercise program consistently while properly managing recovery through icing and rest.

Breaking Records Safely: The Results

Through unwavering dedication to her rehabilitation program, Elina achieved remarkable progress. For 20 consecutive weeks, she showed up every day, putting in the work that would lead to an impressively swift recovery. While she completed her initial recovery in approximately 5 months, it's important to note that every individual's timeline differs.

Important Note: While Elina's recovery timeline was shorter than average, we always recommend following your healthcare team's guidance for the safest, most effective long-term results. The standard recovery timeline of 9-12 months exists for good reason.

Looking Forward: Lessons Learned

Today, Elina reflects on her experience with gratitude: "Now looking back it's crazy but I'm thankful this happened - it built resilience in me in a way that nothing else could have. It pushed me past my limits and made me stronger."

For those beginning their own ACL recovery, consider using the same tools that helped Elina succeed. The Curovate app provides comprehensive support throughout your rehabilitation process, from pre-surgery preparation through return to activity.

Conclusion

Elina's story demonstrates that while ACL recovery presents significant challenges, success is achievable through dedication, proper guidance, and the right tools. Her experience as a fitness professional brings unique insights to the recovery process, highlighting the importance of both physical and mental preparation. Whether you're an athlete, fitness enthusiast, or someone recovering from ACL surgery, the key elements of success remain consistent: commitment to rehabilitation, proper progression through recovery phases, and utilization of appropriate support tools.

While every recovery timeline is unique, having the right resources at your fingertips can make a significant difference. The Curovate app provides the structure, guidance, and tracking tools needed to support your ACL rehabilitation journey, whether you're in the pre-surgery phase or working toward return to activity.

If you need further customized assistance during your ACL recovery check out our Virtual Physical Therapy page to book your 1-on-1 video session with a physical therapist.

Start your guided rehabilitation with Curovate today:

Other Blogs Related to ACL Surgery and Rehabilitation

• Why do I feel weak after surgery?
• How to become more consistent with your exercise program using curovate
• ACL recovery timeline
• Is my ACL graft weaker than my original ACL or is my ACL graft stronger than my original ACL?
• When can I return to sport after ACL injury or surgery?
• Is there a difference in what I need to do if I had a quad tendon graft compared to a patellar tendon graft for my ACL reconstruction?

How do I know I tore my ACL? The 5 most common signs and symptoms of an ACL injury

Here are five signs and symptoms common with ACL injuries:

1. Audible pop
2. Instant pain
3. Immediate swelling
4. Knee instability
5. Reduction in knee range of motion

By being able to identify common signs and symptoms associated with a torn ACL, you can more rapidly understand the severity of your potential injury which will allow you to seek health care sooner. The sooner you seek professional help, the faster you can begin your journey towards recovery.

Watch Aleesha discuss how to identify common signs and symptoms of ACL surgery

Read the full blog that discusses the 5 most common signs and symptoms of an ACL injury here.

Read all 8 of Aleesha's blogs here!

If you are recovering from an ACL injury or ACL surgery and you want to do everything possible to return to running download our Curovate physical therapy app from the links below. Curovate provides daily video guided strengthening exercises, the ability to measure knee range of motion, in-app chat with a physical therapist to answer your surgery and recovery questions and educational blogs and webinars.

If you need further customized assistance during your ACL recovery check out our Virtual Physical Therapy page to book your 1-on-1 video session with a physical therapist.

Other recommended blogs

• How does cycling help with my ACL recovery? Is a stationary bike good after ACL surgery? Do I need a stationary bike after ACL surgery
• After ACL surgery, how much help will I need? And help with what?
• Is my ACL graft weaker than my original ACL? Or is my ACL graft stronger than my original ACL?

References

1. Austermuehle, P.D. Common knee injuries in primary care. The Nurse practitioner. 2001;26(10):26, 32–45; quiz 46. doi: 10.1097/00006205-200110000-00005. PubMed PMID: 11688237.

2. Pines, J.M. and W.W. Everett. Acute Knee Injuries, in Evidence-Based Emergency Care. Oxford, UK: Blackwell Publishing Ltd.; 2008. p. 67–71. doi: 10.1002/9781444300772.ch9.

