First 5 days following injury
Ice: Apply an ice/cold gel pack in a damp t-towel to the injured area for 10 minutes, two to four times daily, to reduce heat and inflammation of the muscles, especially for the first 72 hours.
Effleurage massage: for the fore leg or hind leg starting at the toes, with your fingers together, slowly push up with a medium pressure towards the upper leg region to facilitate lymphatic drainage and blood circulation and reduce local swelling. Repeat for 60 seconds.
Passive Range of Movement Exercises: to maintain or restore normal range of movement in an affected leg and prevent joint stiffness caused by muscle shortening. These are best performed with your pet in side lying. Following surgery, these exercises may be uncomfortable or your pet may show some anxiety. Let your animal’s comfort be your guide. Use a slow bicycle movement of the limb to bend and move the leg.
Husbandry Advice: NO impact activities i.e. jump on/off sofa or bed, up and down stairs, jumping in/out of car. NO slips or trips. NO playing with or without other dogs. CONFINE!!!!
Walks: recommended 3 x 5 minutes daily lead only, walking very slowly. This is otherwise known as a toilet walk.
After 5 days and up to 3 Weeks injury
Contrast Hot and Cold therapy: Heat may be used to increase blood flow to enhance tissue healing and reduce joint stiffness. This may be done using a heat pack or wheat bag for 10-15 minutes. Use towels to moderate the heat output and check on your own skin prior to application on your pet to prevent burning the skin. Apply an ice/cold gel pack in a damp t-towel to the stifle for 10 minutes after treatment to reduce heat and inflammation of the joint.
Kneading Massage (Affected Leg): to increase the blood flow and warm up the muscles in preparation for passive movement and active exercises. Using your fingers behind the muscle and thumb on top of muscles from where you are sitting, perform slow, medium pressure, circular movements up and down the muscle groups. For the muscles over the shoulder or pelvis or along the spine, use fingers only and together starting at the bottom bone (adjacent to the tail), perform small circular movements up towards the back and over the muscles alongside the spine. 60 seconds for each muscle group.
Passive Range of Movement Exercises (as above)
Stretching Exercises:
With one hand in front of the leg and one behind, take the leg back very gently (in line with the body)to stretch the shoulder or hip. Hold 30 seconds. Repeat 3 times.
With the hands as above, slowly and gently take the thigh or foreleg forward to stretch the back of the leg. Hold for up to 30 seconds. Repeat 3 times.
Strengthening Exercises:
Ask the patient to stand from sitting, encouraging square sitting by placing the limbs flexed underneath the patient. Repeat 5-10 times three times daily.
In standing with both fore or hind feet on the ground, slowly push over the shoulders or pelvis to encourage patient to push back against you. Hold this for 10 seconds, repeat 5 times left and right.
Walks: recommended 3 x 10 minutes daily lead only at two weeks, encouraging weight bearing of the affected leg by walking very slowly.
From 3-6 weeks injury
Kneading massage, passive range of movement, stretching and strengthening exercises, if required, as above
Strengthening Exercises:
3 leg standing – with one hand lightly supporting under the stomach and the other hand raising the good fore or hind limb, encourage the patient to bear the weight on the standing limb for 10 seconds, repeat 5-10 times.
Place the patient’s two front or back legs on a low step to increase the load on the hind or fore limbs. Maintain this position for 30 seconds and repeat 3 times.
From 4 weeks 2 leg standing – first raise the fore or hind limb on the same side as the operated limb, then raise the diagonal un-operated hind or fore limb and encourage the patient to hold this for up to 10 seconds. Repeat this 5-10 times.
Walks: recommended 3 x 10 minutes daily lead only encouraging weight bearing of the affected leg by walking very slowly. Add 5 minutes to each walk per week remaining on the lead i.e. 15 minutes in week 4, 20 minutes in week 5 and Check X-ray is usually recommended at week 6 before further progression is made.
From 6-9 weeks injury
Strengthening Exercises:
Place 5-6 poles 8-18 inches apart from each other (depending on the size of the patient and allowing one hind footfall between two poles) and encourage the patient to step over these 6 times. To increase difficulty raise the poles 3-4 inches from the ground to encourage flexion (bending) of the knee and increase the distance slightly to encourage full extension (straightening) of the leg. Progress into trot at week 9.
From 6 weeks (NOT if inflammation is suspected) Supervised steps – with lead control, walk up and down 3-4 steps, increasing the number gradually to a flight and repeat 6 times. It is important that the patient does not scoop his limb outwards as he/she steps up or down.
Add gentle inclines, gradually increasing, into your walk exercise.
Walks: Add 5 minutes to each walk per week remaining on the lead.
Water Treadmill Hydrotherapy: this will assist with muscle strengthening and regaining normal stride length. We will advise on suitable Hydrotherapy units.
Return to Play Stage (9-12 weeks injury)
Running straight off lead work. Preferably the dog should be walking for up to one hour before off lead work begins. It is advised that the patient is let off the lead at the end of a walk in a controlled and calm environment to avoid being over excitable. (Approx time scales to begin off lead 8 weeks if dog not excitable, 12 weeks if excitable)
Keeping your dog on the lean side is a good idea, since excess body weight stresses the joints, and it’s also a good idea to give your dog glucosamine supplements to support joint health.