T.P.L.O. Surgery Rehabilitation
Retriver Field Trial News - October 2004
Susan M. Taylork, DVM
Numerous athletes around the world are treating injuries they have sustained during their training and performances in the Olympics. Some of these athletes have defied great odds to continue in their sport and perform at the elite level. Many of the techniques used with human athletes are now being performed with canine athletes. Canine physical therapy is one of the fastest growing areas of veterinary medicine throughout the United States. Veterinarians are beginning to learn the benefits of rehabilitation for pets. Veterinarians and owners are finding that injuries that were once career ending are no longer. With the development of new surgical procedures, in conjunction with physical therapy, career-ending injuries are declining and dogs are returning to their respective sports in shorter timeframes. Used appropriately, physical therapy is the best tool in the medicine bag for certain cases.
Physical therapy can be used to treat a wide variety of conditions with dogs. It is effective for preoperative and postoperative cases, traumatic injuries whether it is musculoskeletal and/or neurological impairment, conditioning and strength training, weight loss, tendonitis, osteoarthritis, muscle strains and ligament injuries to list a few. Animals benefit by gaining range of motion and improving strength and function with less pain. Disuse muscle atrophy, joint contractures and muscle stiffness can be prevented. Recovery times are improved and the dog is able to return to its prior level of functioning much faster and safer. In addition, physical therapy can be utilized to enhance performance and reduce the risk of injury to healthy dogs. Numerous owners are taking advantage of these techniques and principles creating high performance canines. Your dog must be physically trained to reduce the chance of injury, improve strength and endurance, and gain the competitive edge.
A number of physical therapy modalities can be used to treat specific conditions: heat and cold therapy, therapeutic ultrasound, electrical stimulation, sound wave therapy, pulsed radiofrequency therapy and magnetic wave therapy. Some of these items have been utilized for a long time with proven effectiveness while others have little documented medical research to substantiate the effects. Therefore, owners and caregivers must be cautious when receiving or providing treatment for their pet as some items on the market have unproven effectiveness. Another treatment tool in physical therapy is therapeutic exercise. Several examples include passive range of motion, stretching, strengthening, endurance, and balance and coordination exercises. Numerous problems affecting people and dogs can be attributed to muscle imbalances, meaning some muscles are too weak while others are too tight. This can lead to mal-alignment problems, overuse injuries, muscle spasms, joint contractures and neurological conditions to name just a few. Any of these can lead to further joint problems, traumatic injury and poor performance. A full physical examination including range of motion measurements, girth measurements and even force plate analysis can help detect some of these subtle differences. A therapeutic exercise program can then be prescribed to address these problems. The exercises prescribed must be tailored to the specific problem and/or specific sports Passive range of motion exercises can improve joint mobility, decrease pain and decrease muscle tightness. Stretching will improve flexibility. Strengthening exercises prescribed for the weak musculature will decrease fatigue and improve strength. Other exercises can be given that address musculoskeletal and cardiovascular conditioning, as well as balance and proprioception. If a problem doesn't exist, the program should be geared toward the specific sport or activity the dog will perform.
Numerous pieces of exercise equipment are available to use with your dog. Your imagination is the limit in devising ways to exercise them. A few examples include weave poles, tunnels, ramps. trampolines, balance boards, sand boxes and hoops. My favorite exercise device is the underwater treadmill. This has been adapted from human medicine but manufactured specifically for dogs. The dog is loaded into the front of the treadmill through the hinged door. Water fills from the bottom to the desired levels The water level is determined by the desired therapeutic effects. Due to the buoyancy provided by the water, weight bearing forces on the extremities decrease.
Concussive forces are reduced in the joints allowing effective exercise with less discomfort. The presence of water, surrounding a dog with poor balance and weak musculature, provides feedback and comfort reducing the fear of failing. Dogs also benefit from heated water by improved circulation to the musculature, improved joint flexibility and less pain. Whirlpool jets can be utilized to enhance these effects. The water also provides resistance for the extremities which can improve strength as well as endurance. The clinician can be in the tank with the dog to provide additional support and comfort if needed. Flotation devices give additional buoyancy.
Numerous conditions benefit from aquatic therapy. Several of these include arthritic conditions, postoperative cruciate and total hip replacement cases, fracture repairs, neurological impairments and soft tissue injuries. A good example of the use of the underwater treadmill is rehabilitating dogs with cranial cruciate ligament repairs. With many tibial plateau leveling osteotomy (TPLO) cases, dogs can begin underwater treadmill work when the sutures are removed. Some clinicians will start sooner if the incision is well sealed. This early intervention allows quicker recovery times. At one time, a cranial cruciate ligament injury was a career-ending event. Now through the use of advance surgical techniques and physical therapy, these dogs can return to full function in as little as 12 weeks whether it be field trials, hunting or agility. Not all dogs will progress the same; therefore, recovery rates will vary and therapy programs should be adapted accordingly. The underwater treadmill can also be utilized for swimming. Indications for swimming include dogs that are severely debilitated or have a neurological condition with very subtle signs of motor function. It can also be used with dogs that are reluctant to bear any weight on the extremity, even with the added benefit of buoyancy. Swimming allows the extremities to function through the available range of motion, improve strength and endurance without joint concussive forces.
The underwater treadmill can also be utilized to improve performance in healthy pets by improving strength and endurance. Water level, speed, and water propulsion are different characteristics of the underwater treadmill that can be modified to vary exercise intensity. Swimming can also be used to enhance performance. Some facilities have a swim tank that can be used specifically for this task. These tanks are designed similarly to the underwater treadmill but lack the treadmill component. Water levels are raised so the dogs. are floating. The dog must swim against the current provided by the jets at the end of the unit. Different settings can change the force of the waters The exercise sessions, whether in the underwater treadmill or swim tank, can be enhanced by providing a fun environment for the dog. Tennis balls, bumpers and other devices are used to play with the dog while exercising. The retrievers at our facility are eager to start and difficult to stops
Numerous facilities are present throughout the United States offering canine rehabilitation services. Numerous people with varying backgrounds are delivering these services. It is advisable to perform some homework prior to initiating canine rehabilitation. It is important to discuss the idea with your veterinarian and find a reputable, qualified professional that you can trust with the care of your valued athlete.
Steve Jacobs, DVM, MSPT, owner of SPORTSVET Animal Medical Center in Savoy, IL
Licensed veterinarian and physical therapist
e-mail address: phone: (217) 355-1442
It is important to remember that in all cases, and all affected joints, the sooner the problem is recognized the more favorable the outcome.
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