3. LaBella, C.R., W. Hennrikus, T.E. Hewett, and Council on Sports Medicine and Fitness, and Section on Orthopaedics. Anterior cruciate ligament injuries: diagnosis, treatment, and prevention. Pediatrics. 2014;133(5):e1437-50. doi: 10.1542/peds.2014-0623. PubMed PMID: 24777218.

4. Brukner, P. and K. Khan. Anterior Cruciate Ligament Injuries, in Ebook Brukner & Khan’s Clinical Sports Medicine: Injuries, Vol. 1. 2017. p. 737.

5. Anterior Cruciate Ligament (ACL) Injuries. American Academy of Orthopaedic Surgeons. 2014 [cited 2021 Sep 28].

"I had to change a lot mentally to get better physically," says Lani Woods, perfectly capturing the essence of rehabilitation. Lani's remarkable journey through a complex knee injury and multiple surgeries offers hope and guidance for anyone on their own recovery path.

Note - we have received permission from Lani on Instagram to post her recovery story to help motivate and inspire others.

The Initial Injury and Diagnosis

In October 2019, Lani faced a combination of injuries that would test any athlete's resolve. During a training incident, she experienced:

• A tibial plateau avulsion fracture
• Complete ACL and PCL ruptures
• Lateral and medial meniscus tears

For those who aren't knee experts, think of an avulsion fracture as the ligaments actually pulling away a piece of bone – definitely not your average sports injury! Lani was looking at 6-9 months of recovery, but she took on this challenge with an amazing attitude, asking herself "how bad do you really want it?"

The First Recovery Phase

After her first surgery, where doctors used bioabsorbable screws to reattach the ligaments, Lani dove into rehab head-first. She knew there would be good days and bad days, but that didn't stop her from crushing the workouts she could do while wearing a plaster cast.

Using Technology to Track Progress

During her recovery, Lani found a game-changer in the Curovate app. "I specifically liked that I could use Curovate to measure my knee flexion and extension on my phone!" Lani says. The app helped her track her progress with precise measurements right from her smartphone.

A Twist in the Recovery Tale

By July, things got complicated. Lani's knee started swelling chronically, puzzling her doctors. Here's where her ultrasound tech training came in handy – she used diagnostic ultrasound to discover fluid and blood buildup in her knee. Talk about being your own health advocate!

The rare rejection of her bioabsorbable screws (happening in only 4% of cases) meant another surgery in November 2020.

The Comeback

One year after her final surgery, Lani proved that comebacks are possible. She's back to cycling, crushing obstacle races, and dominating workouts. As Lani says, "Be curious, be adventurous, be unapologetic in your pursuit to find what sets your soul on fire."

What You Can Learn from Lani's Journey

1. Your mindset matters as much as your physical therapy
2. Track your progress - it keeps you motivated
3. Listen to your body and speak up when something feels off
4. Focus on what you can do, not what you can't
5. Keep your eye on the prize, but celebrate small wins

Conclusion

Whether you're an athlete recovering from surgery or someone working through rehabilitation, Lani's journey offers valuable lessons in perseverance. Recovery isn't just about returning to previous activities – it's about emerging stronger, wiser, and more resilient than before.

Remember that every recovery journey is unique. Focus on your own path, celebrate your progress, and maintain faith in the recovery process. As Lani demonstrated, with determination, proper medical care, and the right mindset, coming back stronger is absolutely possible.

If you need further customized assistance during your ACL recovery check out our Virtual Physical Therapy page to book your 1-on-1 video session with a physical therapist.

Start your recovery journey with Curovate:

Blogs related to ACL surgery

• Understanding numbness after ACL surgery
• When can I run after ACL surgery?
• How long does it take for my ACL scar to heal? Scarring after ACL surgery
• Can an ACL injury lead to knee arthritis in the future?
• Why does my knee hurt when it rains? Knee pain and rainy days

People decide to undergo a knee replacement surgery when they are in pain and are no longer able to take part in their everyday life activities. It is a highly effective surgery, and most people have less pain and are able to be more physically active after the surgery.

Typically, people see a gradual improvement in their pain symptoms during the first year after their knee replacement surgery. About 3 months after the surgery most people had less pain than they did before. After about a year, people state they have less pain and an overall improved quality of life.

