I have a human family member who had joint replacement surgery not too long ago. Her surgeon basically told her, "I can perform a flawless surgery, but if you don’t follow through with physical therapy, don’t blame me if you’re not pleased with the results." My aunt has done wonderfully since, due to the combination of a good (and honest) surgeon and her hard work in physical therapy.
I’m not sure veterinarians emphasize the importance of physical therapy (PT) enough. I once worked in a practice where a board-certified orthopedic surgeon traveled to us on a monthly basis to perform tibial plateau leveling osteotomies (TPLOs) for cruciate ligament ruptures and other such surgeries that required special training. Sure, we talked about physical therapy, started it in our hospitalized patients, and provided handouts to owners, but I don’t think we emphasized the "make or break" nature that PT has for some patients.
Physical therapy isn’t just for post-operative rehabilitation. It can be used alone or in combination with other non-surgical interventions to restore a patient’s mobility, strength, comfort, flexibility, endurance, and body position awareness. Sometimes, PT can be done primarily by an animal’s owner under the guidance of a primary care veterinarian. More complicated cases benefit from the involvement of a specially trained veterinary physiotherapist.
PT can involve a wide range of treatments, including:
- passive range of motion (PROM) exercises during which a caretaker gently flexes, extends, and/or rotates affected joint
- stretching, which differs from PROM in that the joints are "pushed" with a bit more pressure
- active range of motion exercises during which the patients are encouraged to move and stretch themselves
- leash walking
- walking up and down ramps and stairs
- repeated sit-stand exercises
- weaving through a line of poles or cones
- walking in figure eights
- alternately moving forward, backward, and to both sides
- stepping over horizontal blocks or poles set at varying heights and distances apart
- the use of physioballs, where the body or feet are placed on a large ball that is then rolled or rocked
- standing on a rocker or wobble board
- standing on balance blocks that can be slid in different directions
- the addition of weights or resistance to any exercise
- underwater treadmills
The type of physical therapy that is right for a particular individual depends on his or her ailment, any other conditions they might be dealing with, and their overall condition, which is why the involvement of trained professionals is invaluable. Whatever type of PT your veterinarian or therapist recommends, follow through with it. Physical therapy is tough love in action. Even if your dog, cat, horse, or other companion animal seems to prefer lounging in the sun, PT can mean the difference between permanent disability or a return to normal or near normal function.
Dr. Jennifer Coates