How we use rehab to benefit post op TPLO patients
As many people know, physical therapy is something we often need to do following any orthopedic surgery as a human. Well, did you know that our pets benefit from this as well? Our practitioners can assess the joint and healing process while working alongside your vet. We are able to work on muscle strengthening, gait retraining and focused exercises relating to your pets injury.
meet Magnum
Magnum came to Touch at about 12 weeks post op after a TPLO on his right stifle. His surgeon was concerned that his gait wasn’t quite where he wanted it to be, so he suggested rehab for Magnum to help him improve.
When Magnum was here for his first assessment, he had stability through his surgical knee but was lacking muscle strength, causing him to have an abnormal gait.
We came up with a plan to help him regain muscle and retrain his gait, all well monitoring the muscles and stifle joint for any tension or pain.
How we helped
We started with Hydrotherapy. The underwater treadmill is a wonderful tool that we have here at Touch. The warm water can help to relax any muscle tension the dog may have, the buoyancy of the water helps alleviate pressure on the joints, which also allows for an Increase in range of motion, and the resistance of walking through the water will help increase and maintain muscle strength. The practitioners can help in the underwater treadmill as well. By providing manual pressure with our hands to certain areas of the patient’s body, it can promote better extension or range of motion and can help engage the proper muscles by bringing awareness to them.
We started with short sessions in the UWTM to make sure we weren’t causing any pain for him or going past his abilities, and as he began to get stronger, we gradually increased the time he spent in the UWTM. By the time Magnum graduated rehab he was doing upwards of ten minutes with a variety of speeds to help challenge him.
Following hydrotherapy, we started to introduce some weight shifting exercises. For Magnum we were looking to help strengthen the muscles in his hind end. Weight shifting exercises can help build strength and even help strengthen the small stabilizer muscles by using simple movements without causing further stress on the joint or injury. We started with simple exercises at the beginning such as a step stretch which is where we are asking the dog to raise their forelimbs on a step. This helps with promoting weight bearing onto the back legs which encourages weight shifting and strengthening of the muscles. We can also add in other exercises such as standing shake a paw, again this is the simple exercise that really helps to encourage muscle strengthening and weight shifting. We built on Magnum’s exercise plan each time he came to the clinic. Using our equipment, we are able to do many exercises that really challenged Magnum and allowed for him to strengthen his hind end all well having fun!
Each visit we also monitor the muscles and the knee joint. Just like in humans, as the use of the surgical limb starts to increase, the muscles can start to tense up. So, with the use of massage, we are able to help loosen the muscles giving them more flexibility and the ability to strengthen without getting sore or painful. We also check over the muscles that may be taking more load while the injury knee is recovering. Our patients will often compensate for the injured limb either through the other limbs or through their back. In Magnums case he was compensating a lot on to his left hind leg, so we continued to check on it throughout his recovery to make sure it wasn’t getting sore as well.
With our reoccurring visits we were able to monitor any progress and make any adjustments to his treatment plan along the way.
At home program
Along with what we do here at the clinic, we also want to include the owners as much as possible in their pet’s recovery. Sending these simple but effective weight shifting exercises home allows us to be effective with our strengthening plan, getting us quicker results. When Magnums owners informed us that he was starting to get bored with the weight shifting exercises, we sent the owners home with some exercise equipment to increase the challenge making Magnum enjoy his exercises that much more!
Conclusion
After several visits to the clinic, we saw improvement with each one, as did the owners. We were able to help strengthen Magnum enough to allow him to have improved gait and comfort level. Re-evaluating his stance analysis from the first session where he was only putting 12% of weight on to his surgery leg (should be 20%) to his last session where it went up to 19%, shows us the great improvements that he made throughout his rehab journey! This allowed Magnum to be able to start exploring his normal off leash activity in moderation as well as graduate from rehab!
All this to say, if owners are committed to helping their pets then we are able to help them get back to their normal or new normal following surgery! We love seeing our patients improve and graduate from rehab!