In the video below, watch physical therapist Monica Kim discuss what to expect during the first year after a knee replacement surgery.

Read the full blog on "Is it normal to still have knee pain after a knee replacement?" here.

Read all of Monica Kim's blogs here!

The Curovate mobile physical therapy app can help you if you have had a knee replacement surgery to reduce pain in your everyday life and help get you back to the activities you love. Curovate is for at-home physical therapy exercises following a knee replacement, ACL surgery, ACL injury or hip replacement. The app includes a personalized exercise program, video guided exercises, and the ability to track your progress, all from your phone! You can download the Curovate app from the App Store or the Play Store using the links below.

If you need further customized assistance during your surgery or injury recovery check out our Virtual Physical Therapy page to book your 1-on-1 video session with a physical therapist.

Other recommended blogs

• Tips and tricks to fit rehab exercises into your daily schedule

• How to use crutches after surgery

• How to speed up recovery after total knee replacement

References

1. Bade, M. J., Kohrt, W. M., & Stevens-Lapsley, J. E. (2010). Outcomes before and after total knee arthroplasty compared to healthy adults. The Journal of orthopaedic and sports physical therapy, 40(9), 559–567. https://doi.org/10.2519/jospt.2010.3317

2. Li, C., Ng Cheong Chung, K., Ali, O., Chung, N., & Li, C. (2020). Literature review of the causes of pain following total knee replacement surgery: prosthesis, inflammation and arthrofibrosis. EFORT Open Reviews, 5(9), 534–543. https://doi.org/10.1302/2058-5241.5.200031

3. Wainwright, A. V., Kennedy, D. M., & Stratford, P. W. (2015). The Group Experience: Remodelling Outpatient Physiotherapy after Knee Replacement Surgery. Physiotherapy Canada. Physiotherapie Canada, 67(4), 350–356. https://doi.org/10.3138/ptc.2014-44

Is it safe for me to exercise if I have knee osteoarthritis or hip osteoarthritis?

Exercise is considered the most effective non-surgical treatment when it comes to managing your hip and knee osteoarthritis. Unfortunately, only about 30 percent of people with OA meet the physical activity guidelines of 150 minutes of moderate to vigorous physical activity each week. Aerobic exercises like walking can actually help to combat a lot of the comorbidities seen with people who have OA such as diabetes, high blood pressure, etc. Strength and flexibility exercises can help to improve your muscle strength, improve the stability in your joint, and increase range of motion. All of which will help you to ultimately reduce your pain. Experiencing some pain during exercise with OA is completely normal. On a scale of 1 to 10 if your pain rating goes up about two to three points during exercise that is considered completely normal. It's worthwhile to push through it because ultimately the benefits of exercise outweigh the risks.

In the video below, watch Aleesha, a physical therapist student, answer the question "Is it safe for me to exercise if I have knee osteoarthritis or hip osteoarthritis?"

Read the full blog on Is it safe for me to exercise if I have knee osteoarthritis or hip osteoarthritis? here.

Read all of Aleesha's blogs here!

Getting help from online physical therapists and our app Curovate can help you to find exercises that are specific to your needs. Curovate is a physical therapy app for ACL reconstruction, knee replacement, and hip replacement. Adding exercise to your routine as a person with osteoarthritis will ultimately help you to improve pain and return to activities that are meaningful to you!

Other Blogs Related to Osteoarthritis

• Does running cause knee osteoarthritis? Can I still run after my ACL surgery? Will running wear out my knee?
• My surgeon said I have knee osteoarthritis but I don't have pain - should I get a knee replacement?
• What is Osteoarthritis?
• What's the difference between Arthritis, Osteoarthritis and Osteoarthrosis?
• How to Become More Consistent with your Exercise Program Using Curovate
• Should I be experiencing pain when I do my rehabilitation exercises?

References

1. Kolasinski SL, Neogi T, Hochberg MC, Oatis C, Guyatt G, Block J, et al. 2019 american college of rheumatology/arthritis foundation guideline for the management of osteoarthritis of the hand, hip, and knee. Arthritis Rheumatol. 2020 Feb;72(2):220–33.

2. Calders P, Van Ginckel A. Presence of comorbidities and prognosis of clinical symptoms in knee and/or hip osteoarthritis: A systematic review and meta-analysis. Semin Arthritis Rheum. 2018 Jun;47(6):805–13.

