Rehabilitation after joint or limb surgery

Rehabilitation after joint or limb surgery

So many dogs these days are rupturing their cruciate ligament in their knee or being born with dislocating kneecaps that need realigning. The surgery to repair the problem is only the start to helping improve your pet’s knee problems. Physiotherapy at home or with a professional could be the difference between a full or partial recovery. Physiotherapy is extremely important for treatment of any joint problem whether or not surgery is involved.

Well what is involved with post operative physiotherapy?

1. Immediately after surgery and continuing through the recovery period, start with passive range of movement exercises, this improves blood supply and movement in the joint.
a. Gentle extension and flexion of the affected joint and holding for a few seconds at the limits of both is all that is required. Never force the joint and the patient should be comfortable and pain free throughout movement of the joint. As time goes on an increased, pain-free, range of movement will occur.
2. From week 4 to 8 post op, start dynamic range of movement exercises to build up strength of the affected limb. Increase the vigour of these exercises depending on the surgery performed and the patient’s progress. Various types of exercises can be utilized and may include the following:
a. Controlled leash walking: the frequency and length of walks will vary but generally will start with 5 minute walks twice daily. Increase each week by 5 minutes to eventually walking 20 to 60 minutes three times a day.
b. Figure eights: walking in a figure of eight pattern can transfer weight onto the affected limb
c. Hurdles: a series of low barriers are spaced apart and the patient is walked then eventually trotted through them forcing a mild bounce to their gait
d. Sit / stand exercises: are excellent for building strength in the quadriceps muscle group (front of thigh). On a leash-walk, stop and allow your dog to start sitting; just before their bottom touches the ground ask them to walk on with their hind-legs already tensed
e. Underwater treadmill: an excellent exercise for knee surgery recovery, it is available through http://www.sydneyanimalphysiotherapy.com A similar option is to leash-walk your dog in knee-deep water (relative to your dogs knee), possibly in a shallow pool or beaches see http://www.urbananimal.net/pdf/issue9/8syd_water_holes.pdf for dog friendly beaches
f. Dancing: lift your dog’s front feet and hold so they are supporting their weight only on their hind-legs. Slowly move around in short steps so they appear to be “dancing” with you. Do this exercise for very short durations on level ground as it is can be quickly fatiguing (1 minute at a time, several times daily)
g. Incline and decline walking and trotting: exercising up and down hills will increase strength but be careful not to lose control (use a leash), starting with a very low grade hill
h. Stair climbing: can be used later in the physical therapy regime if there is not too much osteoarthritis in the joints.
i. Monitor for fatigue: do not allow your dog to become too muscle tired during any physical therapy exercises as the risk of injury increases dramatically. This is especially important at the early phases of treatment when the limb may be weaker from disuse during the post-operative recovery period
j. Swimming is only to be under taken 4 months post injury or operation, as it is not a controlled exercise and is very aggressive to the knee joint. In addition it can be very fatiguing to dogs.