3. Juhl C, Christensen R, Roos EM, Zhang W, Lund H. Impact of exercise type and dose on pain and disability in knee osteoarthritis: A systematic review and meta-regression analysis of randomized controlled trials. Arthritis Rheum. 2013 Dec 18;

4. Messier SP, Resnik AE, Beavers DP, Mihalko SL, Miller GD, Nicklas BJ, et al. Intentional weight loss in overweight and obese patients with knee osteoarthritis: is more better? Arthritis Care Res (Hoboken). 2018 Nov;70(11):1569–75.

5. Loew L, Brosseau L, Wells GA, Tugwell P, Kenny GP, Reid R, et al. Ottawa panel evidence-based clinical practice guidelines for aerobic walking programs in the management of osteoarthritis. Arch Phys Med Rehabil. 2012 Jul;93(7):1269–85.

6. Gay C, Chabaud A, Guilley E, Coudeyre E. Educating patients about the benefits of physical activity and exercise for their hip and knee osteoarthritis. Systematic literature review. Ann Phys Rehabil Med. 2016 Jun;59(3):174–83.

My surgeon said I have knee osteoarthritis, but I don't have pain - should I get a knee replacement?

You do NOT need a knee replacement in a knee you’ve never had pain in, even if an X-ray shows you have osteoarthritis. In addition to arthritic X-ray findings, knee pain and a decreased ability to do everyday activities need to be present to consider getting a knee replacement. To delay or decrease the likelihood of needing a knee replacement, there are several actions you can take. Most importantly, you should continue to move your knee by staying active with activities you enjoy. Additionally, if you are overweight, losing weight will help you decrease pain and improve physical function. Lastly, it is important to recognize the impact that good mental health has on pain prevention. Following these strategies will help keep your knee pain-free and prevent the need for a knee replacement.

Watch the video below, where physiotherapist Andrew discusses if it is possible to have knee arthritis without pain and if knee arthritis alone means you should get a knee replacement.

Read the full blog on "I Have Knee Osteoarthritis but I Don’t Have Pain. Do I need a knee replacement?" here.

Read all of Andrew's blogs here!

Whether you’re managing osteoarthritis or just had a knee replacement, the Curovate mobile physical therapy app is a great tool to use to help you decrease pain and get back to the activities you love. Curovate includes a personalized exercise program, video guided exercises, and the ability to track your progress, all from your phone! You can download the Curovate app from the App Store or the Play Store using the links below.

If you need further customized assistance during your osteoarthritis or knee replacement journey check out our Virtual Physical Therapy page to book your 1-on-1 video session with a physical therapist.

Other Blogs Related to Osteoarthritis and Knee Replacement

• What is Osteoarthritis?
• What is a Total Knee Replacement?
• Should I put off my total knee replacement surgery? What are my other options?
• The Mental Side of Injury: Hot to Keep a Positive Attitude During Recovery
• Is it normal to still have pain after a knee replacement surgery?
• Why does my knee feel weird after my total knee replacement? Why does my knee feel heavy after my total knee replacement?

References

1. Chen D, Shen J, Zhao W, et al. Osteoarthritis: toward a comprehensive understanding of pathological mechanism. Bone Res. 2017;5:16044. doi:10.1038/boneres.2016.44

2. Page CJ, Hinman RS, Bennell KL. Physiotherapy management of knee osteoarthritis. Int J Rheum Dis. 2011;14(2):145-151. doi:10.1111/j.1756-185X.2011.01612.x

3. de Rooij M, van der Leeden M, Heymans MW, et al. Prognosis of Pain and Physical Functioning in Patients With Knee Osteoarthritis: A Systematic Review and Meta-Analysis. Arthritis Care Res (Hoboken). 2016;68(4):481-492. doi:10.1002/acr.22693

4. Gademan MGJ, Hofstede SN, Vliet Vlieland TPM, Nelissen RGHH, Marang-van de Mheen PJ. Indication criteria for total hip or knee arthroplasty in osteoarthritis: a state-of-the-science overview. BMC Musculoskelet Disord. 2016;17(1):463. doi:10.1186/s12891-016-1325-z

5. Bedson J, Croft PR. The discordance between clinical and radiographic knee osteoarthritis: a systematic search and summary of the literature. BMC Musculoskelet Disord. 2008;9:116. doi:10.1186/1471-2474-9-116

6. Duclos M. Osteoarthritis, obesity and type 2 diabetes: The weight of waist circumference. Ann Phys Rehabil Med. 2016;59(3):157-160. doi:10.1016/j.rehab.2016.04.002

7. Bair MJ, Robinson RL, Katon W, Kroenke K. Depression and pain comorbidity: a literature review. Arch Intern Med. 2003;163(20):2433-2445. doi:10.1001/archinte.163.20.2433

Why do rural communities and remote communities have poor access to physical therapy?

Rural and remote communities have poor access to physical therapy. Some communities do not have a local physical therapist and have to travel for over an hour to access care. Areas that do have physical therapists often have long wait times and a lack of specialized care due to limited staff. Residents of rural communities often have to travel to urban centers to access the specific physical therapy care they need. Barriers such as time, cost, and limited access to public transportation make accessing physical therapy much harder. Virtual physical therapy is one solution to try to address some of these barriers. Virtual physical therapy has its own barriers such as internet access and the cost of technology.

Watch Andrew, a physical therapist, address the question "Why do rural communities and remote communities have poor access to physical therapy?" in the video below.

Read the full blog on Why do rural communities and remote communities have poor access to physical therapy? here.

Curovate is a physical therapy app for ACL reconstruction, knee replacement, and hip replacement. One motivation behind creating the Curovate app was to increase access to healthcare and reduce the barriers to providing physical therapy.

For those living in rural areas that have access to an internet connection, this is a great way to access physical therapy. Curovate was designed by a physical therapist and works with you throughout your entire recovery. It provides a list of video-guided exercises to complete each day. As you move through the stages of recovery, you will be given new exercises to ensure you continue to make progress. Other features include the weekly achievements, measuring range of motion, and the option to connect with a licensed physical therapist virtually.

If you need further customized assistance during your surgery or injury recovery check out our Virtual Physical Therapy page to book your 1-on-1 video session with a physical therapist.

Other related blogs:

• “The world is mobile and so are physical therapists!”
• How is physical therapy access changing in 2020? COVID-19: Part 1
• How To Manage Your Recovery Protocols With Curovate
• How to Navigate your exercises in Curovate
• How To Access and Follow Your Exercise Program Using Curovate
• How To Become More Consistent With Your Exercise Program Using Curovate

References

1. Canada S. Number of persons in the total population and the farm population, for rural areas and population centres, classified by sex and age. Government of Canada. 2017. doi:10.25318/3210019701-eng

2. Ford DM. Four persistent rural healthcare challenges. Healthc Manage Forum. 2016;29(6):243-246. doi:10.1177/0840470416658903

3. Nielsen M, D’Agostino D, Gregory P. Addressing rural health challenges head on. Mo Med. 2017;114(5):363-366.

4. Spalevic M, Dimitrijevic L, Kocic M, Stankovic I, Zivkovic V. AB1124 The Importance of the Early Rehabilitation after Total Knee Replacement in Osteoarthritis and Rheumatoid Arthritis Patients. Ann Rheum Dis. 2014;73(Suppl 2):1173.4-1174. doi:10.1136/annrheumdis-2014-eular.4638

5. Adams R, Jones A, Lefmann S, Sheppard L. Rationing is a reality in rural physiotherapy: a qualitative exploration of service level decision-making. BMC Health Serv Res. 2015;15:121. doi:10.1186/s12913-015-0786-3

6. Bourassa C. Addressing the duality of access to healthcare for indigenous communities: racism and geographical barriers to safe care. Healthc Pap. 2018;17(3):6-10. doi:10.12927/hcpap.2018.25507

7. Grona SL, Bath B, Busch A, Rotter T, Trask C, Harrison E. Use of videoconferencing for physical therapy in people with musculoskeletal conditions: A systematic review. J Telemed Telecare. 2018;24(5):341-355. doi:10.1177/1357633X17700781

8. Jiang S, Xiang J, Gao X, Guo K, Liu B. The comparison of telerehabilitation and face-to-face rehabilitation after total knee arthroplasty: A systematic review and meta-analysis. J Telemed Telecare. 2018;24(4):257-262. doi:10.1177/1357633X16686748

9. ‘Left out of this equation’: Why virtual health care is leaving some Ontarians behind | TVO.org. https://www.tvo.org/article/left-out-of-this-equation-why-virtual-health-care-is-leaving-some-ontarians-behind. Accessed August 18, 2021.

What is the difference between Arthritis and Osteoarthritis?

Arthritis is the overall term of many conditions including system-wide conditions like rheumatoid arthritis whereas osteoarthritis is very specific to the joint that has sustained some damage. In the world of ACL tears and knee replacement or hip replacement we are primarily concerned about osteoarthritis. Osteoarthritis means that there is wear and tear of the cartilage inside of a joint and that is what results in osteoarthritis. That is typically what you see with joint injuries whereas other forms of arthritis can be a system-wide problem where it is an immune system response that damages multiple joints in the body.

Osteoarthritis specifically refers to damage of the joint whereas other types of arthritis may be autoimmune disorders. If you have osteoarthritis, you can use our knee replacement or hip replacement protocols to help you decrease pain and improve your ability to do everyday tasks.

In this short video Nirtal Shah, Physical Therapist and CEO of Curovate, will explain the difference between Knee arthritis and knee osteoarthritis.

To learn more, check out the full blog on the difference between Arthritis, OsteoarthrITIS and OsteoarthrOSIS here.

Read all of Nirtal's blogs here.

Check out Curovate! It is a physical therapy app for at-home physical therapy exercises following a knee replacement, ACL surgery, ACL injury or hip replacement. Curovate provides you with video-guided exercises, reminders, and has a feature that allows you to measure your joint range of motion for your knee or hip. Try the app today by clicking the links below!

If you need further customized assistance during your surgery or injury recovery check out our Virtual Physical Therapy page to book your 1-on-1 video session with a physical therapist.

Other Related Blogs

• What is osteoarthritis?
• My Surgeon Said I Have Knee Osteoarthritis but I Don’t Have Pain
• Is It Safe For Me To Exercise If I Have Knee Osteoarthritis or Hip Osteoarthritis?



References




1. Tanchev P. View of Osteoarthritis or Osteoarthrosis: Commentary on Misuse of Terms: Reconstructive Review. View of Osteoarthritis or Osteoarthrosis: Commentary on Misuse of Terms | Reconstructive Review. Published 2017. Accessed December 1, 2020.

2. Centers for Disease Control and Prevention. Frequently Asked Questions (FAQs) about Arthritis. Centers for Disease Control and Prevention. Published January 10, 2019. Accessed December 1, 2020.

3. World Health Organization. Chronic rheumatic conditions. World Health Organization. Published November 17, 2016. Accessed December 1, 2020.

4. Centers for Disease Control and Prevention. Osteoarthritis (OA). Centers for Disease Control and Prevention. Published July 27, 2020. Accessed December 1, 2020.

5. Carteron N. Arthrosis vs. Arthritis: What’s the Difference? healthline. Published September 17, 2018. Accessed November 30, 2020.

6. Atkinson M. Osteoarthrosis. Published 1964. Accessed November 30, 2020.

“Come to Canada, we have free healthcare!” Canada is known around the world for having a publicly funded healthcare system, one that our country is quite proud of. And while the Canadian healthcare system is dynamic and based around the principles of fairness and equity, there are still many parts of critical and necessary healthcare services that are not publicly funded. So how exactly does this public funding work?

The answer is that it varies quite a bit province to province. Ontario allocates about 300 dollars for physio following a hip replacement and 250 following a knee replacement. Given an average PT session costs between $80 to $100, this covers maybe two to four sessions. British Columbia covers about 26 dollars per physio visit but only allows you a max of 10 visits a year. Manitoba has absolutely no public funding for physiotherapy. Quebec and Newfoundland don't have a funding limit but the average wait time to see a physical therapist can range between 140 to 300 days after surgery. The truth is there is not adequate funding available for physio following these surgeries and that's why Curovate was designed: to help improve access to the public so that they can receive great home care and rehab programs that will help them on their road to recovery.

In the video below, Aleesha answers the question, how much public funding is available in Canada, specifically within 5 provinces, after a hip replacement or knee replacement.

Read the full blog that discusses how much public funding is available after knee replacement or hip replacement in Canada here.

Read all 8 of Aleesha's blogs here!

The Curovate physiotherapy app was developed by a physical therapist to help address the lack of access to physical therapy after a knee replacement or hip replacement surgery. Curovate provides daily video guided strengthening exercises, the ability to measure knee range of motion, in-app chat with a physical therapist to answer your surgery and recovery questions and educational blogs and webinars. A full rehabilitation program will be provided to you and conveniently accessible through your mobile device. Check out the links below to download the app and see how it can best serve your rehabilitation needs following a hip replacement or knee replacement surgery.

If you need further customized assistance during your ACL recovery check out our Virtual Physical Therapy page to book your 1-on-1 video session with a physical therapist.

Other recommended blogs

• Why do Indigenous communities have the worst access to healthcare in Canada?
• What to expect after total hip replacement surgery
• What are the benefits of a knee replacement?

References

1. CBC/Radio Canada. (2012, July 11). 30-month wait list for physio in Labrador | CBC News. CBCnews. Retrieved October 14, 2021, from https://www.cbc.ca/news/canada/newfoundland-labrador/30-month-wait-list-for-physio-in-labrador-1.1281686

2. CBC/Radio Canada. (2005, April 26). Physiotherapy wait list swells in Labrador | CBC News. CBCnews. Retrieved October 14, 2021, from https://www.cbc.ca/news/canada/newfoundland-labrador/physiotherapy-wait-list-swells-in-labrador-1.532848

3. Deslauriers, S., Raymond, M.-H., Laliberté, M., Hudon, A., Desmeules, F., Feldman, D. E., & Perreault, K. (2019). Prioritization of referrals in outpatient physiotherapy departments in québec and implications for equity in access. Canadian Journal of Bioethics, 1(3), 49–60.

4. Health Quality Ontario. (2005). Physiotherapy rehabilitation after total knee or hip replacement: an evidence-based analysis. Ontario Health Technology Assessment Series, 5(8), 1–91.

5. Hip and Knee Replacements in Canada: CJRR Annual Statistics Summary, 2019–2020 | CIHI. (n.d.). Retrieved October 14, 2021, from https://www.cihi.ca/en/hip-and-knee-replacements-in-canada-cjrr-annual-statistics-summary-2019-2020

6. Home - Canada.ca. (n.d.). Retrieved October 14, 2021, from https://www.canada.ca/en.html

7. Home - Province of British Columbia. (n.d.). Retrieved October 14, 2021, from https://www2.gov.bc.ca/gov/content/home

8. How Healthcare Works In Nova Scotia: An In-Depth Review. (n.d.). Retrieved October 14, 2021, from https://www.closingthegap.ca/how-healthcare-works-in-nova-scotia-an-in-depth-review

9. Manitoba Physiotherapy Association. (n.d.). Retrieved October 14, 2021, from https://mbphysio.org

10. Medical Care Plan Coverage - Health and Community Services. (n.d.). Retrieved October 14, 2021, from https://www.gov.nl.ca/hcs/mcp/healthplancoverage

11. Ontario Ministry of Health and Long-Term Care. (n.d.). Retrieved October 14, 2021, from https://www.health.gov.on.ca/en

12. Physiotherapy Fees | Toronto Physiotherapy. (n.d.). Retrieved October 14, 2021, from https://torontophysiotherapy.ca/fees/pricing-list

13. Sutherland, G. (2017). The market profile of physiotherapists in Canada. In Ottawa: Conference Board of Canada

14. The value of physiotherapy. (n.d.). Retrieved October 14, 2021, from https://physiotherapy.ca/sites/default/files/valuePT/cpa_valuept_jointarthroplasty-en.pdf

15. Welcome to Quinte Health Care - Exceptional care, inspired by you. (n.d.). Retrieved October 14, 2021, from https://www.qhc.on.ca

16. Wylde, V., Beswick, A., Bruce, J., Blom, A., Howells, N., & Gooberman-Hill, R. (2018). Chronic pain after total knee arthroplasty. EFORT Open Reviews, 3(8), 461–470